The 5 essential supplements during menopause

Here are five supplements we recommend to nearly every woman going through menopause. Not as a substitute for a healthy lifestyle or medical treatment, but as a solid foundation. Below you'll read which ones they are, in what form and dose, and why they make a difference in this particular stage of life.

Menopause isn't a single moment but a hormonal transition that unfolds over years and affects the whole body: bones, muscles, heart, mood, sleep and concentration. Many complaints in this phase are linked to the declining oestrogen level — and that's exactly where targeted support through nutrition and supplements can help.

One thing first: supplements are personal. Dosage and choice depend on your blood values, symptoms and any medication you take. The five below form a good baseline, but always discuss them with your doctor before you start.

The five essential supplements at a glance

1. Vitamin D3 — dose based on blood values, target 100–150 nmol/L
2. Magnesium complex (bisglycinate) — mainly in the evening
3. Creatine — 3–5 grams per day
4. High-dose B-complex — with various forms of B12 and folate (B9)
5. Omega-3 fish oil — 1000 mg per day

The master hormone

1. Vitamin D3: a dose tailored to you

Strictly speaking, vitamin D is not a vitamin but a prohormone: once converted in the liver and kidneys, it becomes calcitriol, an active steroid hormone. Its receptor (VDR) is present in almost every cell type, which explains why it plays a role in so many processes: calcium and phosphate balance, bone mineralisation, muscle function, immune regulation (both innate and adaptive), insulin sensitivity, cell growth and even the production of serotonin. Almost everyone in the Netherlands is deficient, particularly during the winter months with little sunlight. We always set the dose based on blood values and/or a demonstrated deficiency, with a target of 100–150 nmol/L.

Especially relevant during menopause. The declining oestrogen level accelerates bone loss, and vitamin D is essential for calcium absorption and maintaining bone density. It also plays a part in preserving muscle and in immune regulation — two areas under pressure in this phase.

Calm for the nervous system

2. Magnesium complex with bisglycinate

Magnesium is involved in more than three hundred enzymatic processes, from energy production to muscle and nerve function. The bisglycinate form is well absorbed, is gentler on the gut than other forms, and is particularly helpful for relaxation: glycine is itself an inhibitory neurotransmitter, which reinforces the calming effect alongside that of the magnesium. We recommend taking it mainly in the evening.

Especially relevant during menopause. Fluctuating hormone levels make many women more prone to sleep problems, muscle tension and a restless nervous system. Magnesium supports GABA signalling in the brain (the main inhibitory neurotransmitter) and so contributes to deeper sleep and greater relaxation.

Preserving muscle, and more

3. Creatine, 3–5 grams per day

Creatine is best known as a sports supplement, but the science around its role in muscle tissue, bone density and cognition is expanding rapidly. It supports the energy supply of cells and is one of the most thoroughly researched supplements available.

Especially relevant during menopause. The decline in oestrogen accelerates the loss of muscle mass and strength (sarcopenia) and drives bone loss. Creatine, ideally combined with strength training, helps preserve muscle mass. Recent randomised studies specifically in peri- and postmenopausal women also show improvements in reaction time, brain creatine levels and sleep quality, which aligns with the energy and concentration complaints that are common in this phase. There are also indications of a protective effect against dementia, though more research is still needed here.

Methylation and energy

4. High-dose B-complex

A complete B-complex with various forms of B12 and folate (B9), including the active, methylated variants, supports energy metabolism, methylation and the production of neurotransmitters.

Especially relevant during menopause. Methylation — the process in which B12 and folate (together with B6) play a key role — is needed for two processes that deserve extra attention in this phase. First, the breakdown of oestrogens in the liver: oestrogens are converted through methylation into forms the body can safely excrete, and this process runs less smoothly when B-vitamins are lacking. Second, DNA repair: methylation is part of the mechanisms that support cell division and DNA repair, which becomes more important as we age. In addition, homocysteine levels often rise after menopause, which raises cardiovascular risk; B-vitamins are essential for breaking it down. Many women also report concentration problems and 'brain fog' in this phase, and B12 and folate play a direct role in neurotransmitter synthesis and cognitive clarity. In the case of an MTHFR variant, the methylated form is especially relevant, because folic acid is then converted less efficiently.

An anti-inflammatory foundation

5. Omega-3 fish oil, 1000 mg per day

Omega-3 fatty acids are essential for cell membranes, have anti-inflammatory effects, and play a role in cardiovascular health, brain function and mood. The two most important forms are EPA and DHA. EPA (eicosapentaenoic acid) is specifically known to benefit mood: meta-analyses show that formulations high in EPA (60% or more), at doses of roughly 1 to 2 grams per day, can reduce depressive and anxiety symptoms. For cardiovascular health, large studies consistently show a link between higher omega-3 levels and fewer cardiovascular diseases.

Especially relevant during menopause. The declining oestrogen level is accompanied by an increase in low-grade inflammation and a less favourable cardiovascular risk profile, both of which omega-3 can positively influence. Mood complaints are also more common in this phase, and that is precisely the area where the scientific evidence for omega-3 is strongest.

A foundation, not a plaster

Together, these five supplements form a broad foundation: bone and muscle (vitamin D3, creatine), nervous system and sleep (magnesium), energy and methylation (B-complex), and heart and mood (omega-3). They don't replace hormone therapy or lifestyle — they strengthen them. You'll see the most benefit when supplements, nutrition, exercise and, where needed, bioidentical hormone therapy are used together, tailored to your blood values and symptoms.

At Menovia we tailor supplements, lifestyle and treatment to your blood values and symptoms, guided by BIG-registered doctors. Start with a no-obligation screening and discover what's at play for you.

Please note. This article is general information and not personal medical advice. The dosage and choice of supplements are individual and depend on your blood values, symptoms and any medication you take. Always consult a doctor before starting supplements, especially if you take medication or have a medical condition.