When the natural and mainstream medicine worlds battle it out, supplements tend to be caught in the crossfire. There are several truths worth considering here: hormone therapy is not for everyone and hormone therapy might not help everything. The common criticism of most supplements is that there isn’t enough data to be sure about the safety of taking them. But often, as you can see below, there is some data, and certainly what’s seen in clinical practice. And they can be very helpful, as you will also see below. The most important thing is to talk to your doctor before embarking on any supplement regime, to check and make sure there aren’t any contraindications with other medication – or supplements – you are taking. 

Pycnogenol for hot flashes

Pycnogenol is a standardized extract derived from the bark of the maritime pine tree, which grows in the Mediterranean. It also completely stops my hot flashes and night sweats. 

Hundreds of randomized controlled trials involving this antioxidant have been conducted in animals and humans, looking at how this extract impacts everything from blood sugar, blood flow and artery composition to traumatic brain injury. A 2019 meta-analysis indicated Pycnogenol has a role in preventing cardiometabolic disease; that same year another meta-analysis explored how it can improve cognitive function. It’s even been looked at specifically in relation to perimenopause: in a small Italian study conducted in 2017 among 35 women and a control group, 100mg of Pycnogenol per day for eight weeks not only improved quality of life, but normalized fasting glucose levels and several cardiovascular risk factors. It's the one supplement I make sure I am never without and want to tell everyone about. To this day I don't understand why more people don't know about it, or why it's never included in all those 5 ways to reduce your hot flashes articles. Here’s the conspiracy theorist in me: is it just too effective? I take anywhere from 25mg to 100mg a day. Which brings me to something else I love about Pycnogenol: It is regulated and standardized by an independent body in France. And you can't say that about very many supplements. 

Violet (iodine) for breast pain

It was through Instagram that a Hotflash inc follower in Montreal, Canada, gave a rousing endorsement for the daily molecular iodine supplement Violet for breast pain. She asked a doctor about it first, of course, and she’s also on hormone therapy, but still gets menopause symptoms. Here’s what was happening: her breasts get bigger and bigger, they “hurt like hell” and it lasts for months at a time, three to four times a year. After two months on Violet, she reported: “Breast tenderness disappeared and never came back. I can live my life as I used to, doing sport, dancing, walking, lacing my shoes, without holding my boobs." What makes me feel great about telling you all about it? It’s what Lara Briden, author of Your Hormone Manual and a Canadian naturopathic doctor living and working in New Zealand, gives to her patients who have breast pain. Here is her lowdown: “It works by promoting healthy estrogen metabolism, down-regulating estrogen receptors, and stabilizing estrogen-sensitive tissue including breasts, uterus, ovaries, and the brain.”

Lion’s Mane for brain power and mood

Lion’s Mane is an edible mushroom known as a nootropic, aka a catalyst for brain cell regeneration, helping improve memory and cognition. I had been seeing it recommended for a range of benefits, including lowering blood pressure, inflammation and boosting immunity and cardiovascular health, but I only actually tried it when a friend told me it was helping her anxiety, something this study looks at. Boy, does adding it to my daily regime boost my mood – and quickly. Lately I am motivated by studies indicating Lion’s Mane has a neural-protective impact, particularly in light of our elevated dementia threat in menopause.

Milk thistle for hot flashes

A study conducted at Babol University of Medical Sciences in Iran, published in the journal Phytotherapy Research, found that taking 400 mcg per day of milk thistle, also known as silybum marianum, led to fewer and less severe hot flashes. The randomized, double-blind, placebo-controlled study was small – just 80 women – but those who took milk thistle experienced a reduction in hot flashes from 4.3 to 1.3 per day. Milk thistle has been primarily studied for liver-supporting properties, but researchers believe that one of its active components – silibinin – may have what is called an agonist response on estrogen receptors. That is, when silibinin hits an estrogen receptor dormant due to a drop in estrogen, it may initiate its intended physiological response.

Hops for sleep 

Have you thought of hops? The flowers of the plant that gives beer its bitter flavor contain phytoestrogens, those plant-based compounds that mimic female hormones. Many women take them to help with hormone-related symptoms, including insomnia and hot flashes. I like to take it before going to bed, because it really helps me sleep. While some lab studies have shown hops could inhibit or deactivate drug-metabolizing enzymes in certain forms of medication, a study by Oregon State University's Linus Pauling Institute and College of Pharmacy shows that’s not likely to be the case. The scientists gave 16 women a cocktail of four different drugs – Xanax, an over-the-counter cough suppressant, a Type-2 diabetes med and caffeine – and ran the test twice, detecting no enzyme inhibition.

Kudzu flower and mandarin peel

A study from South Korea looked at the efficacy and safety of using a combination of kudzu flower-mandarin (KM) peel extract to reduce hot flashes and improve bone density markers during the menopause transition. Researchers tested the KM combination on 84 healthy women and found that compared with a placebo, it significantly lowered hot flash frequency and severity, reduced bone breakdown, and increased bone formation. There were no problems or hormonal changes seen in either group, prompting the study’s authors to conclude that “KM consumption may improve the quality of life in ways that are important to symptomatic menopausal women”. Kudzu flower and mandarin peel are readily available in a variety of forms wherever supplements are sold. Kudzu has a bad reputation as an invasive plant but is also called the miracle vine. Previous research has suggested it has anti-inflammatory and neuroprotective properties and it’s been used for centuries in traditional Chinese medicine to make healing herbal teas and tinctures to treat alcoholism, diabetes, heart disease, the common cold and more. It’s also a phytoestrogen, and so may not be suitable for everyone, including those undergoing treatment for breast cancer. Mandarin peel, on the other hand, is full of a range of vitamins as well as being rich in polyphenols, which help prevent and manage a variety of chronic conditions, including Type 2 diabetes, obesity and Alzheimer’s.

Ann Marie McQueen is the founder of Hotflash inc, a global platform to inform, inspire and entertain people in peri/menopause while bridging the gap between mainstream medicine and holistic care.