Dietary supplements and perimenopause: how to choose the right one

Pharmacy shelves, social media ads, recommendations in Facebook groups: "menopause" supplements are everywhere. And if you are going through a tiring perimenopause, the urge to try one is completely understandable. But how do you choose? With or without phytohormones? An "all-in-one" formula or a targeted product? And how long does it take to see results?

To answer these questions, we spoke with Flamme Servera, founder of Ginama, a brand of dietary supplements free from hormones and phytohormones designed for perimenopause. Ginama is a partner of our Génération Péri series, co-produced with Reflet. Flamme is not a healthcare professional, but she developed her formulas with a scientific committee: gynecologist Dr. Jean-Philippe Lucot and doctors of pharmacy. She gave us an inside look at the formulation process, and her advice applies to any supplement.

First: a supplement is not a magic pill

This is the first thing Flamme wants to emphasize, and it is quite rare to hear from a brand founder. "It's not a magic pill, it's not a medication. Before taking a dietary supplement, there are still some basics that need to be in place."

These foundations are:

• a balanced diet, with sufficient protein intake, which becomes even more important after age 40;
• regular physical activity, ideally including strength training;
• protected sleep and better stress management.

"If your lifestyle isn't healthy, a dietary supplement isn't going to change everything." The supplement acts as as a supplement, once these foundations are in place. This is exactly what gynecologist Odile Bagot recommended in our series *Osée, ménopausée*: perimenopause is the perfect time to establish habits that will make menopause smoother.

Understanding health claims so you don't get fooled

On a supplement box, you often read "helps reduce fatigue" or "relieves menopause symptoms." These phrases are called health claims, and they are strictly regulated.

In Europe, a claim is linked to an ingredient, not the entire formula. It is only authorized if the ingredient appears on a list validated at the European level. Flamme gives examples from her own formula for hot flashes: vitamin B6, which helps regulate hormonal activity; vitamin B9, which helps reduce fatigue; and saffron, whose claim relates to menopause symptoms.

The trap, according to Flamme: having the claim doesn't guarantee the right dosage. "You can include an ingredient and have the claim, but that doesn't mean you have a high enough dose of the active ingredient for it to be truly effective."

A claim on the box says an ingredient has a recognized benefit. It does not say it is present at the dosage studied. Look at the quantities, not just the promises.

Why a symptom-by-symptom approach

Not all products make this choice, and Flamme stands by it. "Ideally, I would have loved to make one pill that addresses everything." Two reasons prevented her:

• Symptoms vary greatly from one woman to another. In the hundreds of questionnaires she had people fill out before launching Ginama, no two profiles were really the same.
• A capsule has a limited size. To respect the active doses used in clinical studies, you cannot put many ingredients into a single capsule. A formula that promises everything risks underdosing everything.

Ginama therefore offers targeted products: hot flashes, libido, intimate dryness, and vaginal flora balance. The advice to remember, regardless of the brand: identify the symptom that bothers you the most, and choose a product that targets it with well-dosed active ingredients. To take stock of your symptoms, read our article on the 35 symptoms of perimenopause.

With or without phytohormones?

This is a key question, and there is no single answer.

Phytohormones, and in particular phytoestrogens (sage, red clover, soy, hops), are plant molecules that mimic our own estrogen. They are present in many "menopause" supplements. They have significant contraindications, especially if you have a history of hormone-dependent cancer. We cover this in our article on phytoestrogens.

The Flamme choice : formulas without hormones or phytohormones. She explains that the gynecologist on her scientific committee saw many patients refusing hormone therapy and turning to phytoestrogen supplements, which he considered less effective than actual hormones. Hence the idea of an alternative without phytohormones. "I'm not campaigning to say they aren't good. It was a brand choice," she clarifies.

This choice has two benefits:

• It is suitable for more women, including those who cannot take hormones or phytohormones, for example after a hormone-dependent cancer (always with their doctor's approval).
• It can complement hormone therapy when symptoms persist, without the risk of compounding hormonal effects. Again, this should be validated with your doctor.

Even without phytohormones, a supplement still has its own precautions for use: always seek advice before taking it.

The most studied active ingredients for hot flashes

Hot flashes are among the symptoms for which we have the most data. In our series, pharmacist Carole Minker explains that saffron is one of the active ingredients that benefits from numerous clinical studies, particularly for its action on the nervous system. Since stress is a known trigger for hot flashes, soothing the nervous system is an interesting approach.

