If hormone balancing is your focus, the best peri products have these things on the label
Key takeaways:
Perimenopause support is about more than hormones: nutrition, movement, sleep, key nutrients and evidence-informed supplements can all form part of a wider approach to managing this transition.
Look beyond the ingredient list: when choosing a supplement, consider the specific ingredients, doses and clinical research behind them. Shatavari, DIM, evening primrose oil and vitamin B6 are the superstars in Ritual’s perimenopause formula*.
There’s no magic fix for perimenopause: symptoms can be supported with lifestyle changes, supplements and, where appropriate, medical treatments, so persistent or troublesome symptoms are worth discussing with a healthcare professional.
Perimenopause can be a confusing business. One month, everything feels entirely normal (that was last month, for me). The next, there’s rage where I’d built back patience, brain fog where there used to be a functioning filing system and a strange mish-mash of symptoms that could be perimenopause, PMS, mom burnout or simply having a lot going on.
The thing is, I honestly think these days it’s all of the above. And at 40, I’m starting to recognize some of those shifts in my own body.
I’m also still factoring baby number three into the equation, which makes the whole question of hormones particularly interesting. So when I heard that Ritual had developed a perimenopause supplement in partnership with OB/GYNs^, I was all ears.
But – when there are literally so. many. peri products available on and offline – what makes a hormone-free perimenopause treatment worth considering? And what should actually be on the label of a perimenopause supplement?
Here’s what I’m learning.
7 natural menopause treatments that really work, with consistency
From clinically backed herbs to the basics of sleep hygiene, “natural menopause treatment” can mean a lot of things. There isn’t one natural remedy that works for every woman or every symptom, but there are several evidence-informed approaches that can make a real, tangible difference – and form part of a wider perimenopause toolkit.
The seven I’d focus on are:
- Eating a balanced, nutrient-rich diet
- Regular movement, including strength training
- Protecting sleep and managing stress
- Getting the right vitamins and minerals
- Supporting healthy estrogen metabolism with compounds such as DIM
- Considering researched herbs such as shatavari
- Choosing a supplement with clinically studied ingredients
One crucial must-have – consistency. Aside from just simply feeling better from a good night’s sleep, we can’t expect a week of new supplements and nutrition focus to move the needle. Habit stack and build these into your routine, give them months (not days) to become your new normal, and the benefits might just take you by surprise.
That said, shatavari extract is clinically studied to support mood, ease hot flashes and night sweats and improve sleep within four weeks, and support vaginal dryness and fatigue within eight weeks*. So yes, these treatments can really work on a much deeper level, with a consistent approach.
Let’s deep dive.
1. Start with food and nutrition
Nutrition is a useful place to start because the body still needs the same basic building blocks, even when hormones are changing.
A varied diet containing plenty of protein, fibre, fruit and vegetables, whole grains and sources of healthy fats can provide a broad range of essential nutrients.
There is also a particular role for foods containing phytoestrogens, such as soy foods, flaxseeds and some legumes. These plant compounds have estrogen-like activity, although they aren’t the same thing as estrogen and shouldn’t be considered a substitute for it.
And this is where I’d resist the urge to make things unnecessarily complicated. There isn’t a single “menopause diet”. Good nutrition is about the overall pattern rather than one miracle food. Certain star players can really help, though.
2. Keep moving – and don’t forget strength
Exercise is another cornerstone of midlife health.
Walking, swimming, dancing, cycling and other cardiovascular activities can all contribute to fitness, while resistance training and weight-bearing exercise become particularly important for maintaining muscle and supporting bone health as estrogen changes.
For me, this is also one of the more enjoyable parts of the equation. Movement doesn’t have to mean an hour in the gym. A strength session, a swim, a brisk walk or an enthusiastic kitchen dance all count towards a more active day.
My current regular movement plan is as follows, and I’m loving it:
- 10-12K steps / day
- strength training 3-4 / week (using an app)
- weekly yoga class (I’m currently enjoying intermediate vinyasa – it’s chill but definitely still a workout)
- lap swimming (whenever possible, at least once / month)
3. Protect sleep and make space for recovery
Sleep can be both a treatment and a casualty of perimenopause.
Night sweats can obviously interfere with it, but changing hormones aren’t the only consideration. Stress, alcohol, caffeine, screen habits and an overfull schedule can all make restorative sleep harder to achieve.
A consistent bedtime, cooler bedroom, regular movement and a little breathing room before lights out can all help create better conditions for sleep. Targeted supplementation focusing on ingredients like magnesium and melatonin can also be super-helpful – Magnesium+ would be a great bolt-on here, for me.
If sleep disruption is persistent, particularly alongside significant night sweats or other symptoms, it’s worth discussing the wider picture with a healthcare professional rather than assuming it’s something to simply put up with.
4. Consider targeted supplementation
There isn’t one universally ‘best vitamin’ for perimenopause. Different vitamins and minerals have different roles, and supplementation is most useful when it reflects an individual’s needs and symptoms.
Vitamin D, for example, contributes to the maintenance of normal bones and muscles during this period (I take mine separately in a spray, which lets me control the dosage), while vitamin B6 (a key part of Ritual’s Perimenopause Health formula) contributes to the regulation of hormonal activity and normal psychological function.*
That makes the dose and purpose of an ingredient important. A longer ingredient list isn’t automatically a better one – more isn’t necessarily more effective.
It’s also important to distinguish nutritional support from treating a deficiency or symptom. Supplements have a role, but they aren’t a replacement for a varied diet or appropriate medical care.
