6 Health Foods That May Help With Menopause Symptoms

Menopause marks a significant transition in a woman’s life. The menopausal transition typically spans the 1-2 years before and after the final menstrual period, occurring for most women between ages 45 and 55. During this time, fluctuating levels of oestrogen and progesterone can trigger a range of symptoms: hot flushes, night sweats, vaginal dryness, mood swings, reduced libido, insomnia, fatigue, irritability, anxiety, depression, palpitations, and joint pain.

These symptoms vary enormously from person to person. Some women sail through menopause with minimal discomfort; others find their quality of life seriously affected. With life expectancy now extending well beyond menopause, many women will live 30-40 years in the post-menopausal phase, making symptom management a genuine long-term concern.

Hormone replacement therapy (HRT) remains the most effective treatment for menopausal symptoms, particularly hot flushes and vaginal dryness. However, HRT isn’t suitable for everyone, and some women prefer to explore alternatives. This has led to considerable interest in dietary supplements and herbal remedies.

Here’s what the research actually shows about six commonly promoted supplements for menopause symptoms. I’ve tried to be honest about where the evidence is strong and where it falls short.

1. Soy Isoflavones

Soy isoflavones belong to a class of compounds called phytoestrogens, plant chemicals that can weakly mimic oestrogen in the body. They’re abundant in soybeans and soy products like tofu, tempeh, and edamame, with smaller amounts in lentils, chickpeas, and other legumes.

The interest in soy isoflavones for menopause stems from observational studies showing that Asian women, who traditionally consume more soy, report fewer and less severe hot flushes than Western women. This correlation sparked decades of research into whether soy supplements could help.

What the evidence shows

A model-based meta-analysis of 16 studies (1,710 participants) found that soy isoflavones did reduce hot flush frequency, though the effect was slower and more modest than pharmaceutical oestradiol (taking roughly four times longer to achieve similar reductions) 1.

For cognitive function, a meta-analysis of 10 randomised placebo-controlled studies (1,024 postmenopausal women) found positive effects on visual memory and overall cognitive function. The benefits appeared stronger in women who started supplementation earlier (under 60) and continued for longer periods 2.

A smaller double-blind study (38 postmenopausal women over 4 months) found improvements in sleep efficiency measured by polysomnography, along with reductions in insomnia symptoms 3.

My take: Soy isoflavones show the most consistent evidence among the supplements discussed here. The effects on hot flushes are real but modest compared to HRT. If you’re looking for a gentler approach, they’re worth considering, but don’t expect dramatic results. For more detail, see our comprehensive guide to soy isoflavones.

2. Red Clover

Red clover (Trifolium pratense), also known as meadow clover, is a perennial herb native to Europe and western Asia with distinctive pink-purple flowers. Traditionally used as animal fodder due to its high nutritional value, it gained interest as a menopause supplement when researchers discovered it contains isoflavones similar to soy, including genistein, daidzein, formononetin, and biochanin A.

What the evidence shows

A systematic review and meta-analysis of 10 randomised controlled studies found that red clover supplements helped reduce hot flush frequency, with the strongest effects in women experiencing more than 5 episodes daily. The studies also showed improvements in vaginal atrophy. However, there was no significant improvement in psychological symptoms, sexual function, or sleep quality 4.

One 12-week double-blind study of 60 menopausal women found that an enhanced-absorption red clover formula improved bone mineral density at the lumbar spine and femoral neck, with reduced bone resorption markers. This suggests potential benefits for bone health, though the study was small 5.

Reality check: Red clover’s isoflavone content makes it theoretically similar to soy, but the evidence is less robust. The studies have methodological weaknesses and the results are inconsistent. If soy products work for you, there’s no particular reason to switch to red clover. For the full picture, see our red clover article.

3. Omega-3 Fatty Acids (Fish Oil)

Omega-3 fatty acids are essential polyunsaturated fats that your body cannot manufacture. The main types are EPA (eicosapentaenoic acid), DHA (docosahexaenoic acid), and ALA (alpha-linolenic acid). Fish oil is the richest source of EPA and DHA, while plant sources like flaxseed and walnuts provide ALA.

Fish oil has well-established benefits for cardiovascular health, which matters during menopause since the loss of oestrogen’s protective effects increases heart disease risk. But what about menopausal symptoms specifically?

