Menopause

    Researchedby:
    Meredith Yetter, Katie Jantz

    Fact-checked

    by:

    Morgan Pfiffner, James Gaylor
    Last Updated: January 15, 2023

    Menopause is the stage of life when menses permanently cease, and the reproductive system no longer performs functions related to fertility. A woman is considered to have entered menopause after menses have stopped for 12 months.

    Menopause falls under the Women’s Health category.

    30 references on this page
    23,785 participants in 74 trials and 9 meta-analyses

    What is menopause?

    Natural menopause is when menses permanently cease because the ovaries stop producing estrogen and progesterone. It generally occurs in women after 45 years of age with no pathological or physiological cause, but early menopause can result from surgery, chemotherapy, radiotherapy, or primary ovarian insufficiency. Perimenopause is the transitional phase into menopause and may last between 4 to 8 years.[1]

    What are the main signs and symptoms of menopause?

    Hot flashes, night sweats, vaginal dryness, insomnia, trouble focusing, and mood swings are the primary symptoms women experience during the transition into and sometimes throughout menopause. Women can also experience changes in body composition. The main sign of menopause is a lack of menstruation.

    Is menopause associated with an increased risk of cardiovascular disease?

    What are hot flashes, when do they occur, and how long do they last?

    How does menopause affect urogenital tissue?

    What are some other conditions that are associated with menopause?

    How is menopause diagnosed?

    Menopause is clinically diagnosed after 12 months of amenorrhea (lack of mentruation) without other causes, such as surgical removal of the ovaries, chemotherapy or radiotherapy, or primary ovarian insufficiency. It usually occurs after 45 years of age and is considered abnormal if it occurs prior to 40 years of age. Blood and urine tests can be conducted to detect changes in hormone levels.[2]

    What are some of the main medical treatments for menopause?

    The main medical treatments for menopause symptoms include both nonhormonal and hormonal (hormone replacement therapy (HRT)) options. Treatment is usually individualized based on the types of symptoms being managed, personal and family medical history, age, and personal preference.

    For vaginal symptoms, such as dryness, burning, and pain during intercourse, nonhormonal options like vaginal moisturizers and lubricants can be helpful for less severe symptoms. When symptoms are more severe, locally applied estrogen medications can be effective; however, local treatments will not improve other menopause symptoms like hot flashes.[3]

    When systemic symptoms are present (e.g., hot flashes, night sweats, sleep disturbances, low mood), systemic HRT that provides estrogen, with or without progesterone, is the most effective option. This can be taken in a variety of ways (e.g., oral pill, skin patch or gel, vaginal ring), all of which carry their own risks and benefits. HRT may also reduce the risk of osteoporosis, type 2 diabetes, and colorectal cancer.[4][5][6] For people unable or unwilling to take HRT, non-hormonal options, like antidepressants, may also help to reduce hot flashes and improve mood.[7]

    Despite the benefits of HRT, there are risks associated with this treatment, and it is not appropriate for everyone. For most women who start HRT within 10 years of menopause or before age 60, the benefits generally outweigh the risks.[7]

    Is there a role for compounded bioidentical hormones in menopause treatment?

    What are the main risks associated with hormone replacement therapy?

    Are there recommendations for women who started menopause early?

    Have any supplements been studied for menopause?

    A number of botanical and other nutritional supplements have been investigated for the treatment of menopausal symptoms. Black cohosh, red clover, omega-3 fatty acids, dehydroepiandrosterone (DHEA), evening primrose oil, Vitex agnus-castus, soy isoflavones and St. John's wort are among the variety of supplements purported to reduce menopausal symptoms.

    How could diet affect menopause?

    Hormone changes during menopause can negatively affect lipid and glucose metabolism. The American Heart Association recommends women consume a diet rich in fruits, vegetables, high-fiber whole grains, and oily fish, and that they limit saturated fat, cholesterol, alcohol, sodium, and sugar and avoid trans-fatty acids.

    Are there any other treatments for menopause?

