10 Best Menopause Supplements (2026) Reviewed
Menopause affects approximately 1.3 million American women each year, and for many, the transition brings a constellation of symptoms that can significantly impact daily life. Hot flashes, night sweats, mood changes, sleep disruptions, and fatigue are among the most common complaints, with studies showing that more than half of postmenopausal women experience sleep disorders.
While hormone replacement therapy (HRT) remains the gold standard for severe menopausal symptoms, many women seek non-hormonal alternatives due to personal preference, medical contraindications, or concerns about long-term hormone use. The supplement market has responded with numerous products claiming to ease the transition, but quality and evidence vary dramatically.
For this guide, we evaluated dozens of menopause supplements, prioritizing products with clinical research backing their key ingredients, third-party testing, and transparent manufacturing practices. Our top picks include formulas featuring ingredients like ERr 731 rhapontic rhubarb extract (shown in studies to reduce symptoms by up to 60%), clinically studied black cohosh extracts, and Swedish pollen extract—each with meaningful evidence for symptom relief.
Table of Contents
- Quick Comparison Table
- Best by Type
- Product Reviews
- Buying Guide
- How to Take
- Research-Backed Benefits
- Safety Considerations
- FAQ
- Bottom Line
Quick Comparison Table
| Product | Form | Serving Size | Key Differentiator | Best For | Winner |
|---|---|---|---|---|---|
| Estroven Complete | Caplets | 1 daily | ERr 731 rhubarb extract | Multi-symptom relief | 🏆 TOP PICK |
| Metagenics Estrovera | Tablets | 1 daily | Professional-grade ERr 731 | Doctor-recommended option | 🥇 Best Professional Grade |
| Remifemin | Tablets | 2 daily | Most-researched black cohosh | Evidence-focused buyers | 🥇 Most Researched |
| Relizen | Tablets | 2 daily | Swedish pollen extract | Breast cancer survivors | 🥇 Best Non-Herbal |
| Amberen | Capsules | 2 daily | Succinate-based formula | Hormone-free seekers | |
| O Positiv MENO | Capsules | 2 daily | Black cohosh + KSM-66 ashwagandha | Modern formula seekers | 🥇 Best Modern Formula |
| Provitalize | Capsules | 2 daily | Thermogenic probiotics | Digestive health focus | 🥇 Best Probiotic-Based |
| Estroven Sleep Cool | Caplets | 1 daily | Black cohosh + melatonin | Sleep-specific relief | 🥇 Best for Sleep |
| Gaia Herbs Menopause Daytime | Liquid Phyto-Caps | 1-3 daily | Organic liquid extraction | Organic-focused buyers | 🥇 Best Organic |
| NOW Menopause Support | Veg Capsules | 3 daily | Comprehensive herbal blend | Budget-conscious buyers | 🥇 Best Budget |
Best by Type
ERr 731 Rhubarb Extract Supplements
ERr 731 (Siberian/rhapontic rhubarb extract) is among the most clinically studied menopause ingredients. Studies show it may reduce overall symptoms by up to 60% and hot flashes by up to 90% within 12 weeks. Unlike phytoestrogens, ERr 731 works through non-estrogenic pathways, making it suitable for women with hormone-sensitive conditions (with oncologist approval). Look for products standardized to contain specific amounts of rhaponticin and desoxyrhaponticin. Best picks in this category: Estroven Complete and Metagenics Estrovera.
Black Cohosh Supplements
Black cohosh (Actaea racemosa) is the most widely studied herbal remedy for menopause, with research dating back over 60 years. It appears to work through serotonin pathways rather than estrogen modulation. The iCR extraction process used in Remifemin is the most researched, with over 35 clinical trials involving more than 13,000 women. Results typically begin within 4-8 weeks of consistent use. Best for: women seeking a well-researched traditional herbal approach.
Non-Herbal Options
Some women prefer to avoid herbs entirely, whether due to medication interactions, personal preference, or specific health conditions. Swedish pollen extract (Relizen) and succinate-based formulas (Amberen) offer alternatives that work through different mechanisms. Pollen extract has been shown in placebo-controlled trials to reduce hot flashes without affecting hormone levels—particularly important for breast cancer survivors taking tamoxifen, as studies show no interference with the medication.
