Women’s hormonal health has emerged as one of the supplement industry’s fastest-growing innovation categories, and brands are increasingly developing products for menopause, perimenopause, the menstrual cycle and polyendocrine metabolic ovarian syndrome (PMOS, formerly PCOS).
Botanicals and herbal remedies have a long history of use in this space, but trials are beginning to explore more novel approaches, such as probiotics that work on the gut-brain or gut-estrogen axis, and NAD+ boosters, like nicotinamide riboside, that may influence hormones by regulating the body’s ‘master clock’.
While many clinical trials still focus on symptom management, such as reduction in menopausal hot flashes and mood swings, an increasing number are reporting measurable changes in endocrine markers, such as estrogen, progesterone and testosterone levels.
Below a look at the latest research exploring how a broadening range of supplement ingredients may influence women’s hormonal health.
Akkermansia postbiotic may improve metabolic, endocrine, reproductive and gut microbiome measures
Ingredient supplier Maypro recently announced the results of a human clinical trial which evaluated the effects of Akkermansia muciniphila supplementation in women with PMOS, formerly known as polycystic ovary syndrome (PCOS).
The randomized controlled trial included 100 women with obesity-associated PMOS who were receiving standardized oral contraceptive therapy. Participants were randomized to receive either the postbiotic, marketed at AKK Probio, or placebo for 12 weeks. In total, 92 women completed the intervention, including 47 in the intervention arm and 45 in the placebo group. A further 30 healthy women served as a reference group.
Participants in the intervention arm showed improvements in several measures compared to placebo, including significant reductions in fasting insulin, LDL cholesterol and serum testosterone, as well as improvements in acne, hirsutism (excessive hair growth) and regular menstrual cycles.
“This study provides the first clinical evidence that adjunctive [Akkermansia] postbiotic supplementation combined with standard oral contraceptive therapy may further improve metabolic and endocrine abnormalities in women with obesity-associated PMOS, thus establishing a promising therapeutic strategy for PMOS and laying a robust foundation for the future clinical translation of [Akkermansia],” wrote the researchers.
Probiotic supplementation may modulate hormonal factors in women with PMOS
A randomized clinical trial published in Nutrition Journal found that a combination of two probiotic strains, Lactobacillus helveticus and Bifidobacterium longum, may alleviate oxidative stress, modulate certain hormonal factors and reduce inflammation in women with PMOS.
The eight-week trial involved 90 women with PMOS from Iran who were randomized to receive the probiotic or a placebo. The researchers then collected blood samples, body weight measurements and evaluated clinical signs of hirsutism, acne and alopecia.
While between-group scores for hirsutism, acne and alopecia were not significant, the study revealed potential beneficial effects on hormonal parameters (including sex hormone binding globulin and testosterone), as well as oxidative stress and inflammatory markers.
“This study highlights the positive impact of probiotics on inflammation and oxidative stress, crucial factors in the pathophysiology of PCOS, which leads to insulin resistance, hyperandrogenism and menstrual irregularities,” the authors wrote. “These findings align with previous research showing probiotics help restore hormonal balance and reduce oxidative stress in metabolic disorders.”
Fenugreek-shatavari blend linked to estradiol increases in menopausal women
A randomized, double-blind, placebo controled trial evaluated the effects of Fenavari, a botanical ingredient from OmniActive Health Technologies containing a combination of fenugreek and shatavari designed to improve menopausal symptoms across somatic, psychological and vasomotor domains
The researchers recruited 150 menopausal women and randomly assigned them to receive either receive either Fenavari or a placebo for 12 weeks. Hormonal parameters (serum estradiol, progesterone, and follicle-stimulating hormone) were measured at baseline and on days 56 and 84. Menopausal symptoms, sleep, mood and anxiety were also assessed.
The study reported improvements in hot flashes, night sweats, sleep quality, mood and anxiety, as well as significant increases in estradiol and reductions in FSH levels versus placebo.
“Fenavari significantly improved menopausal symptoms across somatic, psychological and vasomotor domains from Day 14 onward and improved sleep, anxiety and mood along with favorable hormonal changes and good tolerability, supporting its potential as a safe non-hormonal option for menopause management,” the researchers wrote in Women’s Health Reports.
