Conducted by public health nutritionist Shefalee Loth, principal researcher at Which?, and consultant dietitian Sophie Medlin, the analysis reviewed 26 popular supplements marketed for perimenopause and menopause sold by retailers such as Amazon, Boots and Holland & Barrett.
Each of the products were evaluated based on their cost per daily dose, vitamin, mineral and botanical content, and additives, such as bulking and filler agents. Overall, none of the products were recommended for Which?’s Best Buys.
This is an anomaly, with Which? recently recommending six vitamin D products and five magnesium supplements for Best Buys after two separate analyses.
Loth said the main issue with menopause supplements is the lack of credible evidence for many botanical ingredients commonly used, low doses of active ingredients, and the cost attached, with some menopause supplements costing £1.33 per daily dose. In contrast, some multivitamin products cost as little as 6p per day.
However, Jen Julian, COO of GenM, home to the universal shopping symbol for menopause-friendly products the MTick, said the analysis has omitted some important considerations, including nutrient forms.
“Whilst the Which? analysis provides guidance on the key nutrients required during the menopause transition, it does not include recommendations on nutrient forms, which can perform different functions and influence bioavailability and absorption in the body. The use of more natural, active forms of nutrients can also significantly affect price,” she said.
“However, the presence of an ingredient does not, on its own, demonstrate that a product will provide the intended support. Both the evidence behind the ingredient and the amount included matter.”
Supplements ‘are not medicines for treating menopause symptoms’
Products evaluated by Which? include menopause supplements from Holland & Barrett, Wild Nutrition and Love Mushrooms.
Containing vitamin B6, sage leaf, green tea extract and red clover extract, Holland & Barrett’s Menopause Complex costs 50p per day. Consumers are directed to take two tablets – one containing a mix of vitamins and minerals and the other a blend of botanicals.
According to the reviewers, the vitamin and mineral tablet contains several well-dosed nutrients that are well established as important in the menopause. However, the botanical tablet only contains red clover at a beneficial dose, with the rest of the ingredients under-dosed.
Dr. Abbie Cawood, director of science at Holland & Barrett, said while the retailer welcomes scrutiny that helps consumers make informed choices about their health, food supplements are designed to provide nutritional support alongside a varied and balanced diet; they are not medicines for treating menopause symptoms.
“Our menopause supplements are multi-ingredient formulations designed to provide nutritional support relevant to women during this life stage,” she said. “When assessing them, it is important to consider the intended role of the complete formulation as well as individual ingredients, their form and dose.
“A number of the vitamins and minerals in our Menopause Complex are provided at or above 100% of their Nutrient Reference Value. This does not mean that every ingredient is intended to replicate the dose used in research on a standalone intervention.”
Evidence for botanical ingredients also varies according to the specific botanical extract, standardization and dose, Cawood said, adding that Holland & Barrett does not assume that the presence of a botanical makes a multi-ingredient supplement equivalent to a standalone clinically studied intervention.
Avoiding a ‘one-size-fits-all’ approach
Wild Nutrition’s Perimenopause Complex suffered the opposite problem – well-dosed botanicals but a lack of vitamins and minerals, according to the reviewers. The supplement contains vitamin B6, magnesium, iron, Shatavari powder and saffron, costing £1.20 a day, making it one of the more expensive supplements on the list.
Two other products from Wild Nutrition were evaluated by Which? including the brand’s Menopause Complex and its Daily Mutli Nutrient 45+ for women. While the first product was criticized for using botanicals which aren’t well documented for menopause use, the latter was “disappointing” due to its nutritional content failing to meet recommended daily intake levels.
Isabelle Nunn, head of nutrition, science and formulation at Wild Nutrition said Women’s Daily 45+ was never released solely for menopause, and featuring this product in the review is “grossly misleading”.
“Designed specifically for women during this life stage [age 45+], our formula blends 32 vitamins, minerals, botanicals and antioxidants,” she said. “It is labeled ‘menopause friendly’ because it complements our wider range and serves as a foundational daily nutrient alongside more targeted formulas. Which? chose not to review these specific transition products, despite receiving this information.”
