Best Supplements for Perimenopause: What I Use and What the Research Actually Shows
Five supplements for perimenopause symptoms, sorted by the symptom you are actually dealing with. What the research shows, where it is thin, and what I take myself.
Where Supplements Actually Fit
Perimenopause got me. I was doing everything I had always done and my body quit cooperating.
I sell supplements. Factor that in as you read.
For each one below I will tell you what the research shows, where it is thin, and what I actually take. Including when the answer is not much.
Supplements are the smallest lever you have right now. Training, protein, sleep, and walking are the big ones. Nothing on this page will do much if those four are not in place.
What supplements do well is close gaps. Most women I work with are short on protein. A lot are short on omega-3s and magnesium. Filling those gaps makes the hard part easier to keep up.
I am a trainer and nutrition specialist, not a physician. If your symptoms are wrecking your quality of life, talk to a doctor who treats menopause. Nothing on this page replaces that, and no product here touches the hormone changes themselves.
Losing Muscle and Gaining Midsection
Same food, same workouts, different body. That is the one I hear most.
As estrogen falls, holding muscle gets harder and fat shifts toward your middle. Estrogen was doing some of that work for you. Now protein and lifting have to do it instead.
Protein has the best research of anything on this page. The sports nutrition position stand puts higher protein as necessary for holding onto lean mass when you are eating in a deficit. Studies pairing protein with lifting show more muscle and more strength than lifting alone, at every age they looked at.
Aim for 0.8 to 1.2 grams per pound of goal body weight. Most women I assess are eating about half that.
A protein powder is not magic. It is the easiest way to close a gap food alone is not closing on a busy day.
Beverly International Ultimate Muscle Protein. It blends casein and whey so it digests slower and keeps me full longer than straight whey. It does not leave me bloated. I use it in shakes, overnight oats, and baking. The best protein powder is the one you will actually drink every day.
If you are not sure what your daily target should look like on a plate, my guide to what 30 grams of protein looks like has the portion chart, and there are more ways to use it in my protein powder recipes.
Waking Up at 3 a.m.
Three in the morning, wide awake. That one shows up on almost every intake form I read.
Sleep runs everything else. Your appetite, your workouts, your mood, your recovery.
Magnesium is involved in nerve signaling and muscle relaxation, and plenty of adults are not getting enough from food. Zinc and B6 usually come along with it.
The research is better than I expected. Researchers pooled the trials in older adults with insomnia and found the magnesium groups fell asleep about 17 minutes faster than placebo. Total sleep time did not really change, so it gets you to sleep more than it keeps you there.
Only a few small studies went into that, and the reviewers rated the certainty of the evidence as low. Promising rather than settled. Filling a real dietary gap is worth doing either way.
Beverly International ZMA 2000, which is zinc, magnesium, and B6. I fall asleep easier and wake up less groggy. Clients dealing with 3 a.m. wakeups often tell me it was the first thing that helped. That is their experience and mine, not trial data.
If you are up at 3 a.m. every night, bring it to your doctor too. Sleep is one of the perimenopause symptoms that responds best to medical treatment, and a supplement will not get at the cause.
L-Carnitine for Perimenopause: What the Research Actually Found
Carnitine is the ingredient women ask me about more than any other.
What L-carnitine does
Carnitine carries fat into your cells so it can be burned for fuel. No carnitine, no fat burning. That part is basic biology, not marketing.
The best results are about energy, not the scale
In one study, 66 older adults who got worn out after even light activity took either 2 grams of carnitine a day or a placebo. The carnitine group came back with significant improvements across the board. Less physical fatigue, less mental fatigue, better cognitive scores, less fat, and more muscle.
That is what my clients tell me too. Not big weight loss. More in the tank, better workouts, easier recovery.
Worth noting that trial studied a much older and frailer group than you, so how much carries over is a fair question. It was a well built study though, and the differences were not small.
What it does for body composition
Researchers pooled nine studies covering more than 900 people. The carnitine groups lost about three more pounds than the ones who did not take it. That is more than I expected to find when I went looking.
It is also not a transformation, and the weight loss effect diminished the longer people stayed on it. Two studies looking specifically at healthy older women did not show body composition changes at all. Getting carnitine into your blood turns out to be easier than getting it into your muscle, and muscle is where it works.
A small average benefit, then. Better evidence for how you feel than for what the scale says.
Carnitine will not do the work for you. But the women I coach who take it keep telling me the same thing. They have more in the tank. That counts for something.