Waleria Healthtech’s Shatavari root extract shows promise for symptoms of perimenopause
A double-blind, randomized, placebo-controlled trial published in the Journal of Dietary Supplements suggests Shatavari root extract may offer benefits for perimenopausal women.
The researchers randomized 145 healthy perimenopausal women in India to receive either 500 mg of a full-spectrum shatavari root extract (Aspurus by Waleria Healthtech) per day or a placebo. Using the Menopause Symptom Severity Index (MSSI-38), the researchers found supplementation stabilized vasomotor symptoms such as hot flashes and night sweats within 14 days.
By the end of the 84-day trial, participants reported a 44% improvement in estrogen-linked brain fog and a 74% improvement in irritability and physical fatigue-energy. These improvements did not cease immediately after discontinuation, with benefits shown to continue over two weeks post-treatment.
“Perimenopause is a multifaceted transition; its clinical response cannot be judged by a single symptom or a single time point,” said Komal Baldwa, founder of Waleria Healthtech Pvt. Ltd., in India, which funded the study. “Showing an early response by day 14 provides the rapid validation consumers demand, while the broader, evolving efficacy up to 12 weeks underscores the strict commercial importance of continued compliance for long-term quality-of-life outcomes.”
Olly’s Mellow Menopause may relieve hormone-related hot flashes and improve mood
A combination of EstroG-100 (a herbal supplement made from Wilford’s cynanchum, Jerusalem sage and Korean angelica) and γ-aminobutyric acid (GABA) may support menopausal symptoms, including hot flashes, stress and mood swings.
Writing in the journal Menopause, a team of researchers evaluated the combination in 80 menopausal women, who were randomized to receive either the daily supplement (marketed as Mellow Menopause by Olly) or a placebo daily for five weeks.
Compared with placebo, supplementation significantly reduced the frequency and severity of hot flashes and was associated with improvements in sleep quality, anxiety, mood, stress and sexual function. Some benefits were observed after just 24 hours, whereas others appeared nearer the end of the five-week trial.
The authors suggested the supplement may therefore offer both short-term symptom relief and longer-term support.
Review assesses effects of inositol supplementation in women with PMOS
An umbrella review published in Frontiers in Endocrinology reported that inositol supplementation is a “promising therapy” for women with PMOS.
The review assessed 13 meta-analyses, with pooled analyses demonstrating that inositol significantly improved multiple outcomes compared to placebo, including a reduction in serum luteinizing hormone and free testosterone, and improved levels of sex hormone-binding globulin (SHBG) and androstenedione.
While high levels of luteinizing hormone can overstimulate the ovaries, disrupting ovulation and causing irregular periods, elevated levels of testosterone can cause hirsutism (excessive facial or body hair) and weight gain. Meanwhile, SHBG can lead to higher levels of male hormones and androstenedione can cause acne.
The researchers concluded that a daily intake of 2 to 4 grams of inositol is likely to be the most effective dose, preferably in combination with folic acid. They also recommended supplementation for at least 12 weeks to observe stable improvements in hormonal and metabolic markers, but warned that the findings are preliminary.
“These findings may offer novel insights for clinical PCOS management: Inositol could serve as a primary or adjunctive therapeutic agent,” the wrote. “While this discovery suggests potential value in improving these parameters, it should be regarded as a preliminary signal rather than a definitive conclusion.”
Elysium’s NR and PT supplement may improve estrogen ratios in menopausal women
Healthy aging and longevity supplement brand Elysium conducted an open-label pilot trial to test the effects of its supplement, marketed as Basis, in menopausal women.
Basis contains 250 mg of nicotinamide riboside chloride (NR) and 50 mg of pterostilbene (PT) per serving. In the trial, 40 healthy women over the age of 35 (of which 32 had menopausal symptoms and eight did not) were instructed to take one serving of the supplement daily for seven days.