Nunn added that managing the risks of both under-dosing and over-dosing is central to Wild Nutrition’s formulation process. For example, while calcium is recommended for menopause, excessive supplementation (i.e. 700 mg daily) carries risks, as unabsorbed calcium can deposit in soft tissue and increase cardiovascular risks. The same is true for vitamin D, which is fat soluble and bioaccumulates.
Wild Nutrition’s supplements also use a ‘food grown’ approach, focusing on the synergistic action of combined nutrients along with all their co-factors, bioflavonoids and antioxidants rather than isolated ingredients. This impacts both the bioavailability and absorption of the ingredients, as well as the overall cost.
“Our co-founder and technical director Henrietta Norton and I both have decades of experience in nutrition, science, and women’s health,” Nunn added. “Drawing on my pharmacy background and our combined expertise, we do not take a one-size-fits-all approach. This does not work in the medical industry or the pharmaceutical industry, as well as in the supplements industry.”
High costs often reflect ingredient quality
Some of the menopause products evaluated took a different approach. For example, costing 50p-£1.33 per day, Love Mushrooms’ Empower Mushroom Blend contains lion’s mane, shiitake, cordyceps and reishi alongside vitamins, minerals and botanicals such as red clover, sage leaf and hops.
The assessors praised the product for its well-dosed, well-chosen vitamin and mineral complex (bar the omission of calcium and magnesium), but said the many of the botanical and mushroom ingredients are not currently supported by a large body of high-quality, robust clinical evidence to support their use for menopause.
Smith Feeney, founder of Love Mushrooms, said while the brand welcomes independent scrutiny of the supplement industry, the range was developed as a targeted formulation combining functional mushrooms, botanicals vitamins and minerals, rather than as an all-in-one complete menopause multivitamin designed to provide every nutrient that may be relevant during menopause.
“Regarding magnesium and calcium, Empower was intentionally formulated as a broader combination of specialist ingredients rather than as a conventional calcium or magnesium supplement,” he said. “It was not designed to be a catch-all multivitamin, but to bring together a carefully selected range of ingredients at meaningful levels.”
Smith also defended the cost of the product, highlighting that the blend contains a high inclusion level of saffron, which is an exceptionally costly botanical ingredient, alongside lion’s mane and a substantial range of other mushroom extracts, botanicals, vitamins and minerals. The brand also offers subscription plans which significantly reduces the overall price.
“The retail price reflects both the breadth of the formulation and the cost and quality of the ingredients used,” he said. “Looking only at the daily headline cost does not, in our view, give consumers the full picture of the value of the formulation.”
MTick designed to help women identify evidence-based products
While Which?’s review frequently highlighted low doses of active ingredients in menopause supplements, a recent review by UCL researchers published in Climacteric highlighted that some nutrients can have adverse effects when consumed in excess over time.
In addition, first author Poppy Sullivan, UCL EGA Institute for Women’s Health and Queen Mary University of London, highlighted that certain botanical ingredients carry risks. For example, black cohosh is known to carry a potential risk of liver toxicity. Conservative dosing is therefore often intentional to ensure safety.
The review of 201 menopause supplements also found large cost variations and highly variable ingredients, concluding that “they are being sold to women as a way to reduce menopause symptoms despite the limited empirical evidence currently available.”
Julian told NI that these variations are exactly why the MTick was created, with each product awarded the accreditation undergoing a rigorous, independent assessment against robust menopause-friendly criteria, demonstrating how it can support one or more specific signs of menopause.
“For supplements and nutritional products, this includes alignment with EFSA-approved health claims, minimum inclusion levels of key nutrients relevant to the needs of menopausal women, compliance with established safe upper limits, clinical evidence supporting ingredient inclusion, adherence to applicable labeling regulations and post-manufacture product analysis,” she said. “Where nutrient reference values are unavailable, as is typically the case for botanicals, ingredient inclusion levels must be supported by appropriate scientific evidence and relevant herbal guidance.
“Fundamentally, supplements should complement a healthy diet and lifestyle, with food remaining the primary source of key nutrients for women during menopause.”