Probiotic-Based Formulas
Emerging research suggests the gut microbiome may influence menopause symptoms through its role in estrogen metabolism. Probiotic-based supplements like Provitalize combine specific bacterial strains (L. gasseri, B. breve, B. lactis) with anti-inflammatory herbs. While the evidence base is still developing, this approach may benefit women with concurrent digestive concerns.
Product Reviews
Estroven Complete — Best Overall
The #1 pharmacist-recommended menopause brand, featuring clinically studied ERr 731 rhapontic rhubarb extract shown to reduce total symptoms by 60% and hot flashes by up to 90%.
Estroven Complete stands out as our top pick for its combination of clinical evidence, convenience, and comprehensive symptom relief. The formula centers on ERr 731, a proprietary rhapontic rhubarb extract that has been used by women in Europe for decades. Clinical trials demonstrate significant improvements across multiple menopause symptoms, with benefits typically appearing within 28 days and continuing to improve through 12 weeks of use.
What distinguishes Estroven is its focus on multi-symptom relief. Beyond hot flashes and night sweats, the formula addresses mood changes, energy levels, sleep quality, and even joint discomfort—all common menopause complaints. The once-daily dosing makes compliance easy, and the small caplet size is manageable for most women.
Key Specifications:
- Active Ingredient: ERr 731 Rhapontic Rhubarb Extract (4mg)
- Serving Size: 1 caplet daily
- Count: 28 caplets (1-month supply)
- Certifications: Drug-free, gluten-free, soy-free, non-GMO, vegan
- Third-Party Testing: Yes
Considerations: Results may take 4 weeks to appear; some women may need the 60-count Estroven Complete + Ashwagandha version for additional stress support.
Metagenics Estrovera — Best Professional Grade
The #1 OBGYN-recommended ingredient in a practitioner-quality formula, with 83% of women reporting symptom relief within 1-4 weeks.
Metagenics Estrovera delivers the same ERr 731 rhapontic rhubarb extract as Estroven but in a professional-grade formulation designed for healthcare practitioner distribution. The company claims it addresses 12 common menopause symptoms, including hot flashes, irritability, sleep issues, and menopausal anxiety.
What sets Estrovera apart is its pharmaceutical-grade manufacturing standards and extensive company-sponsored research. Metagenics reports that their studies show hot flash reduction of up to 83%. The product passes USP Good Manufacturing Practices testing and undergoes third-party verification for purity and potency.
Key Specifications:
- Active Ingredient: ERr 731 Rhapontic Rhubarb Root Extract (4mg)
- Serving Size: 1 tablet daily
- Count: 30 tablets (1-month supply)
- Certifications: Hormone-free, gluten-free, dairy-free, non-GMO, vegetarian
- Third-Party Testing: USP GMP certified
Considerations: Higher price point than drugstore alternatives; primarily sold through healthcare practitioners, though available on Amazon.
Remifemin — Most Researched
Backed by over 35 clinical studies involving 13,000+ women, Remifemin uses the most extensively researched black cohosh extract available.
Remifemin has been the subject of scientific study for over 60 years, making it the most researched black cohosh product globally. The RemiSure black cohosh extract uses an innovative iCR extraction process that distinguishes it from generic black cohosh supplements. Clinical trials show it may reduce hot flashes, night sweats, mood swings, and irritability associated with menopause.
Made in Germany under strict manufacturing standards, Remifemin works through mechanisms that appear unrelated to estrogen, making it potentially suitable for women who cannot use hormone-based treatments. Unlike phytoestrogens, black cohosh in Remifemin seems to interact with serotonin and opioid receptors in ways that may explain its effects on hot flashes and mood.
Key Specifications:
- Active Ingredient: RemiSure Black Cohosh Extract (20mg equivalent)
- Serving Size: 2 tablets daily
- Count: 60 tablets (1-month supply)
- Certifications: 100% hormone-free, estrogen-free
- Manufacturing: Made in Germany
Considerations: Requires twice-daily dosing; full effects may take 8-12 weeks; should be discussed with healthcare provider if you have liver concerns.
Relizen — Best Non-Herbal Option
A unique Swedish pollen extract that has safely been used by over 1 million women in Europe, with clinical trials showing it doesn’t affect hormone levels—making it suitable for breast cancer survivors.
