Women's Health: Menopause Support | Elite Nutrition Serv

Menopause Support

Menopause management remains a significant gap in women’s healthcare. Only one-third of OB/GYN residency programs offer formal menopause training, leaving many providers underprepared to address menopausal symptoms. (1) This deficit is concerning given the prevalence of menopausal symptoms; 80% of women experience at least one symptom of menopause. (2)

While hormone therapy remains a cornerstone of menopause care, many women are exploring complementary and alternative therapies to support symptom management, either in conjunction with or independent of conventional treatment. (3)

The protocol focuses on foundational care for common menopausal symptoms (e.g., hot flashes, mood, and mild stress), particularly vasomotor symptoms such as hot flashes and night sweats. It includes evidence-based ingredients like black cohosh, chaste tree, rhubarb, ashwagandha, and saffron.

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About the Protocol

Black Cohosh

Recommended Dose: 40mg/day for at least 8 weeks (4-5)

Findings on black cohosh suggest it is most supportive for the following menopause-related symptoms: hot flashes – day or night, mood swings, sleep disorders and body aches.
In a double blind study, black cohosh was shown to be as effective as estrogen and superior to placebo in reducing hot flash symptoms. (6)
A systematic review of 25 clinical studies, found that black cohosh was superior to placebo for treating menopausal symptoms, including hot flashes, night sweats, sleep disturbances, mood swings, anxiety, and depression.

Ashwagandha

Recommended Dose: 125-600mg/day for at least 8 weeks (7 - 8)

Helps to counteract the effects of occasional stress
May support cardiovascular, immune, cognitive and joint function
These properties can be beneficial for menopausal women who are at increased risk of experiencing anxiety, depression, and sleep disturbances.

Saffron

Recommended Dose: 15mg 2x/day for at least 6 weeks (9)

A meta-analysis of eight studies found that saffron outperformed a placebo and was just as effective as fluoxetine (an SSRI) to treat depression. (10) Saffron can also be used safely alongside antidepressant medications to augment therapeutic outcomes in treating depression. (11)
The results of a double blind randomized clinical trial demonstrated significant improvements in hot flash-related daily interference and depression scores in the saffron-treated group compared to those who received the placebo, with no difference in rates of adverse effects. (9)

Chaste Tree Berry

Recommended Dose: 20-40mg/day (12 -13)

Chaste tree berry extract is a source of phytoestrogens and a popular herb among women who need support during premenstrual and menstrual cycles.

May help alleviate these symptoms by stabilizing hormonal fluctuations through its action on the hypothalamic-pituitary-gonadal axis. (13)
In a randomized clinical trial, women were given a placebo or chaste tree berry. Women who were given chaste tree berry had significantly lower mean scores for total menopausal disorder, anxiety, and vasomotor dysfunction compared to the placebo group. (14)

Rhaptonic Rhubarb

Recommended Dose: 4mg/day for 3 months to up to 2 years (15-17)

A randomized clinical trial demonstrated that rhaptonic rhubarb significantly decreased the Menopause Rating Scale II (MRS II) total score and the severity of hot flushes in perimenopausal women compared to placebo.(15)
Daily supplementation with rhubarb significantly reduced the MRS total score from 14.5 points at baseline to 6.5 points after six months. (16)

