Written by Charles Gumbley, BHSc (Clinical Nutrition), DipHSc (Western Herbal Medicine)
Evidence checked: 19 July 2026
New or disruptive midlife symptoms deserve assessment. Heavy or unexplained bleeding, bleeding after sex, a breast change, severe low mood, chest pain, fainting or sudden neurological symptoms should not be attributed to the menopause transition or managed from a supplement list.
Conflict disclosure: Nutrition Market sells supplements. This article contains no products, categories, prices, stock feeds or shop links.
People searching this topic often want a ranked answer, but there is no universal winner. The useful question is whether a specific option has evidence for a specific symptom, fits your health history and medicines, and adds value beside established care.
Key points
- The transition can begin while periods continue, and pregnancy may still be possible.
- Most complementary medicines do not have strong evidence for menopausal symptoms.
- Prescription hormone treatment has stronger evidence for vasomotor symptoms than any retail supplement.
- An AUST number supports an Australian regulatory check; it does not prove personal effectiveness.
Symptoms need a health professional or health practitioner
This is the transition before the final menstrual period. Hormonal changes can make cycles irregular and contribute to hot flushes, sleep disruption, mood change, vaginal dryness and other menopause symptoms. Symptoms of menopause are not identical for every person. Menopause is confirmed retrospectively after 12 months without a period, when no other cause explains it.
Thyroid disease, iron deficiency, pregnancy, medicine effects, sleep disorders and mental-health conditions can overlap. A clinician can review the pattern, bleeding, contraception, cardiovascular and bone risk, prescribed medicines and whether testing is needed. Do not assume every symptom in women during midlife is caused by oestrogen and progesterone fluctuation.
Safe and effective menopause treatment options
The Australian Government lists hormonal, non-hormonal, psychological and complementary approaches.¹ Menopausal hormone therapy, formerly hormone replacement therapy, is a prescription treatment and can be an effective treatment for most healthy people with troublesome flushes and night sweats. Personal history and risk matter; this treatment is not right for everyone.
Prescription non-hormonal options, cognitive behavioural therapy and clinical hypnosis are other therapies for hot flushes and selected symptoms. Lifestyle measures such as physical activity, sleep routines, limiting smoking and excess alcohol, and a balanced diet support general wellbeing and sleep quality even when they do not directly stop a hot flush.² A practitioner can help separate symptom relief from broader goals such as bone, cardiovascular and women’s health. Jean Hailes also provides Australian consumer information on these options.¹
Perimenopause supplements: evidence for menopausal symptoms
The Australasian Menopause Society describes evidence that is mixed, small or preparation-specific.³ Soy isoflavones are phytoestrogen compounds; some clinical trials report fewer vasomotor symptoms, while others show no benefit versus placebo. Individual metabolism and product composition differ.
Specific red clover extracts may slightly reduce the frequency of hot flushes, particularly in postmenopausal women, but this does not establish a class effect. Black cohosh has mixed extract-specific findings and possible safety concerns. One systematic review and meta-analysis may not apply to a different extract or dose. Long-term safety is uncertain, especially with hormonally sensitive conditions.
Evening primrose oil has no convincing evidence for treatment of hot flushes. Wild yam or progesterone cream has no evidence that it protects the uterine lining and must not replace prescribed MHT. A vitamin or mineral can be relevant when diet, a blood result or bone-health assessment identifies a need; it is not automatically a menopause supplement.
Herbal supplements, hormone history and interactions
Botanical preparations can interact with anticoagulants, antidepressants, tamoxifen and other pharmaceutical medicines. A breast or uterine cancer history, unexplained bleeding, liver disease, migraine, clot risk or planned surgery changes the safety conversation. “Natural” is not a synonym for harmless or effective.
The 2023 non-hormone position statement did not recommend supplements and herbal remedies as evidence-based therapies for vasomotor symptoms.⁴ That conclusion does not mean every complementary medicine is inert; it means evidence for their effectiveness, formulation consistency and long-term safety is insufficient for a broad recommendation.
A naturopath should work within training, registration and referral limits. Tell your GP about every botanical, vitamin and compounded product. Compounded “bioidentical” preparations are not a safer natural substitute for regulated MHT.
Supplements in Australia and TGA checks
Many dietary supplements, including vitamins and minerals available in Australia, are regulated medicines. The Therapeutic Goods Administration oversees complementary medicines that make health claims.¹ Look for an AUST L, AUST L(A) or AUST R number and confirm it on the ARTG.
Most AUST L medicines are not individually assessed before sale for whether their indications work. AUST L(A) and AUST R products receive different levels of pre-market evaluation, but even the regulator’s assessed claim is not a recommendation that one medicine is better for a person than another.⁵ Be cautious with products bought overseas, undisclosed blends, claims to “balance hormones”, and testimonials presented as clinical proof.
For Australian women, complementary and alternative medicines still require the same questions: what exact preparation was studied, compared with what, for how long, in which population, and with which adverse effects? Product claims should not be broader than the evidence.
Before buying, write down the symptom you want to change and how you will measure it. Check the ingredient amount rather than the front-label blend name, note the trial duration, and agree on a review point. Stop and seek advice if a new symptom or suspected adverse effect appears. This makes a time-limited trial easier to assess and reduces the chance of continuing several products without knowing what helped.
Questions about supplements: talk to your doctor
What are the best supplements to take during perimenopause?
There is no universal winner. A nutrient may be appropriate for a confirmed deficiency, while a standardised botanical may have a small symptom-specific signal. The choice should follow the symptom, evidence, medicine list and personal risk rather than a ranked shopping list.
What supplements should I take for perimenopause Australia?
Start with assessment, not a product. If a complementary medicine is considered, check its AUST number, ingredient amounts, interactions and evidence with a doctor or pharmacist. Tell your doctor before starting and do not use it to delay established care.
What do Japanese do for menopause?
Japanese diets often include soy foods, but population patterns do not prove that an isoflavone capsule will reproduce the same outcome. Genetics, dietary pattern and equol metabolism differ. Traditional Chinese medicine is also a different system and should not be treated as a Japanese or universal answer.
What can I take naturally instead of HRT?
No natural product is an equivalent substitute for MHT. If it is unsuitable or unwanted, discuss evidence-based non-hormonal medicines, CBT, hypnosis and symptom-specific care. A complementary option can be discussed honestly without presenting it as hormone replacement.
References
- Australian Government Department of Health, Disability and Ageing. Treatment guide. Health.gov.au
- Australian Government. Managing menopause-related symptoms. Fact sheet
- Australasian Menopause Society. Complementary medicines and therapies. AMS
- The Menopause Society. Nonhormone therapy position statement. 2023. PubMed
- Australian medicines regulator. Using the assessed claim on medicine labels. Regulator guidance