Relizen represents a fundamentally different approach to menopause symptom relief. Rather than using herbs or phytoestrogens, it contains a purified cytoplasmic extract from Swedish flower pollen. The manufacturing process removes pollen allergens, making it suitable for most women including those with pollen allergies. Three placebo-controlled clinical trials support its use for hot flashes and night sweats.
What makes Relizen particularly valuable is its safety profile for breast cancer survivors. Research published in Menopause journal found that purified Swedish pollen extract does not inhibit CYP2D6 enzymes—meaning it won’t interfere with tamoxifen metabolism. Over 6,400 healthcare providers recommend Relizen, and it has been used safely in Europe for more than 15 years.
Key Specifications:
- Active Ingredient: Purified Swedish Flower Pollen Extract (Sérélys)
- Serving Size: 2 tablets daily
- Count: 60 tablets (1-month supply)
- Certifications: Hormone-free, soy-free, non-GMO
- Manufacturing: cGMP certified facility, USA
Considerations: May take 2-3 months for full effects; higher price point; best results with consistent daily use.
Amberen — Best Non-Botanical
A unique succinate-based formula without herbs or hormones, clinically shown to help the body self-regulate hormone production with results in 30-60 days.
Amberen takes a completely different approach than herbal supplements. Its proprietary Amber-M Complex contains succinates (compounds naturally found in the body), amino acids, minerals, and vitamin E. The theory is that succinates help stimulate cells to support the body’s natural hormone production rather than introducing external hormone-like substances.
Three clinical trials have evaluated Amberen’s proprietary formulation, showing it to be well-tolerated with no reported adverse side effects. The company reports that 91% of trial participants experienced hot flash relief, 78% had night sweats relief, and 80% experienced mood swing improvement. It’s a compelling option for women who prefer to avoid herbs entirely.
Key Specifications:
- Active Ingredients: Ammonium Succinate, Calcium Disuccinate, Amino Acids, Vitamin E
- Serving Size: 2 capsules daily (1 white, 1 orange)
- Count: 60 capsules (1-month supply)
- Certifications: Drug-free, hormone-free, gluten-free, soy-free
- Manufacturing: USA, cGMP facilities
Considerations: Not suitable for women with severe hypertension; optimal results require 90 days of use; unique mechanism may not work for everyone.
O Positiv MENO — Best Modern Formula
A sleek, modern supplement combining black cohosh with patented KSM-66 ashwagandha for both physical symptom relief and stress support.
O Positiv MENO represents a newer generation of menopause supplements, combining traditional ingredients like black cohosh with modern adaptogen science. The formula features KSM-66, the most clinically studied form of ashwagandha, which has been shown to support sleep quality and help manage stress—both common concerns during menopause.
The brand has earned endorsements from OBGYNs and reproductive endocrinologists who appreciate the evidence-based ingredient selection. Black cohosh addresses hot flashes and night sweats through its serotonin-like effects, while chasteberry supports hormone balance and ashwagandha helps with the stress response that can worsen menopausal symptoms.
Key Specifications:
- Active Ingredients: Black Cohosh (40mg), KSM-66 Ashwagandha (300mg), Chasteberry (40mg), Vitamins D3 & B6
- Serving Size: 2 capsules daily
- Count: 60 capsules (30 servings)
- Certifications: Third-party tested, vegan, gluten-free, non-GMO, cruelty-free
Considerations: Full benefits may take 2-3 months; not for use during pregnancy or nursing; check with physician if on hormone therapy.
Provitalize — Best Probiotic-Based
A unique thermogenic probiotic formula combining L. gasseri, B. breve, and B. lactis with turmeric and moringa for gut health and menopause support.
Provitalize approaches menopause from a gut-health perspective. Emerging research suggests that the gut microbiome plays a role in estrogen metabolism through what scientists call the “estrobolome.” By supporting healthy gut bacteria, Provitalize aims to influence how the body processes hormones during menopause.
The formula combines three probiotic strains studied for their thermogenic and weight management properties with anti-inflammatory herbs like turmeric curcumin and moringa leaf. BioPerine enhances curcumin absorption by up to 2000%, and delayed-release capsules protect the probiotics from stomach acid.