    Exercise like yoga may be particularly helpful for vasomotor and psychological symptoms.[8] Strength and resistance training are especially important for maintaining muscle mass and bone mineral density, especially when combined with high-impact exercises like jumping, skipping, and jogging.[9]

    What causes menopause?

    Menopause is a natural condition that occurs as women age. Over time, a woman’s ovarian follicles and granulosa cells diminish. Given these cells are the main producers of estradiol and inhibin[10] (a hormone that tells the pituitary gland to make less follicle-stimulating hormone), the body’s hormonal balance shifts toward lower estrogen and progesterone levels and increased follicle-stimulating hormone and luteinizing hormone levels. This hormonal profile results in irregular menstrual cycles, which ultimately stop altogether.

    Hormonal variations across a woman's lifetime

    image

    Does low estrogen cause sexual dysfunction?

    Examine Database: Menopause

    Red Clover Extract
    Black Cohosh
    DHEA
    Maca
    Fish Oil
    Panax Ginseng (Korean Ginseng)
    Vitamin K
    Boron
    Curcumin
    Magnesium
    Valerian
    Astaxanthin
    Blueberry
    Cannabis
    Conjugated Linoleic Acid
    Creatine
    Evening Primrose Oil
    Inositol
    Kudzu
    Lion's Mane
    Paleolithic Diet
    Progressive Muscle Relaxation
    Pueraria Mirifica
    Pycnogenol
    Resveratrol
    Royal Jelly
    Safflower Oil
    Saffron
    Sodium Bicarbonate
    Soy Protein
    Traditional Chinese Medicine
    Tribulus Terrestris
    Vegan Diet
    Vitamin D
    Whey Protein
    Yerba Mate

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    Frequently asked questions

    What is menopause?

    Natural menopause is when menses permanently cease because the ovaries stop producing estrogen and progesterone. It generally occurs in women after 45 years of age with no pathological or physiological cause, but early menopause can result from surgery, chemotherapy, radiotherapy, or primary ovarian insufficiency. Perimenopause is the transitional phase into menopause and may last between 4 to 8 years.[1]

    What are the main signs and symptoms of menopause?

    Hot flashes, night sweats, vaginal dryness, insomnia, trouble focusing, and mood swings are the primary symptoms women experience during the transition into and sometimes throughout menopause. Women can also experience changes in body composition. The main sign of menopause is a lack of menstruation.

    Is menopause associated with an increased risk of cardiovascular disease?

    Menopause has been associated with increases in many cardiovascular risk factors including higher total serum cholesterol, triglycerides, and diastolic blood pressure.[11] Longitudinal research has found that HDL levels decrease postmenopausally, and this change appears to be more pronounced among women with a high BMI.[12] Furthermore, menopause has been associated with changes in lipoprotein metabolism and increased inflammation.[13]

    The association between menopause timing and cardiovascular disease (CVD) risk may be bidirectional, meaning that younger age at natural menopause is considered a marker of increased risk of CVD.[14]

    Keep in mind, though, that menopause is not a disease. It is a natural phase of life. Overall the association between menopause and CVD risk is mixed, particularly in otherwise healthy women (e.g., nonsmoking women with a healthy BMI) who transition into menopause at a typical age.[15]

    What are hot flashes, when do they occur, and how long do they last?

    Vasomotor symptoms (VMS), more commonly known as hot flashes and night sweats, affect roughly 80% of women in their late-forties to mid-fifties. They often begin in perimenopause (i.e., the time around menopause), and peak in the later perimenopause and early postmenopausal years. Hot flashes present as a feeling of intense heat, resulting in sweating and flushing, predominantly around the head, neck, chest, and upper back. The physiology of hot flashes is not fully known, but they are presumed to be linked to low estrogen and elevated luteinizing hormone.[18]

    Not all menopausal women experience hot flashes, so there may be other biological mechanisms at play. Some evidence points to a narrowing of the thermal neutral zone (the range of body temperatures where an organism doesn’t have to expend extra energy to warm or cool) during menopause, meaning slight temperature fluctuations can trigger thermoregulatory processes that dissipate heat, resulting in flushing and sweating.[19]

    How does menopause affect urogenital tissue?

