Perimenopause, Profit, and Pills: The Truth About Menopause Supplements

Menopause—and by extension, perimenopause—is big business. In 2024, the global market for menopause-related products was valued at roughly $17.6 billion, and it’s projected to grow to $24.4 billion by 2030.

The drivers of this market are pretty straightforward: By 2025, around 1 billion women will be postmenopausal, according to the North American Menopause Society. While the number of perimenopausal women is harder to pin down (since perimenopause doesn’t have a defined start date), we know it’s sizable—and growing.

The Menopause Market Is Booming—But Medical Support Is Lagging

Unfortunately, these women are often underserved by the current medical system. Only 20% of OB-GYN residency programs in the U.S. offer any training in menopause, and even among those that do, more than 70% only provide two lectures on the topic per year (AARP).

Meanwhile, a Yale University study found that although 60% of women with perimenopausal symptoms seek medical help, 75% of them don’t actually receive treatment.

Combine this with the general lack of research in women’s health, and you’ve got a huge population of women left to figure things out on their own.

As a result of these gaps in health care for women, many women have turned to the menopause market—  which now includes things like women’s health apps, devices that claim to help with hot flashes, products that promise to support vaginal health (pelvic floor tone, dryness, bladder control), estrogen creams form compounded pharmacies, and loads of dietary supplements that are marketed heavily by menopause influencers.

But given that these products are unregulated, are any of them effective? Let’s talk about it.

The Symptoms of Perimenopause Are Complex—and So Is the “Care”

What Women Experience During Perimenopause

Perimenopause presents with a wide—and often overwhelming—range of symptoms, including:

• Irregular menstrual cycles

• Hot flashes and night sweats

• Mood changes, including anxiety and irritability

• Sleep disturbances

• Vaginal dryness or pain

• Decreased libido and painful sex

• Brain fog

• Joint pain and muscle aches

• Weight gain and bloating

• Skin rashes or irritation

And it doesn’t just last a few months. Perimenopause can drag on for 7–14 years.

Why Diagnosis Isn’t Always Clear-Cut

Science currently attributes these symptoms to hormonal fluctuations, but because those hormone levels shift constantly, there’s no definitive or effective test for perimenopause. In many cases, diagnosis is based on vibes—not labs.

Supplements for Menopause: A Convenience or a Trap?

The Supplement Industry Is Unregulated—and Full of Promises

In the gap left by lacking medical care, a thriving supplement industry has stepped in. Supplements are huge business: in 2023, the global supplement market was valued at $177 billion—about 10x larger than the menopause market itself.

I think we can all agree that it’s a really great thing that more women are talking about perimenopause and are demanding better care and more treatment options. In fact, many of the products and services that have come onto the market have been created by women who themselves felt unsupported and dismissed when they started perimenopause.

While some of the apps and services actually do help women get better access to perimenopause care and feel more supported, the dietary supplements are another story.

Here’s the problem: supplements aren’t regulated. Manufacturers aren’t required to test their products for safety or effectiveness before selling them. They’re also allowed to make lofty health claims with no clinical evidence to back them up.

Many supplements marketed to women for perimenopause symptoms carry steep price tags, especially when wrapped in “wellness” branding. Often, they’re sold with the same ingredients as other cheaper supplements, just with different marketing copy.

It’s called the “pink tax”—products like razors and pain medication when geared towards women typically have a higher price.

So by marketing it to women specifically, despite being identical to the same products for men, many of supplements marketed for perimenopause are higher priced than similar supplements with the same ingredients.

And yet, supplements tend to be very popular with women going through perimenopause and menopause—even choosing them over menopause hormone therapy (MHT, formerly known as hormone replacement therapy or HRT) which has been proven to be safe for many women and is well documented to ease menopausal symptoms.

Diet Culture Sells Women a “Cure” for Their Changing Bodies

Registered dietitian Leslie Weidner says it’s no surprise that many women reach for supplements over MHT—especially when they’ve spent decades being dismissed by the medical system.

“Women especially are getting blown off when it comes to their symptoms,” she says. Whether it’s perimenopause or earlier issues like endometriosis or PCOS, women are often told by their doctors that it’s their fault. “A lot of doctors will say you need to control your weight. I think that leads to this idea that when we go into perimenopause, if we’re not controlling our weight we’re doing something wrong.”

Weidner says the most common concern she hears from women entering perimenopause is weight gain—particularly around the middle. In a culture that equates thinness with health, many women are trained to view natural weight gain as failure.

