What supplements matter during perimenopause?

A woman in her late 40s stands in front of the mirror, brushing her hair, and notices something subtle but unmistakable: her reflection looks the same, but the feeling behind it is shifting. Sleep is patchy.

Perimenopause is the phase that can last a decade before menopause officially arrives. Hormones are in flux, not gone.

Medium-dose creatine hydrochloride at 1,500 mg per day improves reaction time and reduces mood swings in perimenopausal women. Creatine is often thought of as a muscle supplement, but the brain also uses creatine for energy, particularly in high-demand areas like the frontal cortex.

Certain probiotics, specifically Levilactobacillus brevis KABP052, have shown the ability to maintain serum estradiol and estrone levels in perimenopausal women. This strain produces β-glucuronidase, an enzyme that can reactivate conjugated estrogen in the gut, potentially helping to modulate estrogen levels through the microbiome.

Calcium supplementation remains relevant for bone health, particularly for women with low dietary calcium intake. Bone density declines more rapidly in the first five years after menopause, and calcium intake during this window can help attenuate that loss, especially in the radius and spine.