Now that I've entered menopause, what supplements do you have for my hot flashes?

Answer: Because we have never found any dietary supplement therapy to be universally effective for symptoms of menopause, we don’t produce any formulas for this condition.

Patients considering alternative treatments for menopause should discuss their options with a doctor for guidance on dosages, efficacy and contraindications with medicines. Physicians are more open these days to the use of alternative medicine especially if an organization such as the American College of Obstetricians and Gynecologists (ACOG) is agreeable with a treatment.

Our suggestion: perimenopausal and menopausal women should try to lead a healthy life, exercise frequently and consume a healthy diet. It may help to stay cool when you are in a warm environment as well as decrease spicy food, caffeine and alcohol to reduce hot flashes. Relaxation and breathing techniques may help as well. In addition, women in this age group should take at least 1000mg of calcium and 1000 IU of vitamin D daily from food and supplements.

More info
As many as two-thirds of women experience menopausal symptoms such as hot flashes, mood swings, depression and changes in sexual function and desire. Up to a third of them seek help for relief of symptoms. The most common symptom for which women seek treatment is hot flashes. There are numerous over-the-counter products sold to treat hot flashes and other menopausal symptoms. The most commonly used and best-researched dietary supplements are black cohosh, red clover and soy isoflavones.   None of them work as well as traditional pharmaceutical treatment with estrogen, but for their shortcomings, the better-studied treatments do not share the increased risk of breast cancer that hormone replacement has, which explains their popularity.

Below is a list of common dietary supplements used to potentially ameliorate the symptoms of menopause.

Black cohosh is a North American herb used for decades in America and many other countries to address female issues. Several small studies have shown that it reduces hot flashes. One larger study in 2006 showed it was no greater than a placebo. How it works is still not clear. It appears to be more similar to some antidepressants through action at the serotonin receptor than to estrogen. It has not been shown to change estrogen levels, the hormones that increase estrogen and progesterone (follicle stimulating hormone and luteinizing hormone), or the proteins that bind and carry estrogen. There are case reports, considered weak evidence, that associate liver damage with using black cohosh. No studies on humans or animals have found evidence of liver toxicity, but we still recommend you consult with your doctor first in case they wish to do simple tests for liver function and because of potential interactions with medicine.


Soy isoflavones are found in the protein of soy and are often used for menopausal symptoms.  Soy isoflavones contain many phytoestrogens such as genistein and daidzein. These isoflavones may be safe for women who have breast or endometrial cancers based on some recent trials, but until more is known consult with your physician if you have either. Soy isoflavones have mixed results in clinical trials. The trials showing the most benefit tended to be with forms of soy isoflavones with a lot of genistein in women with a greater number of hot flashes. Soy isoflavones are also considered beneficial for lipid profiles and possibly for bone mineral density.

Red Clover is another herb with a high phytoestrogen content like soy. It has a shorter history of use and less efficacy for menopausal symptoms in the clinical trials. Red clover has some of the same phytoestrogens as soy, but in different amounts, which may account for the decreased benefit. It is a relatively safe compound.