And wouldn’t you know it, many menopause supplements are marketed as weight-loss solutions, while also claiming to help with energy, mood, sleep, hot flashes, and more.

Take these examples:

• Over 30 Hormone Support by Gleefull: Claims to promote weight loss, increase energy, improve sleep, and reduce mood swings and hot flashes.

• Hormone Harmony by Happy Mammoth: Promises to support hormonal balance, relieve symptoms of menopause, support cortisol/estrogen/progesterone levels, improve sleep quality, help with irritability, enhance the body’s stress response, support mental function, and of course, promote healthy weight loss and curb carb cravings.

Those are big promises for a single pill.

Yet buried in the FAQs? That standard disclaimer:

“These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”

In other words, these products have not been proven to do anything and aren’t intended to treat any of the symptoms we’ve claimed they help. Nice. 

What the Experts Say About Efficacy and Safety

Weidner is skeptical.

“Since perimenopause and menopause is a buzzword now, companies are realizing this, and there’s so many formulated supplements out to help your perimenopause symptoms. But there’s absolutely zero research that shows that a combination of herbs in a supplement is going to do anything.”

In other words, the convenience is appealing, but the science just isn’t there.

Additionally, supplements that use so-called proprietary blends often include so many ingredients in one pill that it’s tricky to know how all of those herbs will interact with a person’s unique needs or any other medications they are taking.

Dr. Monica Barbieri, in an interview with the Today Show, agrees. “I cannot tell you how many times I have identified supplements people were using that were unnecessary, potentially harmful or interacting with other medications,” she says. “Or people who were using 25 supplements where they could just use hormone therapy.” 

Hormone Therapy: Why Some Women Are Choosing It—and Others Aren’t

The Stigma Around MHT Still Lingers

MHT is one of the most clinically backed, highly effective treatments for many perimenopause symptoms. But because of past bad press, many women are still hesitant.

Sarah, now postmenopausal, remembers the fear and negativity about MHT. But once she found a doctor who explained the research and took the time to talk through her options, it changed everything.

Sarah’s doctor spent 30 minutes discussing the benefits of MHT for her sleep and vulvovaginal pain—and it worked. “I was having horrible hot flashes, almost every hour in the middle of the night and I couldn’t get decent sleep as a result. Hormone therapy made a huge difference. I don’t regret it at all.”

Sarah didn’t go for supplements or alternative treatments prior to MHT, but lots of women do because it feels a little bit easier than going to a doctor who might not listen anyway. 

What Happens When Doctors Don’t Listen

For many women, though, getting the right care takes years—or doesn’t happen at all.

Patient C (name omitted for privacy) shares her experience of having a wide array of frustrating and painful perimenopause symptoms for years that felt clearly hormonal to her, but doctors couldn’t seem to identify as symptomatic of perimenopause.

Patient C’s symptoms included a psoriasis-type rash that lasted for 7 years, difficulty sleeping, connective tissue injuries that stopped recovering quickly, and “cycle related incontinence that nobody seemed to care about or want to help treat which was very frustrating.”

She tried a compounded estrogen cream that gave her a yeast infection but did not get rid of the rash and otherwise suffered with these symptoms for years until she finally started taking MHT. And in a short amount of time, her quality of life changed dramatically. 

“Three months into hot flashes and very little sleep because of waking up constantly to throw the covers on and off, I started hormone therapy and the side effects were a little bit brutal for the first three weeks. But the hot flashes completely stopped and I am sleeping through the night, so just based on that alone I’m feeling way better!! Sleep is important.”

Patient C’s story highlights that women are more accustomed to tolerating extreme levels of pain and discomfort for long periods of time simply because the medical establishment isn’t always inclined to listen or take them seriously. And it feels too frustrating and overwhelming to try.

It’s not surprising that women are more likely to turn to supplements because they feel easier. And they’re often sold by women like them who promise that one pill will solve all of their problems, including the ones that are pushed hard by diet culture and the patriarchy like “fixing” weight gain and wrinkles.

And that feels so easy, so convenient.

What if it was possible to solve your perimenopause symptoms with a pill or two that you don’t need a doctor’s appointment or a prescription for—one that you can purchase from your favorite celebrity or even from the health food store down the block?

Real Women, Real Results with MHT

Patient T had a similar experience to Patient C. Her doctors dismissed her symptoms and gave her terrible advice, leading her to suffer painful perimenopause symptoms for longer than necessary.

