scientific evidence on effectiveness and long-term safety is mixed. Glucosamine/Chondroitin: This evidence-backed supplement is made of naturally occurring components Menopause is the time when menstrual periods permanently stop, marking the end of the reproductive stage for the female human. It typically occurs between the ages of 45 and 55, although the exact timing can vary. Menopause is usually a natural change related to a decrease in circulating blood estrogen levels. It can occur earlier in those who smoke tobacco. Other causes include surgery that remov Vitamin D & Calcium: Crucial to maintaining bone density, which can begin to decline in perimenopause. Vitamin D can also help with immunities and mood. B-Complex: B viatmins (especially B6) can boost energy, cognitive function, and ease irritability. Black Cohosh: Popular for hot flash relief, though scientific evidence on effectiveness and long-term safety is mixed. Glucosamine/Chondroitin: This evidence-backed supplement is made of naturally occurring components of cartilage. Supplementation can slow cartilage breakdown and help manage osteoarthritis discomfort. Flaxseed: Rich in omega-3 fatty acids and lignans, which can help manage hormone levels and decrease the severity of night sweats. Maca Root: Popular, non-hormonal adaptogen used to help manage perimenopause and menopause symptoms. Works by supporting the endocrine and nervous systems to aid with hormone balance (without acting as a direct source of estrogen), energy & mood, and libido. And others. Consult your physician for further recommendations and before starting on any supplementation. There is evidence of small decreases in verbal memory, on average, which may be caused by the effects of declining estrogen levels on the brain, or perhaps by reduced blood flow to the brain during hot flashes. However, these tend to resolve for most women during the postmenopause. Subjective reports of memory and concentration problems are associated with several factors, such as lack of sleep, and stress. === Long-term effects === ==== Cardiovascular health ==== Exposure to endogenous estrogen during reproductive years provides women with protection against cardiovascular disease, which is lost around 10 years after the onset of menopause. The average age of the last period in the United States is 51 years, in Russia is 50 years, in Greece is 49 years, in Turkey is 47 years, in Egypt is 47 years and in India is 46 years. Beyond the influence of genetics, these differences are also due to early-life environmental conditions and associated with epigenetic effects. The menopausal transition or perimenopause leading up to menopause usually lasts 3–4 years (sometimes as long as 5–14 years). Undiagnosed and untreated coeliac disease is a risk factor for early menopause. Coeliac disease can present with several non-gastrointestinal symptoms, in the absence of gastrointestinal symptoms, and most cases escape timely recognition and go undiagnosed, leading to a risk of long-term complications. A strict gluten-free diet reduces the risk. Women with early diagnosis and treatment of coeliac disease present a normal duration of fertile life span. Women who have undergone hysterectomy with ovary conservation go through menopause on average 1.5 years earlier than the expected age. === Premature ovarian insufficiency === In rare cases, a woman's ovaries stop working at a very early age, ranging anywhere from the age of puberty to age 40. Outdated research cited the use of MHT appeared to increase the risk of strokes and blood clots, but the FDA removed broad "black box" warnings related to this misinformation from most MHT products in February of 2026. When used for menopausal symptoms the global recommendation is MHT should be prescribed for as long as there are defined treatment effects and goals for the individual woman. MHT is also effective for preventing bone loss and osteoporotic fracture, but it is generally recommended only for women at significant risk for whom other therapies are unsuitable. Tamoxifen is in widespread use for treatment of hormone sensitive breast cancer. Raloxifene prevents vertebral fractures in postmenopausal, osteoporotic women and reduces the risk of invasive breast cancer. === Other medications === Some of the SSRIs and SNRIs appear to provide some relief from vasomotor symptoms. The most effective SSRIs and SNRIs are paroxetine, escitalopram, citalopram, venlafaxine, and desvenlafaxine. They may, however, be associated with appetite and sleeping problems, constipation and nausea. Gabapentin or fezolinetant can also improve the frequency and severity of vasomotor symptoms. Side effects of using gabapentin include drowsiness and headaches. That being said, every woman's body is different and many women in perimenopause and menopause have been given medical advice to try OTC dietary supplements to ease symptoms. Some of the supplements often recommended by doctors are: Vitamin D & Calcium: Crucial to maintaining bone density, which can begin to decline in perimenopause. Vitamin D can also help with immunities and mood. B-Complex: B viatmins (especially B6) can boost energy, cognitive function, and ease irritability. Black Cohosh: Popular for hot flash relief, though scientific evidence on effectiveness and long-term safety is mixed. Glucosamine/Chondroitin: This evidence-backed supplement is made of naturally occurring components of cartilage. Supplementation can slow cartilage breakdown and help manage osteoarthritis discomfort. Flaxseed: Rich in omega-3 fatty acids and lignans, which can help manage hormone levels and decrease the severity of night sweats. Maca Root: Popular, non-hormonal adaptogen used to help manage perimenopause and menopause symptoms. Works by supporting the endocrine and nervous systems to aid with hormone balance (without acting as a direct source of estrogen), energy & mood, and libido. And others. Consult your physician for