5. Can vitamins increase estrogen levels?
This is where the language around “hormone balance” can get a little muddled.
There isn’t a vitamin that can reliably and predictably increase estrogen levels during perimenopause. Estrogen doesn’t simply decline in a straight line – levels can fluctuate considerably throughout the transition.
Rather than trying to increase estrogen, some supplements focus on supporting healthy estrogen metabolism and balance.
One example is DIM, or diindolylmethane.
6. Where does DIM fit with estrogen metabolism?
DIM is a compound produced when the body digests indole-3-carbinol, which occurs naturally in cruciferous vegetables such as broccoli and cabbage.
It has attracted interest because of its involvement in estrogen metabolism. It isn’t estrogen itself and isn’t an estrogen replacement. The rationale is instead around supporting how the body processes estrogen.
Ritual’s Perimenopause Health contains 60mg of DIM per serving, alongside shatavari, evening primrose oil and vitamin B6.
That combination is designed to support hormone balance rather than simply attempting to increase estrogen levels.*
7. What about herbs for perimenopause?
Herbs have a long history in women’s health, but the evidence behind them varies considerably.
Shatavari is one botanical that has attracted particular interest. An Ayurvedic herb, it has been studied in relation to women’s hormonal health and several areas relevant to perimenopause.
Ritual uses a standardized shatavari extract called SheVari4™. It’s been evaluated in three separate clinical studies, including research into hot flashes and night sweats, sleep, mood, vaginal dryness and physical and mental fatigue.*
Ritual also states that the extract has been clinically studied in relation to healthy levels of estrogen, progesterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH).*
That’s an important distinction when considering herbs for perimenopause. The botanical name alone doesn’t tell the whole story – the particular extract, amount used and research behind it all matter.
What can I take for hot flashes and night sweats?
Hot flashes and night sweats are among the symptoms most closely associated with perimenopause, although not everyone experiences them. My hot flashes started about a year ago but seem to have stopped – I have no idea why, other than that I really have been using the tool kit you’re reading now with obsessive consistency this year! And yes, I supplement with shatavari almost every day.
There are several nutrients and botanical ingredients that have been studied in relation to these symptoms, but the strength of evidence varies.
Ritual’s Perimenopause formula contains 100mg of SheVari4™ shatavari extract, which has been clinically shown to support hot flashes and night sweats and improve sleep in as little as four weeks.
That doesn’t mean shatavari will work for everyone, or that a supplement should replace medical treatment as discussed with your doctor. It means there is specific clinical research behind the shatavari extract used in this particular formula.
Look for clinically backed claims
Our supplement in the spotlight here is Ritual’s Perimenopause Health.
Developed in partnership with OB/GYNs on Ritual’s Scientific Advisory Board, the formula is designed for women over 40 or experiencing perimenopausal symptoms. It is hormone-free and combines four key ingredients:
- 60mg diindolylmethane (DIM) per serving
- 250mg evening primrose oil
- 100mg SheVari4™ shatavari extract
- 0.9mg vitamin B6
DIM and shatavari are included to support estrogen balance, while vitamin B6 supports hormonal activity. Checking in with Ritual, I’ve learned that evening primrose oil can help support the absorption of DIM and may help ease perimenopausal discomfort, such as hot flashes.
The formula is vegan, third-party tested, sugar-free, gluten-free, soy-free, major-allergen free and drug-free.
For me, that’s much more appealing than simply having the longest possible ingredient list. I want to know what I’m taking, how much I’m taking and why those particular ingredients have been selected. And, that potency is sound.
How to test for perimenopause
At 40, this is something I’m particularly interested in, because a collection of new symptoms doesn’t necessarily arrive with a neat label attached.
For women over 45, perimenopause is generally diagnosed based on symptoms and menstrual changes rather than routine hormone testing, because hormone levels can fluctuate considerably during the transition.
Under 45, the situation can be different. If symptoms suggest early perimenopause, a doctor may consider the overall clinical picture and whether blood tests or other investigations are appropriate.
A single hormone test isn’t necessarily a definitive “yes, this is perimenopause” result. FSH, estrogen and other reproductive hormones can vary according to where someone is in their menstrual cycle and the stage of the transition.
Can you reverse perimenopause?
No supplement or treatment can reverse perimenopause.
The menopause transition is a natural biological process. The aim of lifestyle changes, supplements and medical treatments is to support the body and manage symptoms rather than turn the clock back.
For me, that’s actually quite a reassuring way to look at it.
At 40, my experience so far is less a textbook list of symptoms and more a confusing collection of “Is this perimenopause, PMS or just Tuesday?”
Hello, rage. Hello, brain fog. Hello, mysterious symptoms that seem to move around from month to month.
I’m not looking for a magic capsule that turns back the clock. I’m looking for sensible, evidence-informed support for a stage of life that can feel surprisingly murky – particularly when I’m still leaving the door open to baby number three. And yes, you can absolutely still get pregnant in perimenopause.
Scanning the label? This is what we like to see
When it comes to what to look for in a perimenopause supplement, Ritual’s formula checks the boxes we’ve covered:
- a hormone-free formula developed with OB/GYN^ input
- intentional ingredients at considered doses, and
- clinical research behind key ingredients such as shatavari and DIM.
It gets a big ‘yes’ from me, as a clinically-studied, supportive option – one to potentially add to my wider perimenopause toolkit.
Explore Ritual Perimenopause to learn more about the formulation and ingredients.
^Developed with 2 medical [doctors/practitioners] on Ritual’s Scientific Advisory Board
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