    Genitourinary syndrome of menopause (GSM), or vaginal atrophy, results from a loss of estrogen. GSM results in a variety of adverse consequences, like vaginal dryness, burning, increased urinary frequency, and recurring bladder infections. For many women, this condition requires long-term management. For moderate to severe cases of GSM, low-dose vaginal estrogen is regarded as the most effective treatment, and for mild cases, non-hormonal topical lubricants are recommended.[20]

    What are some other conditions that are associated with menopause?

    The following are some other conditions that commonly occur during menopause:

    • Perimenopausal women are 2 to 4 times more likely to suffer from depression, and some women have reported increased episodes of forgetfulness during this time.
    • The risk of developing heart disease increases with age, and it increases even more in women after menopause due to declining estrogen and increased blood pressure, LDL cholesterol, and triglycerides.
    • Osteoporosis risk increases in menopause. Bone loss occurs in two phases. The first phase occurs in perimenopause, as bone resorption increases due to estrogen deficiency. The second phase occurs 4 to 8 years after the menopausal transition, when bone formation slows.[1]
    How is menopause diagnosed?

    Menopause is clinically diagnosed after 12 months of amenorrhea (lack of mentruation) without other causes, such as surgical removal of the ovaries, chemotherapy or radiotherapy, or primary ovarian insufficiency. It usually occurs after 45 years of age and is considered abnormal if it occurs prior to 40 years of age. Blood and urine tests can be conducted to detect changes in hormone levels.[2]

    What are some of the main medical treatments for menopause?

    The main medical treatments for menopause symptoms include both nonhormonal and hormonal (hormone replacement therapy (HRT)) options. Treatment is usually individualized based on the types of symptoms being managed, personal and family medical history, age, and personal preference.

    For vaginal symptoms, such as dryness, burning, and pain during intercourse, nonhormonal options like vaginal moisturizers and lubricants can be helpful for less severe symptoms. When symptoms are more severe, locally applied estrogen medications can be effective; however, local treatments will not improve other menopause symptoms like hot flashes.[3]

    When systemic symptoms are present (e.g., hot flashes, night sweats, sleep disturbances, low mood), systemic HRT that provides estrogen, with or without progesterone, is the most effective option. This can be taken in a variety of ways (e.g., oral pill, skin patch or gel, vaginal ring), all of which carry their own risks and benefits. HRT may also reduce the risk of osteoporosis, type 2 diabetes, and colorectal cancer.[4][5][6] For people unable or unwilling to take HRT, non-hormonal options, like antidepressants, may also help to reduce hot flashes and improve mood.[7]

    Despite the benefits of HRT, there are risks associated with this treatment, and it is not appropriate for everyone. For most women who start HRT within 10 years of menopause or before age 60, the benefits generally outweigh the risks.[7]

    Is there a role for compounded bioidentical hormones in menopause treatment?

    Bioidentical hormones are hormones that are identical to what is found naturally in the body, and compounded medications are those that are prepared in a pharmacy (as opposed to being commercially manufactured). Compounded bioidentical hormones are often marketed as being a “natural” HRT alternative, but many people don’t realize that some conventional, commercially-manufactured HRT medications also use bioidentical hormones.

    Compounded bioidentical hormones can be advantageous for people requiring a unique formulation that is not commercially made, or who are allergic to an ingredient in a commercially-made product.[7] However, there is little research on the effectiveness or safety of compounded bioidentical hormone therapies.[21] There are also inherent risks with compounded medications due to variations in compounding methods, ingredients used, and quality control practices between pharmacies. This can increase the risk of bacterial contamination and lead to inconsistencies in drug potency and absorption. For example, one study comparing compounded bioidentical hormone medications prepared by 13 different pharmacies found that the products contained anywhere from 26% less to 31% more of the active ingredient than intended.[22]

    Compared to compounded bioidentical hormones, commercially-made bioidentical hormones should be preferentially used, as they have a substantial evidence base defining their safety and efficacy and are held to higher quality control measures during manufacturing.[7]

    What are the main risks associated with hormone replacement therapy?