The researchers conducted a menopausal symptom survey at the beginning and end of the trial, and assessed estrone, estradiol and vitamin B3 metabolism using urine samples. After one week, there were significant decreases in bloating, hot flashes and poor sleep, and improvements in estrogen ratios.
Specifically, there was an increase in estradiol-to-estrone ratio, which may support bone density, cardiovascular function, regular menstrual cycles, and cognitive or mood stability.
Because the study lacked a placebo group, a larger randomized, placebo-controlled study is currently being planned.
Ashwagandha root extract shown to improve hormonal parameters in menopausal women
Ashwagandha root extract may help to manage menopausal symptoms in healthy women, according to a study published in Frontiers in Reproductive Health.
The randomized, double-blind, placebo-controlled trial investigated the effects of ashwagandha supplementation in 60 women between the ages of 45 and 55. Half the women were randomly assigned to receive KSM-66 ashwagandha and the other a placebo.
After 56 days, women in the intervention arm reported significant improvements in menopause-related symptoms, including hot flashes, stress and quality of life compared with placebo. Significant hormonal changes were also observed, including increases in both estradiol and progesterone levels alongside reductions in follicle-stimulating hormone (FSH) and luteinizing hormone, but the researchers noted the need for further long-term studies.
“Ashwagandha (Withania somnifera) appears to be a promising herbal intervention for the management of menopausal symptoms,” they wrote. “The present study demonstrated statistically significant improvement in the MRS scale, selected hormonal parameters, hot flash, SF-12 scale, and perceived stress, over a duration of 56 days without adverse effects.”
Probiotic supplementation reduced androgen markers in women with PCOS
To evaluate whether probiotics may be an effective tool for PMOS, Iranian researchers evaluated the effect of probiotic supplementation on metabolic parameters and androgen levels in women with the condition.
Published in the Journal of Research in Pharmacy Practice, their randomized, double-blind trial examined the effects of Saccharomyces boulardii (a probiotic yeast) in 84 women over a 12-week period. By the end of the trial, women in the treatment group had significantly reduced circulating testosterone and dehydroepiandrosterone sulfate (DHEA-S) compared with placebo, suggesting that probiotic supplementation may influence hyperandrogenism, one of the hallmark features of PCOS.
The intervention, however, did not affect, weight, BMI or fasting blood sugar in most women.
“Several potential mechanisms could describe the favorable effects of probiotics in women with PCOS, including anti-inflammatory, antioxidant and beneficial metabolic effects, regulation of sex hormones and anti-lipopolysaccharide activities,” the researchers explained. “These effects, combined with the dysbiosis theory in PCOS pathogenesis, led to conducting studies to evaluate the therapeutic efficacy of prebiotics, probiotics and synbiotics.”
Key takeaways
- Science is moving beyond menopause into broader hormonal health: While menopause remains a major research focus, new studies are increasingly targeting PMOS/PCOS and menstrual health. This reflects a broader market shift from age-specific solutions to products that support women's hormonal health across different life stages.
- Gut-hormone axis is a major area of innovation: Several studies highlighted potential links between the microbiome and hormonal health. Postbiotics and probiotics are being utilized to improve endocrine markers, such as testosterone and SHBG, suggesting microbiome-targeted interventions could become an increasingly important category.
- Researchers are increasingly measuring hormones, not just symptoms: Historically, many women's health supplement trials relied on subjective endpoints such as hot flashes, mood and sleep. Increasingly, studies are also reporting changes in biomarkers including estradiol, progesterone, testosterone, FSH, LH, SHBG and DHEA-S, helping to strengthen scientific substantiation.
- Botanicals continue to dominate the evidence base: Despite growing interest in probiotics and longevity ingredients, herbal ingredients such as ashwagandha, shatavari and fenugreek continue to generate the largest volume of clinical data, reinforcing the enduring role of botanicals in women's health formulations.
- Many interventions appear to work through multiple pathways: The latest research suggests women's hormonal health is not solely about changing hormone levels. Several ingredients simultaneously influenced metabolic health, inflammation, oxidative stress, sleep, mood, cognition and reproductive outcomes. This reflects growing recognition that hormonal health is closely interconnected with broader physiological systems.