Julie LohreHow I use it
On top of consistent training and enough protein, not instead of them. If those two are not dialed in yet, carnitine is not what is holding you back.
Two options. Beverly International Lean Out is my longtime favorite. No stimulants, so you can take it day or night, and clients tell me over and over that it helps with cravings. Beverly International Quadracarn has four forms of carnitine in it. That is the one I reach for when energy, recovery, and strength are what I am after.
Joint Pain, Skin Changes, and Inflammation
Stiff joints catch a lot of women off guard in perimenopause. So does drier skin and taking longer to bounce back between workouts. Estrogen was protecting your cartilage and connective tissue, and your own collagen production drops off with it.
Omega-3 fatty acids
Worth taking, probably not for the reason you read. I went looking for the hot flash evidence and it is not there. Several trials in postmenopausal women found no effect on hot flashes or on sleep.
Where omega-3s hold up is heart and metabolic health, which matters more after 40 as estrogen’s protection falls off. Most women are short on them. Getting enough from food means two or three servings of fatty fish a week and almost nobody eats that.
Beverly International EFA Gold. A gap filler for me, and the gap is real for most women. I notice it most in my joints and skin.
Collagen peptides
Collagen surprised me when I went back through the research.
For skin, 26 studies covering more than 1,700 people. Better hydration and better elasticity than placebo. A real body of evidence, not a couple of small trials.
For joints, a 2023 review of trials in people with knee arthritis found real pain relief compared to placebo, rated moderate quality. It pooled only four studies and all four carried a high risk of bias, so promising rather than proven.
Here is my own experience. One woman’s experience, not a study.
I have taken collagen peptides every single day for six months and it has made the biggest difference of anything on this page. My joint pain is the lowest it has been in years. My nails are growing again. If you have watched your nails go thin and brittle in your forties, you know that is not a small thing.
I cannot separate that cleanly from everything else I do. But six months is long enough to notice, and it points the same direction the research does. If stiff joints are one of your main complaints, this is the one I would try first.
One thing to know either way. Collagen is not a complete protein and does not count toward your protein target the way whey or food protein does. It is low in several essential amino acids. Take it alongside your protein, not in place of it.
Beverly International Collagen Peptides, every day, in my morning coffee or my shake. Six months in, this is the one I would give up last.
What to Take First, and What to Skip
You do not need all five. This is the order I would add them.
| Priority | What | For | Evidence quality |
|---|---|---|---|
| 1 | Protein | Muscle retention, appetite, body composition | Strong, decades of trials |
| 2 | Collagen peptides | Skin, joint comfort, nails | Strong for skin, moderate for joint pain |
| 3 | L-carnitine | Energy, fatigue, fat metabolism | Moderate, 9-trial meta-analysis |
| 4 | Magnesium and zinc | Falling asleep, recovery | Significant effect, low certainty |
| 5 | Omega-3 fatty acids | Cardiometabolic health, inflammation | Strong generally, weak for hot flashes |
What to skip
- Anything promising to balance your hormones. No supplement on a shelf does that. It is a marketing phrase, not a real thing.
- Blends that will not tell you the doses. If the label hides how much of each ingredient is in there, you have no way to judge it.
- Six things at once. Add one. Give it a month. Decide if it did anything. Otherwise you are paying for a mystery.
- Anything you are taking instead of eating enough protein or lifting. That trade never works.
The foundation has not changed. Lift two to four times a week, get protein at every meal, sleep, and walk. Supplements are the finishing touch on that, never the substitute for it.
For the full picture of how training and nutrition shift in this stage, start with my guide to fitness and nutrition strategies for perimenopause. If what you want is to lose fat and hold onto muscle, that is body recomposition for women.
Perimenopause Supplement FAQ
The ones I get asked most.
What does L-carnitine do for perimenopause?
Carnitine carries fat into your cells to be burned for fuel, so it sits right in the middle of how your body uses fat for energy. The best results in the research are about energy, not the scale. In one study, older adults who got worn out after even light activity took 2 grams a day and came back with less physical fatigue, less mental fatigue, and better cognitive scores than the placebo group. That is what my clients describe too. More in the tank, better workouts, easier recovery. The body composition research is more modest, and I would not take it expecting the scale to move on its own.
What are the best supplements for perimenopause?
Protein first, and it is not close. After that I would go collagen, then carnitine, then magnesium if falling asleep is your problem, then omega-3s if you rarely eat fish. You do not need all five. If you are taking six supplements and eating 70 grams of protein a day, the supplements are not your problem.
