Understanding Menopause and Supplements: Essential Insights for Women Over 40

As women move through their 40s and beyond, the body enters a period of gradual hormonal transition. Perimenopause and menopause are natural stages of life, but they often bring changes that affect bone density, metabolism, mood, sleep, and cardiovascular health. While no supplement can replace a balanced diet, regular movement, and good sleep, certain nutrients may help address common gaps and support overall well-being during this phase.

Below are five supplements frequently considered by women over 40, along with what science and clinical practice suggest about their potential role.

Calcium

Bone health becomes a central concern as estrogen levels decline. Estrogen helps regulate bone turnover, and lower levels can accelerate bone loss, increasing the risk of osteopenia and osteoporosis.

Calcium is a structural component of bones and teeth and is essential for maintaining skeletal strength. Many women do not reach recommended intake levels through diet alone, especially if dairy consumption is low.

Most guidelines suggest a total daily intake of approximately 1,000 mg for women in their early 40s, increasing to about 1,200 mg after menopause. This total includes both food and supplements. Calcium absorption is improved when intake is spread throughout the day and combined with adequate vitamin D.

Vitamin D

Vitamin D plays a critical role in calcium absorption, bone mineralization, immune regulation, and muscle function. Low vitamin D levels are common, particularly in individuals with limited sun exposure, darker skin, or certain medical conditions.

During perimenopause and menopause, vitamin D deficiency may contribute not only to bone loss but also to fatigue, muscle weakness, and mood changes. Typical supplemental doses range from 800 to 2,000 IU per day, though blood testing allows for more personalized recommendations.

Because vitamin D is fat-soluble, it should be taken with meals that contain fat for optimal absorption.

Magnesium

Magnesium is involved in hundreds of enzymatic reactions in the body, including those related to muscle contraction, nerve signaling, glucose metabolism, and stress regulation. During midlife, magnesium may be particularly helpful for women experiencing sleep disturbances, muscle cramps, tension, or heightened stress sensitivity.

Some evidence suggests magnesium may help reduce the frequency or intensity of hot flashes and support more stable mood and sleep patterns. Forms such as magnesium glycinate or citrate are often preferred due to better absorption and gastrointestinal tolerance.

Dietary sources include leafy greens, nuts, seeds, whole grains, and legumes, but supplementation can help when intake is insufficient.

Omega-3 fatty acids

Omega-3 fatty acids, especially EPA and DHA, are known for their role in cardiovascular health, inflammation regulation, and brain function. Heart disease risk increases after menopause, making omega-3 intake particularly relevant during this stage.

Omega-3s may also support joint comfort, cognitive health, and emotional balance. Some women report improvements in mood stability and reduced inflammatory discomfort when omega-3 intake is adequate.

Supplements typically provide combined EPA and DHA doses of around 1,000 mg per day, though dietary sources such as fatty fish remain a foundational option.

B-complex vitamins

B vitamins are essential for energy production, nervous system function, red blood cell formation, and mood regulation. Hormonal changes, chronic stress, and aging-related absorption changes can increase the risk of suboptimal B-vitamin status.

Vitamin B12 deficiency, in particular, becomes more common with age and may contribute to fatigue, cognitive changes, and nerve symptoms. A balanced B-complex supplement provides all eight B vitamins and may help support energy levels and emotional resilience during hormonal transitions.

Before starting supplementation

Although these supplements are commonly used, individual needs vary. Factors such as existing medical conditions, medications, dietary patterns, and baseline nutrient levels should guide decisions. Blood testing and professional guidance help reduce the risk of unnecessary or excessive supplementation.

2. Scientific references

1. North American Menopause Society. Management of osteoporosis and bone health in midlife women.

2. National Institutes of Health Office of Dietary Supplements. Calcium, Vitamin D, Magnesium, and B Vitamins Fact Sheets.

3. Weaver CM et al. Calcium plus vitamin D supplementation and bone health. New England Journal of Medicine.

4. Manson JE et al. Vitamin D supplementation and health outcomes. New England Journal of Medicine.

5. Thies F et al. Omega-3 fatty acids and cardiovascular risk in postmenopausal women. American Journal of Clinical Nutrition.

6. Ried K, Fakler P. Magnesium for menopausal symptoms. Nutrients.

7. Allen LH. Causes of vitamin B12 and folate deficiency. Food and Nutrition Bulletin.