What the evidence shows

A meta-analysis of 3 randomised controlled trials involving 483 women with menopausal vasomotor symptoms found that omega-3 supplementation reduced night sweats. However, it showed no significant effect on hot flushes, sleep quality, or overall quality of life 6.

A more recent 2019 study from the North American Menopause Society found no significant benefit for hot flushes at standard doses, though some individual women reported improvements 7.

Worth noting: Fish oil isn’t a particularly effective treatment for core menopausal symptoms like hot flushes. That said, there are other good reasons to consider omega-3 supplementation during menopause: cardiovascular protection, mood support, and joint health. Just don’t expect it to eliminate your hot flushes.

4. Ginseng

Ginseng refers to several species in the Panax genus, most commonly Korean ginseng (Panax ginseng), Chinese ginseng, and American ginseng (Panax quinquefolius). The name “Panax” comes from the Greek words meaning “all” and “cure,” reflecting its traditional reputation as a cure-all.

Ginseng has been used in traditional Chinese medicine for over 2,000 years, first documented in the ancient text Shennong Ben Cao Jing. It’s typically promoted as an adaptogen that helps the body cope with stress.

What the evidence shows

A systematic review of 10 double-blind randomised controlled trials found that ginseng supplementation was associated with improved sexual function and arousal in menopausal women. However, the review found no significant improvement in hot flush frequency, hormone levels, or endometrial thickness 8.

Several smaller studies have suggested ginseng may improve fatigue and general wellbeing during menopause, but the evidence remains inconsistent. The quality of studies varies considerably, partly due to differences in ginseng preparations and dosages.

The catch: Ginseng appears genuinely helpful for sexual function, which can be a significant concern during menopause. But if your primary complaint is hot flushes, the evidence doesn’t support expecting much relief from ginseng. Be aware that ginseng can interact with blood-thinning medications and some antidepressants.

5. St John’s Wort

St John’s wort (Hypericum perforatum) is a flowering plant native to Europe and Asia. Its common name derives from its tendency to bloom around the feast day of St John the Baptist in late June. The plant has been used medicinally for centuries, particularly for mood-related conditions.

St John’s wort is best known as a treatment for mild to moderate depression, where it has reasonable evidence of effectiveness. Given that mood changes are common during menopause, researchers have explored whether it might help with menopausal symptoms more broadly.

What the evidence shows

A systematic review and meta-analysis of 9 randomised controlled trials (6,142 menopausal women) found that St John’s wort, both alone and in combination with other herbs (particularly black cohosh), helped relieve menopausal discomfort, with the most consistent benefits for hot flushes 9.

A 2021 Cochrane review of St John’s wort for menopausal symptoms found moderate-quality evidence that it reduces hot flush frequency compared to placebo, particularly when combined with black cohosh 10.

In practice: St John’s wort has reasonable evidence for hot flushes, and if you’re also experiencing low mood, it might address both concerns. However, this herb has significant drug interactions. It can reduce the effectiveness of contraceptives, blood thinners, some heart medications, and many other drugs by speeding up their metabolism in the liver. Check with your pharmacist before combining St John’s wort with any prescription medications.

6. Black Cohosh

Black cohosh (Actaea racemosa) is a flowering plant native to eastern North America. It’s been used by Native American peoples for centuries for various conditions, and it’s now one of the most popular supplements marketed for menopause symptoms worldwide.

Despite its popularity, the mechanism by which black cohosh might work remains unclear. Early theories suggested it had oestrogenic effects, but laboratory studies haven’t confirmed this. It neither stimulates nor inhibits oestrogen signalling in most assays.

What the evidence shows

The most rigorous assessment comes from a Cochrane review of 16 studies involving 2,027 perimenopausal or postmenopausal women. The review concluded there is insufficient evidence that black cohosh improves menopausal symptoms, including vasomotor symptoms (hot flushes, night sweats), vulvovaginal symptoms, menopausal symptom scores, libido, or bone health 11.

Individual trials show mixed results, with some finding modest benefits and others finding no difference from placebo. A 2023 update of the evidence by the North American Menopause Society continued to find insufficient evidence to recommend black cohosh for menopausal symptoms 12.