Do supplements help with perimenopause weight gain?
Not much on their own. What is driving the weight gain is falling estrogen, lost muscle, less daily movement, and often years of on-and-off dieting. No capsule fixes those. What supplements do is make the real work easier to keep up. Enough protein protects the muscle that keeps your metabolism up. Better sleep makes you less hungry and your workouts better. Those are real, just indirect.
Which supplement should I start with?
Protein. Get that consistent for a month before you add anything else. Most women in perimenopause are eating far less protein than they need, right when falling estrogen makes muscle harder to hold onto. If sleep is your biggest complaint instead of your body, start with magnesium.
Does magnesium help with perimenopause sleep problems?
It helps you fall asleep. Researchers pooled the trials in older adults with insomnia and found the magnesium groups fell asleep about 17 minutes faster than placebo. Total sleep time did not really change, so it gets you to sleep more than it keeps you there. Only a few small studies went into that, so I would call it promising rather than settled. If you are waking at 3 a.m. every night, that is worth bringing up with your doctor too.
Do omega-3s help with hot flashes?
I went looking for that evidence and it is not there. Several trials in postmenopausal women found no effect on hot flashes or on sleep. Where omega-3s hold up is heart and metabolic health, which matters more after 40 as estrogen’s protection falls off. Most women are short on them, because getting enough from food means two or three servings of fatty fish a week and almost nobody eats that.
Does collagen actually do anything?
For skin, yes. Researchers pooled 26 studies covering more than 1,700 people and found better hydration and better elasticity than placebo. For joints, a 2023 review of trials in people with knee arthritis found real pain relief, rated moderate quality, though it only pooled four studies and all four had problems. It is also the one I have personally noticed the most from after six months of taking it daily. One thing to know: collagen is not a complete protein, so it does not count toward your protein target.
Can supplements replace hormone therapy?
No. That is a conversation for you and your doctor, not a fitness coach. Supplements do not touch the hormone changes themselves, they support the systems around them. If your symptoms are wrecking your quality of life, talk to a doctor who treats menopause about all of your options. Nothing here replaces that.
How long before I notice a difference?
Sleep support is usually fastest, often a week or two. Protein you feel right away in how full you are, but the body changes it protects take two or three months to show up. The collagen studies run eight to twelve weeks before they measure skin, and my own joint and nail changes took longer than that. If you have taken something for two months and felt nothing, stop it instead of adding a third thing on top.
Supplements Are the Small Lever. Let’s Fix the Big Ones.
I’m Julie Lohre, an IFBB Fitness Pro, Certified Personal Trainer, and Certified Nutrition Specialist. I have been through menopause myself and I have coached women over 40 for 20+ years using my FITBODY Recomposition System™. Your training and nutrition built around your body, adjusted every two weeks based on how you are actually responding. No product on this page does that.
- Jäger, Ralf, et al. “International Society of Sports Nutrition Position Stand: Protein and Exercise.” Journal of the International Society of Sports Nutrition, vol. 14, no. 20, June 2017.
- Morton, Robert W., et al. “A Systematic Review, Meta-Analysis and Meta-Regression of the Effect of Protein Supplementation on Resistance Training-Induced Gains in Muscle Mass and Strength in Healthy Adults.” British Journal of Sports Medicine, vol. 52, no. 6, Mar. 2018, pp. 376-384.
- Malaguarnera, Mariano, et al. “L-Carnitine Treatment Reduces Severity of Physical and Mental Fatigue and Increases Cognitive Functions in Centenarians: A Randomized and Controlled Clinical Trial.” The American Journal of Clinical Nutrition, vol. 86, no. 6, Dec. 2007, pp. 1738-1744.
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- Pu, Shi-Yu, et al. “Effects of Oral Collagen for Skin Anti-Aging: A Systematic Review and Meta-Analysis.” Nutrients, vol. 15, no. 9, Apr. 2023, article 2080.
- Lin, Chun-Ru, et al. “Analgesic Efficacy of Collagen Peptide in Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials.” Journal of Orthopaedic Surgery and Research, vol. 18, no. 1, Sept. 2023, article 694.
- Mah, Jasmine, and Tyler Pitre. “Oral Magnesium Supplementation for Insomnia in Older Adults: A Systematic Review and Meta-Analysis.” BMC Complementary Medicine and Therapies, vol. 21, no. 1, Apr. 2021, article 125.