“My primary care doc and the OBGYN I initially saw both had me in tears – one suggesting I probably needed antidepressants despite having a regular therapist who didn’t feel that was the case and the other suggesting maybe I’m tired because I could be snoring and not know it (?!?). How do you see someone with all these common perimenopause symptoms and think ‘maybe we should look at snoring first?’

I did finally find an OBGYN who was willing to listen to me and try HRT and who is kind and lets me have a voice in my care. She said I would probably feel some difference in 7 days. I literally felt a cloud lift off of me in the first 36 hours. I had been suffering for years and here we were in 36 hours, I could feel better.”

Patient T no longer has night sweats or brain fog or difficulty sleeping, but despite working out 3-5 days a week including strength training, she still hasn’t lost any of the weight gain from perimenopause.

Thankfully, her new OBGYN isn’t concerned and agrees with Weidner that bodies can change with age, which isn’t necessarily a bad thing.

“My new OBGYN  said there’s no magic bullet for weight gain. It’s all genetics, calories, and exercise. She also is not concerned about my weight and says I’m perfectly healthy.”

Patient M tried multiple supplements before MHT and says none of them helped with her hot flashes, night sweats, anxiety, or sleep. Only MHT made a measurable difference.

“My main symptoms were hot flashes, night sweats, weight gain, anxiety (very atypical for me), and 90-120 minute sleep cycles – meaning awake every 90-120 mins.

I was taking wild yam, black cohosh, adaptogens, b12, and magnesium.  None of those supplements made a dent.

I went on the lowest levels of oral estrogen (estradiol) + progesterone. The hot flashes immediately stopped and I was sleeping much better. Night sweats became very mild.”

Despite this, Patient M second guessed herself, thinking that perhaps other factors might be impacting the improvement in her symptoms, so she weaned off of the hormones. Within 8-10 days of weaning, the symptoms were back. 

So I increased to the next mg level of estradiol, this time in patch form,” she says. “All symptoms are now gone.”

Patient M hasn’t lost the weight she gained as a result of perimenopause. And while she has conflicting feelings about that, for the most part, she’s tired of diet culture dictating how she feels about her body or lives her life.

“I’m acutely aware of the idealized body image which I believe disempowers women.  I don’t give a shit what I’m supposed to look like. I’m supposed to age and change. 

I’m healthy, strong, have glowy skin, and feel good most of the time. 

Here’s where I usually land: The limited type and amount of food I would need to eat to lose, then maintain weight, is not how I want to live. If this is what I look like enjoying my life, then I’m ok with it.”

So What Actually Helps?

Lifestyle Changes Backed by Research

Weidner explains, no dietary supplement can do all what they promise. Particularly when it comes back to that diet culture obsession with burning fat.

“I don’t know why people have it in their mind that just taking a single pill is going to melt your belly fat, give you clear skin, make your anxiety go away. That’s just not possible. No supplement whatsoever can burn fat. Why not? Well, because the only way to burn fat is to burn energy – to basically take in less than you put out. You know the saying, ‘calories in, calories out,’ that’s how you burn energy. There’s no fat burning foods. That’s a myth.”

So what does work to help manage perimenopause symptoms?

Weidner says some basic but effective changes can make a huge difference:

• Eat a balanced, nutrient-dense diet

• Get 7–8 hours of sleep (and address any perimenopause symptoms that interfere)

• Manage stress

• Move your body regularly—strength training if you can

• Supplement with Vitamin D and Omega-3s (if needed, and with medical guidance)

“It’s not flashy,” she says. But it does help.

She adds that she is also a proponent of hormone therapy “because it is safe and effective for most women. And it’s helped me tremendously.”

Finding Providers Who Actually Hear You

Weidner and other women interviewed agree: what matters most is being heard. The right provider can be the difference between years of silent suffering and feeling better within days.

MHT isn’t for everyone, but for most women, it’s safe, effective, and underutilized. Supplements can help in some cases—but only when paired with expert oversight and realistic expectations.

The Bottom Line: Women Deserve Better Than Snake Oil

Women deserve science-backed options, accessible medical care, and respect—not overpriced pills promising miracles and delivering disappointment.

Aging is not a disease. Weight gain is not failure. Menopause is not a market trend.

Your body is not broken. It’s changing. And you deserve support that honors that. —Naomi