Key Specifications:
- Active Ingredients: L. gasseri, B. breve, B. lactis, Turmeric, Moringa, Curry Leaf, BioPerine
- Serving Size: 2 capsules daily
- Count: 60 capsules (1-month supply)
- Certifications: Natural, soy-free, non-GMO
- Capsule Technology: DRCaps delayed-release
Considerations: Should not be taken with NSAIDs, blood thinners, or COX-2 inhibitors due to turmeric content; results may take 8-12 weeks.
Estroven Sleep Cool — Best for Sleep
Specifically formulated for women whose menopause symptoms disrupt sleep, combining black cohosh and soy isoflavones with melatonin.
Sleep disturbances affect over half of menopausal women, and Estroven Sleep Cool targets this specific concern. The formula combines two clinically studied ingredients for hot flash relief—black cohosh and soy isoflavones—with melatonin to support the natural sleep-wake cycle. Taken as part of a nightly regimen, it helps women both fall asleep and stay asleep.
A 2024 research review found that magnesium supplements may improve sleep quality in people with mild insomnia, particularly those who are low in magnesium. While Estroven Sleep Cool doesn’t contain magnesium, its melatonin content directly addresses the circadian rhythm disruptions that worsen during menopause as estrogen levels decline.
Key Specifications:
- Active Ingredients: Black Cohosh, Soy Isoflavones, Melatonin (3mg)
- Serving Size: 1 caplet nightly
- Count: 30 caplets (1-month supply)
- Certifications: Drug-free, estrogen-free, gluten-free, vegan
Considerations: Contains melatonin (may cause drowsiness); not for daytime use; may interact with sedatives or blood pressure medications.
Gaia Herbs Menopause Support Daytime — Best Organic
A comprehensive organic herbal blend in liquid phyto-caps for optimal absorption, from a company with 35+ years of herbal expertise.
Gaia Herbs brings over 35 years of herbal expertise to their Menopause Support Daytime formula. The liquid phyto-cap technology extracts herbs without harsh solvents or chemicals, preserving the full spectrum of beneficial plant compounds. Their 270-acre Regenerative Organic Certified farm in North Carolina grows many of the herbs used in their products.
The formula combines black cohosh with vitex (chasteberry), St. John’s wort, oats, red clover, and other traditional women’s herbs. This comprehensive approach addresses not just hot flashes but also mood changes, emotional balance, and the overall hormonal shifts of menopause. Oats are extracted fresh immediately after harvest to preserve optimal potency.
Key Specifications:
- Active Ingredients: Black Cohosh Extract (200mg), Vitex, St. John’s Wort, Oats, Red Clover, Alfalfa, Dandelion, Sage
- Serving Size: 1-3 capsules daily
- Count: 60 capsules (20-60 day supply)
- Certifications: Vegan, gluten-free, dairy-free, Regenerative Organic Certified farm
- Testing: Tested for purity using GC-MS/MS
Considerations: Contains St. John’s wort (may interact with many medications); not for use during pregnancy; higher serving size requirement.
NOW Menopause Support — Best Budget
A comprehensive herbal blend at an accessible price point from a trusted supplement brand with NPA A-rated GMP certification.
NOW Foods delivers a well-balanced menopause formula at a fraction of premium brand prices. The product includes standardized herbal extracts of black cohosh, vitex, dong quai, wild yam, and other traditional women’s herbs, plus soy isoflavones for phytoestrogenic support. NOW’s NPA A-rated GMP certification means every aspect of manufacturing has been examined for quality.
While it may not have the extensive clinical research of single-ingredient products like Remifemin or Estrovera, NOW Menopause Support provides a comprehensive approach for women who want to try multiple supportive herbs without purchasing separate products. The vegan capsules make it suitable for plant-based lifestyles.
Key Specifications:
- Active Ingredients: Black Cohosh, Soy Isoflavones, Vitex, Wild Yam, Dong Quai, Licorice Root
- Serving Size: 3 capsules daily
- Count: 90 capsules (1-month supply)
- Certifications: NPA A-rated GMP, vegan/vegetarian
- Contains: Soy (non-GMO)
Considerations: Requires three capsules daily; contains dong quai (may interact with blood thinners); contains soy.
Buying Guide: What to Look For
Evidence-Based Ingredients
The most studied menopause supplement ingredients include ERr 731 rhapontic rhubarb extract, black cohosh (particularly the iCR extract in Remifemin), and Swedish pollen extract. Soy isoflavones have mixed evidence—they may work well for some women but not others, potentially depending on gut microbiome composition. Be skeptical of products with lengthy ingredient lists but no clinical evidence for the combination.