For example, Hot but Cool, Ginama's best-selling supplement dedicated to hot flashes, combines saffron, vitamin B6, vitamin B9, borage oil, and vitamin E. We explain the role of each active ingredient in our article on plants for hot flashes.

How long before feeling an effect?

This is one of the points Flamme insists on most, almost going against the grain. Online reviews sometimes promise ultra-fast results, which creates very high expectations. "Most of the time, you start to feel the effects after three or four weeks, or a month. And it's normal not to feel the first effects in the very first week."

A few benchmarks:

• Allow at least one month of regular use before judging.
• Results should be evaluated over relatively long periods, not just a few days.
• Take highly enthusiastic reviews with a grain of salt : every woman reacts differently.
• Check in with a professional if you don't see any improvement after a full course.

Seeking advice: pharmacist, midwife, naturopath

Flamme is a firm believer in professional advice. A supplement bought randomly online may not meet your needs, or could even be problematic if you have an undiagnosed thyroid condition or other health issue. She suggests several professionals you can turn to:

• your pharmacist, to check for interactions with your current medications;
• a midwife, who is increasingly trained in dietary supplements;
• a qualified naturopath , as a complement to your medical care;
• and of course your gynecologist or doctor, especially if you are hesitant about hormone therapy.

A midwife actually shared her approach with her: try a supplement at the very onset of symptoms, and if that isn't enough, consider hormone therapy with a doctor. This is just one approach among many: some gynecologists suggest hormone therapy as early as perimenopause, while others prefer to wait until menopause because hormone levels fluctuate wildly during that time. It is something to work out with your doctor, and if you haven't found the right professional yet, keep looking.

Precautions to keep in mind

• History of hormone-sensitive cancer : avoid supplements containing phytoestrogens, and discuss any use with your oncologist or doctor.
• Current medication (hormonal, antidepressant, anticoagulant, thyroid): ask your pharmacist for advice before adding a supplement.
• Pregnancy and breastfeeding : many active ingredients are not recommended, particularly saffron supplements. Remember that pregnancy is still possible during perimenopause.
• Do not combine : avoid taking multiple supplements that contain the same active ingredients.
• Unusual symptoms (abnormal bleeding, heart palpitations, very low mood): consult a doctor before turning to a supplement.

What Flamme wants women in their 40s to know

"You aren't crazy, it's not all in your head, it's genuinely hormonal. It's not a life sentence: there are plenty of solutions, whether it's dietary supplements, hormone therapy, yoga..." The first step, according to her, is simply understanding what is happening. And her conclusion: "You are in perimenopause, but you aren't expired." That is the whole point of our guide on perimenopause and our content on perimenopause.

Discover the episode with Flamme Servera

Discover the Generation Peri series

Key takeaways

• A supplement is not a substitute for a healthy lifestyle or medical care: it is meant to be taken in addition.
• A health claim refers to an ingredient, not the dosage: check the actual quantities.
• A formula targeted at your main symptom is often better dosed than an "all-in-one" product.
• Whether or not it contains phytohormones, the choice depends on your medical history and current treatments.
• Allow at least a month before judging the effects, and seek advice from a professional.

FAQ

Which dietary supplement should I take for perimenopause?

That depends on your main symptom, your medical history, and your current treatments. Choose a targeted, well-dosed formula and seek advice from a professional.

Can a supplement replace hormone therapy?

No, they are not the same thing. A supplement may relieve certain symptoms, but hormone therapy should be discussed with your doctor based on your specific situation.

How long do I need to take a supplement before seeing results?

Generally, effects are felt after three to four weeks. Plan for a course of at least one month before evaluating the results.

Why choose a supplement without phytohormones?

Because phytohormones have contraindications, particularly for those with a history of hormone-dependent cancer. A formula without phytohormones may be suitable for more women, but it still comes with its own precautions.

Can I take a supplement in addition to hormone therapy?

Sometimes yes, if symptoms persist, but only with your doctor's approval and by avoiding products containing phytoestrogens.

The information in this article is for educational purposes only and does not replace professional medical advice. This article is based on an episode of the Génération Péri series, co-produced with Ginama. Flamme Servera is the founder of the brand Ginama; she is not a healthcare professional. Before taking any dietary supplement, especially if you have a history of cancer, are currently undergoing treatment, are pregnant, or are breastfeeding, seek advice from your doctor or pharmacist.