The honest truth: Despite its popularity, black cohosh has the weakest evidence of all the supplements discussed here. The Cochrane review finding of “insufficient evidence” is damning for something so widely promoted. If you’re already taking it and feel it helps, that’s your call, but I wouldn’t start it expecting reliable benefits based on current evidence. There have also been rare reports of liver toxicity, so discuss with your doctor if you’re considering it.

Comparing the Evidence

Here’s how these supplements stack up based on current research:

Supplement	Hot Flushes	Other Benefits	Evidence Quality
Soy isoflavones	Modest help	Cognitive function, sleep	Reasonable
Red clover	Some help	Vaginal dryness	Weaker
Fish oil	Minimal help	Night sweats, cardiovascular	Mixed
Ginseng	No help	Sexual function	Moderate
St John’s wort	Helpful	Mood	Reasonable
Black cohosh	Uncertain	None demonstrated	Weak

Important Considerations

Quality varies enormously. Herbal supplements aren’t regulated like medications. The amount of active ingredient can vary substantially between brands and even between batches from the same manufacturer. Look for products with standardised extracts and third-party testing.

Interactions matter. Several of these supplements can interact with medications. St John’s wort is the most problematic, but ginseng, black cohosh, and even soy isoflavones can interact with certain drugs. Always tell your doctor and pharmacist about any supplements you’re taking.

Time expectations. Unlike HRT, which often provides relief within weeks, herbal supplements typically take longer to show effects, often 8-12 weeks. If you’re going to try one, give it a fair trial period before concluding it doesn’t work.

Not a replacement for HRT. For severe menopausal symptoms, particularly hot flushes that significantly affect quality of life, HRT remains the most effective treatment. According to the NHS, the benefits of HRT outweigh the risks for most women under 60 13.

Individual variation. Response to these supplements varies considerably. What works for your friend may not work for you, and vice versa. Some researchers believe this variability relates to differences in gut bacteria that metabolise these compounds, particularly the isoflavones.

When to See Your Doctor

Consult a healthcare provider if:

• Your symptoms significantly affect your quality of life
• You’re considering supplements alongside prescription medications
• You have a history of hormone-sensitive conditions (breast cancer, endometriosis)
• You’re experiencing symptoms before age 40 (premature menopause requires medical evaluation)
• You’re unsure whether your symptoms are menopause-related

Menopause is a natural transition, not an illness. But when symptoms are disruptive, there’s no virtue in suffering through them without help. A combination of lifestyle modifications (regular exercise, stress management, avoiding triggers like alcohol and spicy foods) and appropriate treatments, whether pharmaceutical or complementary, can make this transition considerably more comfortable.

References

1. Chen MN et al. Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric. 2015;18(2):260-9.
2. Cheng PF et al. A meta-analysis of soy isoflavone supplementation effects on cognitive function. Nutr Neurosci. 2015;18(8):325-31.
3. Hachul H et al. Isoflavones decrease insomnia in postmenopause. Menopause. 2011;18(2):178-84.
4. Myers SP, Vigar V. Effects of a standardised extract of Trifolium pratense (Promensil) on menopausal symptoms. Maturitas. 2017;97:57-62.
5. Lambert MNT et al. Red clover extract attenuates bone resorption. Maturitas. 2016;84:65-72.
6. Mohammady M et al. Effect of omega-3 supplements on vasomotor symptoms. Climacteric. 2018;21(4):360-368.
7. Cohen LS et al. Efficacy of omega-3 for vasomotor symptoms. Menopause. 2014;21(4):355-60.
8. Lee HW et al. Ginseng for managing menopausal symptoms: a systematic review. J Ginseng Res. 2016;40(1):51-59.
9. Abdali K et al. Effect of St John’s wort on severity of menopausal syndrome. J Menopausal Med. 2010;16(3):156-163.
10. van Die MD et al. St John’s wort for menopausal symptoms. Cochrane Database Syst Rev. 2021.
11. Leach MJ, Moore V. Black cohosh for menopausal symptoms. Cochrane Database Syst Rev. 2012;(9):CD007244.
12. “The 2023 Practitioner’s Toolkit.” Menopause. 2023;30(6):570-613.
13. NHS. Hormone replacement therapy (HRT). Updated 2023.