    HRT may increase the risk of blood clots (venous thromboembolism), breast cancer, stroke, and dementia.[6] However, these risks are influenced by several factors, including the type or combination of hormones used, the dosage form (e.g., oral pill, patch, vaginal cream), a woman's age or time since menopause onset, and personal or family medical history. For example, HRT for local use in the vagina is not significantly absorbed into the blood and does not seem to contribute to the above risks (accordingly, it also does not improve hot flashes).[23][24]

    To put the potential risks (and benefits) of HRT into context, let’s imagine we have a group of 1,000 postmenopausal women and we follow them for 5–7 years. Compared to women who are not receiving HRT, the group of 1,000 women taking HRT might experience the following:[6]

    Estrogen*Estrogen + Progesterone
    Stroke8 more cases5 more cases
    Invasive Breast CancerNo difference5 more cases
    Venous Thromboembolism8 more cases12 more cases
    DementiaNo difference9 more cases
    Colorectal CancerNo difference3 less cases
    Fractures39 less cases23 less cases
    Type 2 Diabetes13 less cases8 less cases

    * Taking estrogen alone is only appropriate for women who have had their uterus removed, due to an increased risk of endometrial cancer when estrogen is taken without progesterone.[7]

    Importantly, these numbers are based on studies that primarily used oral HRT in postmenopausal women over 60. Some research suggests that when HRT is started within 10 years of menopause onset, or before the age of 60, there is little to no increased risk of stroke or dementia.[25][26][23] Additionally, observational research suggests that transdermal HRT (e.g., topical gel or patch) may not carry the same risk of blood clots as oral HRT.[27][28] This may be due to how the medications interact with the liver. Oral HRT must first pass through the liver before entering the blood, and this interaction can increase the production of several proteins that promote clotting. In contrast, transdermal HRT absorbs directly into the blood through the skin, bypassing the liver, which allows for lower overall doses and reduced production of clotting proteins.[28]

    Ultimately, the choice for or against HRT needs to be made in consultation with a healthcare provider and on a case-by-case basis depending on one's unique situation.

    Are there recommendations for women who started menopause early?

    Young women with primary ovarian insufficiency (POI) experience symptoms similar to menopause. For women with POI and no contraindications (like breast cancer), the American College of Obstetricians and Gynecologists recommends hormone replacement therapy. This includes the use of prescription estrogen therapy until around age 50 to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy. Some women may require vaginal estrogen in addition to systemic estrogen. Young women with POI should have an annual thyroid exam as they are at increased risk of developing Hashimoto's thyroiditis.[29]

    In addition to medical management, women with POI may find the following lifestyle interventions helpful: Eat a diet rich in calcium, maintain adequate vitamin D levels, perform weight-bearing exercises, limit caffeine and alcohol intake, and avoid smoking.[30]

    Have any supplements been studied for menopause?

    A number of botanical and other nutritional supplements have been investigated for the treatment of menopausal symptoms. Black cohosh, red clover, omega-3 fatty acids, dehydroepiandrosterone (DHEA), evening primrose oil, Vitex agnus-castus, soy isoflavones and St. John's wort are among the variety of supplements purported to reduce menopausal symptoms.

    How could diet affect menopause?

    Hormone changes during menopause can negatively affect lipid and glucose metabolism. The American Heart Association recommends women consume a diet rich in fruits, vegetables, high-fiber whole grains, and oily fish, and that they limit saturated fat, cholesterol, alcohol, sodium, and sugar and avoid trans-fatty acids.

    Are there any other treatments for menopause?

    Exercise like yoga may be particularly helpful for vasomotor and psychological symptoms.[8] Strength and resistance training are especially important for maintaining muscle mass and bone mineral density, especially when combined with high-impact exercises like jumping, skipping, and jogging.[9]

    What causes menopause?