Standardized Extracts
Look for products that standardize their herbal extracts to specific active compounds. For black cohosh, this means triterpene glycosides; for ERr 731, it’s rhaponticin and desoxyrhaponticin. Standardization ensures consistent potency from batch to batch. Generic “black cohosh root powder” may vary dramatically in active compound content.
Third-Party Testing
Quality supplements undergo testing for purity, potency, and contaminants. Look for certifications like USP, NSF, or GMP. Brands like Metagenics and NOW Foods prominently feature their quality certifications. Third-party testing is particularly important for herbal products, as some have been found to contain different species or adulterants.
Appropriate Dosing
Check that ingredients are present at clinically relevant doses. A supplement listing black cohosh but providing only 10mg when studies use 40mg won’t deliver expected results. Compare the supplement facts panel to dosages used in clinical research.
Red Flags to Avoid
- Products claiming to “cure” menopause or eliminate symptoms entirely
- Proprietary blends that hide individual ingredient amounts
- Unsubstantiated hormone claims
- Supplements with excessive fillers or artificial additives
- Companies without transparent manufacturing information
How to Take Menopause Supplements
Timing and Consistency
Most menopause supplements require consistent daily use for 4-12 weeks before full effects become apparent. Take your supplement at the same time each day to establish a routine. Products containing melatonin (like Estroven Sleep Cool) should be taken at night, while others can be taken with breakfast.
With or Without Food
Most herbal menopause supplements are best taken with food to improve absorption and reduce the chance of stomach upset. Probiotic-based formulas like Provitalize may work best when taken in the morning on an empty stomach, though they can be taken with food if needed.
Duration of Use
Clinical trials typically run 12 weeks to 6 months, and most products recommend consistent use for at least 90 days to evaluate effectiveness. Some women use menopause supplements for years as symptoms persist, while others may taper off as their bodies adjust to post-menopausal hormone levels.
Cycling Considerations
Some practitioners recommend cycling certain herbs—using them for a few months, then taking a break. This may be particularly relevant for products containing St. John’s wort or adaptogenic herbs. Follow package directions or consult with a healthcare provider about long-term use strategies.
Research-Backed Benefits
Hot Flash Reduction
Clinical evidence supports several ingredients for hot flash relief. ERr 731 rhubarb extract has shown up to 90% reduction in hot flashes in some studies. Black cohosh meta-analyses show statistically significant improvements compared to placebo. Swedish pollen extract studies report 65-86% of users experiencing fewer hot flashes.
Sleep Support
Night sweats disrupt sleep quality, creating a cascade of daytime fatigue and mood issues. By reducing vasomotor symptoms, menopause supplements may indirectly improve sleep. Products combining hot flash ingredients with melatonin or calming herbs provide more direct sleep support.
Mood Balance
Declining estrogen affects neurotransmitters involved in mood regulation. Black cohosh appears to interact with serotonin receptors, which may explain its mood-supporting effects. A 2023 meta-analysis found black cohosh significantly improved depression and anxiety scores across multiple studies. Ashwagandha (in products like O Positiv MENO) has separate research supporting its stress-relieving effects.
Bone Health Considerations
While menopause supplements aren’t a replacement for bone-building nutrients, some ingredients may offer modest support. Phytoestrogens have shown mixed effects on bone density in research. Women concerned about bone health should ensure adequate calcium, vitamin D, and weight-bearing exercise regardless of supplement choice.
Safety Considerations
Drug Interactions
Several common menopause supplement ingredients can interact with medications:
- St. John’s Wort: Affects metabolism of birth control, antidepressants, blood thinners, and immunosuppressants
- Black Cohosh: May interact with hormone medications; theoretical concerns with hepatotoxic drugs
- Dong Quai: Increases bleeding risk with anticoagulants like warfarin
- Turmeric/Curcumin: May interact with blood thinners and NSAIDs
Hormone-Sensitive Conditions
Women with a history of breast cancer, ovarian cancer, endometriosis, or uterine fibroids should exercise caution with phytoestrogen-containing supplements. Non-estrogenic options like ERr 731 rhubarb extract and Swedish pollen extract may be more appropriate—but always consult with an oncologist before starting any supplement.