References

1. Allen, J. T., Laks, S., Zahler-Miller, C., et al. (2023). Needs assessment of menopause education in United States obstetrics and gynecology residency training programs. Menopause, 30(10), 1002–1005. https://doi.org/10.1097/gme.0000000000002234 2. Vazirani, A., & Ravichandiran, N. (2024). Prevalence of Menopausal Symptoms and Their Health Seeking Behavior in Postmenopausal Women in a Tertiary Care Hospital. Journal of Obstetrics Gynecology and Cancer Research, 9(4), 385–394. https://doi.org/10.30699/jogcr.9.4.385 3. Johnson, A., Roberts, L., & Elkins, G. (2019). Complementary and Alternative Medicine for Menopause. Journal of Evidence-Based Integrative Medicine, 24, 2515690X1982938. https://doi.org/10.1177/2515690×19829380 4. Carroll, D. G. (2006). Nonhormonal Therapies for Hot Flashes in Menopause. American Family Physician, 73(3), 457–464. https://www.aafp.org/pubs/afp/issues/2006/0201/p457.html 5. Castelo-Branco, C., Gambacciani, M., Cano, A., et al. (2020). Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms – an update on the evidence. Climacteric, 24(2), 1–11. https://doi.org/10.1080/13697137.2020.1820477 6. Wuttke, W., Seidlová-Wuttke, D., & Gorkow, C. (2003). The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas, 44 Suppl 1, S67-77. https://doi.org/10.1016/s0378-5122(02)00350-x 7. Akhgarjand, C., Asoudeh, F., Bagheri, A., et al. (2022). Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta‐analysis of randomized controlled trials. Phytotherapy Research, 36(11), 4115–4124. https://doi.org/10.1002/ptr.7598 8. Pandit, S., Srivastav, A. K., Sur, T. K., et al. (2024). Effects of Withania somnifera Extract in Chronically Stressed Adults: A Randomized Controlled Trial. Nutrients, 16(9), 1293. https://doi.org/10.3390/nu16091293 9. Kashani, L., Esalatmanesh, S., Eftekhari, F., et al. (2018). Efficacy of Crocus sativus (saffron) in treatment of major depressive disorder associated with post-menopausal hot flashes: a double-blind, randomized, placebo-controlled trial. Archives of Gynecology and Obstetrics, 297(3), 717–724. https://doi.org/10.1007/s00404-018-4655-2 10. Khaksarian, M., Behzadifar, M., Behzadifar, M., et al. (2019). The efficacy of Crocus sativus (Saffron) versus placebo and Fluoxetine in treating depression: a systematic review and meta-analysis. Psychology Research and Behavior Management, 12, 297–305. https://doi.org/10.2147/PRBM.S199343 11. Marx, W., Lane, M., Rocks, T., et al. (2019). Effect of saffron supplementation on symptoms of depression and anxiety: a systematic review and meta-analysis. Nutrition Reviews, 77(8), 557–571. https://doi.org/10.1093/nutrit/nuz023 12. Schellenberg, R. (2001). Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ, 322(7279), 134–137. https://doi.org/10.1136/bmj.322.7279.134 13. Webster, D. E., He, Y., Chen, S.-N., et al. (2010). Opioidergic mechanisms underlying the actions of Vitex agnus-castus L. Biochemical Pharmacology, 81(1), 170–177. https://doi.org/10.1016/j.bcp.2010.09.013 14. Naseri, R., Farnia, V., Yazdchi, K., et al. (2019). Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study. Korean Journal of Family Medicine, 40(6), 362–367. https://doi.org/10.4082/kjfm.18.0067 15. Naseri, R., Farnia, V., Yazdchi, K., et al. (2019). Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study. Korean Journal of Family Medicine, 40(6), 362–367. https://doi.org/10.4082/kjfm.18.0067 15. Heger, M., Ventskovskiy, B. M., Borzenko, I., et al. (2006). Efficacy and safety of a special extract of Rheum rhaponticum (ERr 731) in perimenopausal women with climacteric complaints. Menopause, 13(5), 744–759. 16. Kaszkin-Bettag, M., Beck, S., Richardson, A., et al. (2008). Efficacy of the special extract ERr 731 from rhapontic rhubarb for menopausal complaints: a 6-month open observational study. Alternative Therapies in Health and Medicine, 14(6), 32–38. https://pubmed.ncbi.nlm.nih.gov/19043936/ 17. Hasper, I., Ventskovskiy, B. M., Rettenberger, R., et al. (2009). Long-term efficacy and safety of the special extract ERr 731 of Rheum rhaponticum in perimenopausal women with menopausal symptoms. Menopause, 16(1), 117–131. https://doi.org/10.1097/gme.0b013e3181806446