    Menopause is a natural condition that occurs as women age. Over time, a woman’s ovarian follicles and granulosa cells diminish. Given these cells are the main producers of estradiol and inhibin[10] (a hormone that tells the pituitary gland to make less follicle-stimulating hormone), the body’s hormonal balance shifts toward lower estrogen and progesterone levels and increased follicle-stimulating hormone and luteinizing hormone levels. This hormonal profile results in irregular menstrual cycles, which ultimately stop altogether.

    Hormonal variations across a woman's lifetime

    image
    Does low estrogen cause sexual dysfunction?

    During menopause, the decline in estrogen and testosterone can diminish one’s sex drive, arousal, and interest in sex. However, not all postmenopausal women report a loss of sex drive and, in fact, lower levels of stress and anxiety due to motherhood may actually lead to improved intimacy and libido during this stage of life. Low estrogen levels do contribute to vulvovaginal atrophy (characterized by dryness, itching, irritation, and reduced vaginal lubrication),reduced vaginal blood flow, and the capacity for arousal and orgasm.[16] Treatment with estrogen therapy seems to improve many of these symptoms.[17]

    Update History

    Examine Database References

    1. Libido - de Souza KZ, Vale FB, Geber SEfficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women: a randomized, double-blinded, placebo-controlled trialMenopause.(2016 Nov)
    2. Libido - Dayal M, Sammel MD, Zhao J, Hummel AC, Vandenbourne K, Barnhart KTSupplementation with DHEA: effect on muscle size, strength, quality of life, and lipidsJ Womens Health (Larchmt).(2005 Jun)
    3. Testosterone - Genazzani AR, Pluchino N, Begliuomini S, Stomati M, Bernardi F, Pieri M, Casarosa E, Palumbo M, Genazzani AD, Luisi MLong-term low-dose oral administration of dehydroepiandrosterone modulates adrenal response to adrenocorticotropic hormone in early and late postmenopausal womenGynecol Endocrinol.(2006 Nov)
    4. Testosterone - Igwebuike A, Irving BA, Bigelow ML, Short KR, McConnell JP, Nair KSLack of dehydroepiandrosterone effect on a combined endurance and resistance exercise program in postmenopausal womenJ Clin Endocrinol Metab.(2008 Feb)
    5. Testosterone - Alessandro D Genazzani, Massimo Stomati, Francesca Bernardi, Matteo Pieri, Lucio Rovati, Andrea R GenazzaniLong-term low-dose dehydroepiandrosterone oral supplementation in early and late postmenopausal women modulates endocrine parameters and synthesis of neuroactive steroidsFertil Steril.(2003 Dec)
    6. Testosterone - Stomati M, Monteleone P, Casarosa E, Quirici B, Puccetti S, Bernardi F, Genazzani AD, Rovati L, Luisi M, Genazzani ARSix-month oral dehydroepiandrosterone supplementation in early and late postmenopauseGynecol Endocrinol.(2000 Oct)
    7. Libido - Oh KJ, Chae MJ, Lee HS, Hong HD, Park KEffects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical studyJ Sex Med.(2010 Apr)
    8. C-Reactive Protein (CRP) - Kim SY, Seo SK, Choi YM, Jeon YE, Lim KJ, Cho S, Choi YS, Lee BSEffects of red ginseng supplementation on menopausal symptoms and cardiovascular risk factors in postmenopausal women: a double-blind randomized controlled trialMenopause.(2012 Apr)
    9. Subjective Well-Being - Wiklund IK, Mattsson LA, Lindgren R, Limoni CEffects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine GroupInt J Clin Pharmacol Res.(1999)
    10. Testosterone - Hidalgo LA, Chedraui PA, Morocho N, Ross S, San Miguel GThe effect of red clover isoflavones on menopausal symptoms, lipids and vaginal cytology in menopausal women: a randomized, double-blind, placebo-controlled studyGynecol Endocrinol.(2005 Nov)