Liver Considerations
Rare cases of liver problems have been reported with black cohosh use, though causality remains unclear. Women with liver conditions or those taking medications metabolized by the liver should discuss black cohosh use with their healthcare provider and monitor for symptoms like dark urine, fatigue, or abdominal pain.
Who Should Avoid
- Pregnant or nursing women
- Women with severe hypertension (particularly Amberen)
- Those taking multiple medications without healthcare provider guidance
- Women scheduled for surgery (stop supplements 2 weeks prior)
Frequently Asked Questions
How long do menopause supplements take to work?
Most women begin noticing improvements within 4-8 weeks of consistent daily use, with optimal results typically occurring at 12 weeks. Some products like ERr 731-based supplements may show preliminary benefits within 28 days. Patience and consistency are key—don’t abandon a supplement before giving it adequate time to work.
Can I take menopause supplements with HRT?
This depends on the specific supplement and your healthcare provider’s guidance. Some women use supplements alongside low-dose HRT, while others use supplements as an alternative. Products containing phytoestrogens may theoretically interact with hormone therapy. Always disclose all supplements to your prescribing physician.
Are menopause supplements safe for breast cancer survivors?
Some options are considered safer than others. Swedish pollen extract (Relizen) has been specifically studied for safety with tamoxifen and shows no CYP2D6 inhibition. ERr 731 rhubarb extract works through non-estrogenic pathways. However, any supplement use should be discussed with your oncology team, as individual circumstances vary.
Do menopause supplements cause weight gain?
Most menopause supplements should not cause weight gain. Clinical trials for ERr 731 specifically noted no weight gain among participants. Some supplements like Provitalize are marketed for weight management support. Menopausal weight changes are more commonly related to hormonal shifts and metabolic changes than supplement use.
Can I take multiple menopause supplements together?
It’s generally best to start with one product and evaluate its effects before adding others. Taking multiple supplements with similar ingredients (like multiple black cohosh products) could lead to excessive dosing. If combining products, choose those with complementary mechanisms—for example, a hot flash supplement with a separate sleep support product.
Are natural menopause supplements really effective?
The effectiveness of menopause supplements varies by ingredient and individual. ERr 731 rhubarb extract and black cohosh have the strongest clinical evidence. However, supplement effects are typically more modest than prescription HRT. Many women find supplements helpful for mild to moderate symptoms, while severe symptoms may require prescription treatments.
How do I know if a menopause supplement is working?
Keep a symptom diary before starting and during supplement use. Track hot flash frequency and severity, sleep quality, mood, and energy levels. Compare your experience at 4, 8, and 12 weeks to your baseline. Many women notice gradual improvement rather than dramatic overnight changes.
Should I continue taking menopause supplements indefinitely?
Duration depends on your symptom trajectory and healthcare provider’s advice. Some women use supplements for a few years during peak symptom periods, then taper off as symptoms naturally diminish. Others continue longer-term use. Periodically reassess whether you still need supplementation by briefly stopping (with provider approval) to see if symptoms return.
What if menopause supplements don’t work for me?
If one supplement doesn’t provide relief after 12 weeks, consider trying a different mechanism of action. For example, if black cohosh doesn’t help, try ERr 731 rhubarb or Swedish pollen extract. If supplements prove insufficient, discuss prescription options like low-dose HRT or non-hormonal medications like fezolinetant with your healthcare provider.
Bottom Line
For most women: Estroven Complete offers the best combination of clinical evidence, convenience, and comprehensive symptom relief. Its ERr 731 rhubarb extract is backed by robust research showing up to 60% total symptom reduction.
For professional-grade quality: Metagenics Estrovera delivers the same clinically studied ERr 731 in a practitioner-quality format with stringent manufacturing standards.
For evidence-focused buyers: Remifemin remains the most extensively researched black cohosh product globally, with over 35 clinical trials supporting its use.
For breast cancer survivors: Relizen offers a non-hormonal, non-phytoestrogenic option that studies show doesn’t interfere with tamoxifen—though oncologist approval is essential.
For sleep-specific relief: Estroven Sleep Cool combines hot flash ingredients with melatonin for women whose primary complaint is disrupted sleep.
For budget-conscious buyers: NOW Menopause Support provides a comprehensive herbal approach at an accessible price point from a GMP-certified manufacturer.
