Menopause supplements: black cohosh, WomenSense and more on our supplement aisle

Menopause is a natural stage of life, and our supplement aisle has a shelf for it. This guide walks through what's there, from black cohosh and WomenSense MenoSense to combination formulas, magnesium and a moisturiser for changing skin, by format and by what each product is licensed for. If you're in perimenopause, past it, or shopping for someone who is, we hope it makes the shelf easier to read.

Menopause, perimenopause and the stages in between

Menopause is the point when you've gone 12 months in a row without a menstrual period. The years leading up to it are perimenopause, when estrogen and progesterone levels rise and fall unpredictably and the menstrual cycle starts to change. Most people notice the changes of perimenopause in their 40s or early 50s, and 95% reach menopause after age 45; in Canada the average age is around 51. The years after are postmenopause.

The common symptoms of the menopause transition are familiar to anyone who's been through it: hot flashes and night sweats (together called vasomotor symptoms), sleep disturbances and trouble falling asleep, mood swings and irritability, difficulty concentrating, vaginal dryness and drier skin. Hot flashes affect up to 80% of women at some point, night sweats can disrupt sleep and leave you tired the next day, and vaginal dryness comes from lower estrogen levels. Some women have few symptoms; others find them bothersome for years. Bone density also tends to fall after menopause, which is one reason calcium and vitamin D come up so often at this stage.

Black cohosh: the best-known menopause herb

Black cohosh (Actaea racemosa, also called Cimicifuga racemosa) is a woodland plant in the buttercup family, native to the forests of eastern North America. The root and rhizome are what's used, and it has a long history in Indigenous North American herbal traditions. It's the herb at the heart of most menopause supplements, and black cohosh products are used in herbal medicine to help relieve symptoms associated with menopause, such as hot flashes and night sweats. Black cohosh isn't a hormone, and the supplements don't contain estrogen.

It comes in several formats on our shelves. WomenSense Black Cohosh and Natural Factors Black Cohosh are both 40 mg standardised extracts in vegetarian capsules; the Natural Factors extract is standardised to 2.5% triterpene glycosides. St. Francis Herb Farm Femance Black Cohosh is a tincture, used in traditional herbal medicine to help relieve menopausal symptoms, ease nervous tension and relax skeletal muscle. Celebration Herbals makes an organic black cohosh root tea, and our bulk section has dried, cut black cohosh root by weight for people who make their own decoctions.

WomenSense menopause formulas

WomenSense is a Canadian line of women's health supplements, and its MenoSense is the menopause formula we're asked about most. It's a botanical blend for perimenopause and menopause that helps relieve hot flashes and night sweats and promotes regular cycles during perimenopause. It comes in 90 and 180 capsule bottles and a bonus size.

The WomenSense Menopause Hair Formula is a hormone-free blend for women who've noticed their hair thinning at this stage. It combines biotin with plant extracts and helps support hair thickness and density, helps relieve hot flashes and night sweats, and helps support a healthy mood balance and skin health. Give it at least four weeks; hair grows slowly. WomenSense Sage Leaf rounds out the range: sage has a long history in European herbal tradition for hot flushes and excess perspiration.

Combination formulas

Many menopause supplements combine several herbs, sometimes with vitamins or minerals, in one product. Here are the ones on our shelf, by format.

CanPrev Meno Chill helps relieve symptoms of menopause such as hot flashes, night sweats, sleeplessness, nervousness and fatigue, and helps support a healthy mood balance. It's vegan, taken with food. Harmony Menopause Day and Night, from the family-owned Australian company Martin & Pleasance, splits its herbs between a day tablet and a night tablet built around ziziphus seed, a herb traditionally used for sleep. St. Francis Herb Farm Menopause Support, formerly Femance Vitex Combo, is a tincture that pairs black cohosh with dong quai, chaste tree (Vitex agnus-castus), motherwort, sage and rhodiola.

There's no single menopause supplement for everyone; there's the format and formula that fits your days.

Magnesium, vitamin D and the basics

Beyond the herbs, a few everyday nutrients come up again and again at this stage of life. Magnesium plays a part in muscle and nerve function and helps build and maintain bones, and many women make a magnesium bisglycinate capsule or powder part of their evening routine. Our guide to the best form of magnesium compares the options. Vitamin D, with calcium, helps build and maintain strong bones, particularly important after menopause, and in Atlantic Canada our vitamin D in winter guide explains why it's worth a look.

Food counts, too. Soy foods such as tofu, edamame and soy milk contain isoflavones, plant compounds often called phytoestrogens, and red clover is another plant rich in them. Many women make soy a regular part of their meals at this stage.

Skin changes too: many women find it turns drier and more reactive. Antipodes Jasmine Flower Menopause Cream is a rich face moisturiser made for skin in perimenopause and beyond, with organic oat, avocado oil, manuka honey and hyaluronic acid. It isn't a hormone cream; it's simply a good moisturiser for this stage.

AntipodesJasmine Flower Menopause CreamA rich face cream for drier, more reactive skin.Shop →

Everyday tips for common menopause symptoms

Supplements are one part of the picture. These simple habits come up again and again, and they work alongside anything on your shelf.

How to choose on the supplement aisle

1. Start with what bothers you most. Hot flashes and night sweats, sleep, mood, hair or skin: the licensed uses on each label tell you what a product is for.
2. Pick a format you'll keep up. Capsules are simple; tinctures let you adjust the dose in water; tablets like Harmony split day and night.
3. Choose a single herb or a combination. A black cohosh capsule is the simplest place to begin. Combination formulas cover more ground in one product.
4. Check for an NPN. An eight-digit NPN on the label shows the product is licensed for sale in Canada, and the label lists its licensed uses and directions.
5. Give it time. Herbal products usually take a few weeks of daily use. Follow the label and the length of use it suggests.
6. Look at the whole routine. Magnesium, vitamin D, movement, sleep habits and a good moisturiser all play a part alongside any formula.

Questions we get a lot

What does black cohosh do for the body?

Black cohosh is used in herbal medicine to help relieve symptoms associated with menopause, such as hot flashes and night sweats. Tinctures like Femance are also used to ease nervous tension.

Does black cohosh raise estrogen levels?

Black cohosh isn't a hormone, and black cohosh supplements contain no estrogen.

Who should avoid black cohosh?

Each black cohosh product lists its own cautions on the label. Give them a read before you start, and bring any questions to us in the supplement aisle.

Is there a menopause supplement that actually works?

Many women find a black cohosh product or a combination formula like MenoSense helpful for hot flashes and night sweats. Everyone's different, so it's worth starting with one product and giving it a few weeks.

What are the best vitamins to take during perimenopause?

Magnesium and vitamin D are the two we're asked about most, along with calcium for bone health. A women's multivitamin can cover the basics in one.

What are the three stages of menopause?

Perimenopause, when hormone levels fluctuate and symptoms often begin; menopause, the point 12 months after your last period; and postmenopause, the years after.

Where can I find free resources for menopause?

The SOGC's Menopause and U website shares free, reliable information on perimenopause, menopause and the years after.

Menopause supplements are in the supplement aisle at both stores: 486 Starboard Drive in Bedford and 590 Portland Street in Dartmouth, open seven days. In HRM, order by 11 am with Luminate Express for same-day delivery, or choose pickup. Anywhere else in Canada, orders over $80 ship free.

Sources: SOGC, Menopause and U; SOGC, Menopause FAQ; NCCIH, Black Cohosh; WomenSense; St. Francis Herb Farm; Martin & Pleasance, Our History; product labels. This article is general information, not medical advice.