    11. Testosterone - Imhof M, Gocan A, Reithmayr F, Lipovac M, Schimitzek C, Chedraui P, Huber JEffects of a red clover extract (MF11RCE) on endometrium and sex hormones in postmenopausal womenMaturitas.(2006 Aug 20)
    12. Testosterone - Lee CC, Bloem CJ, Kasa-Vubu JZ, Liang LJEffect of oral phytoestrogen on androgenicity and insulin sensitivity in postmenopausal womenDiabetes Obes Metab.(2012 Apr)
    13. High-density lipoprotein (HDL) - Schult TM, Ensrud KE, Blackwell T, Ettinger B, Wallace R, Tice JAEffect of isoflavones on lipids and bone turnover markers in menopausal womenMaturitas.(2004 Jul 15)
    14. High-density lipoprotein (HDL) - Knight DC, Howes JB, Eden JAThe effect of Promensil, an isoflavone extract, on menopausal symptomsClimacteric.(1999 Jun)
    15. High-density lipoprotein (HDL) - Nestel PJ, Pomeroy S, Kay S, Komesaroff P, Behrsing J, Cameron JD, West LIsoflavones from red clover improve systemic arterial compliance but not plasma lipids in menopausal womenJ Clin Endocrinol Metab.(1999 Mar)
    16. High-density lipoprotein (HDL) - Howes JB, Sullivan D, Lai N, Nestel P, Pomeroy S, West L, Eden JA, Howes LGThe effects of dietary supplementation with isoflavones from red clover on the lipoprotein profiles of post menopausal women with mild to moderate hypercholesterolaemiaAtherosclerosis.(2000 Sep)
    17. High-density lipoprotein (HDL) - Terzic MM, Dotlic J, Maricic S, Mihailovic T, Tosic-Race BInfluence of red clover-derived isoflavones on serum lipid profile in postmenopausal womenJ Obstet Gynaecol Res.(2009 Dec)
    18. High-density lipoprotein (HDL) - Błaszczuk A, Barańska A, Kanadys W, Malm M, Jach ME, Religioni U, Wróbel R, Herda J, Polz-Dacewicz MRole of Phytoestrogen-Rich Bioactive Substances ( L., L., L.) in Cardiovascular Disease Prevention in Postmenopausal Women: A Systematic Review and Meta-Analysis.Nutrients.(2022-Jun-14)
    19. Skin Quality - Lipovac M, Chedraui P, Gruenhut C, Gocan A, Kurz C, Neuber B, Imhof MEffect of Red Clover Isoflavones over Skin, Appendages, and Mucosal Status in Postmenopausal WomenObstet Gynecol Int.(2011)
    20. Subjective Well-Being - Ehsanpour S, Salehi K, Zolfaghari B, Bakhtiari SThe effects of red clover on quality of life in post-menopausal womenIran J Nurs Midwifery Res.(2012 Jan)
    21. Menopausal Symptoms - Lipovac M, Chedraui P, Gruenhut C, Gocan A, Kurz C, Neuber B, Imhof MThe effect of red clover isoflavone supplementation over vasomotor and menopausal symptoms in postmenopausal womenGynecol Endocrinol.(2012 Mar)
    22. Menopausal Symptoms - van de Weijer PH, Barentsen RIsoflavones from red clover (Promensil) significantly reduce menopausal hot flush symptoms compared with placeboMaturitas.(2002 Jul 25)
    23. Menopausal Symptoms - Baber RJ, Templeman C, Morton T, Kelly GE, West LRandomized placebo-controlled trial of an isoflavone supplement and menopausal symptoms in womenClimacteric.(1999 Jun)
    24. Menopausal Symptoms - del Giorno C, Fonseca AM, Bagnoli VR, Assis JS, Soares JM Jr, Baracat ECEffects of Trifolium pratense on the climacteric and sexual symptoms in postmenopause womenRev Assoc Med Bras.(2010 Sep-Oct)
    25. Total cholesterol - Howes JB, Bray K, Lorenz L, Smerdely P, Howes LGThe effects of dietary supplementation with isoflavones from red clover on cognitive function in postmenopausal womenClimacteric.(2004 Mar)
    26. Depression Symptoms - Lipovac M, Chedraui P, Gruenhut C, Gocan A, Stammler M, Imhof MImprovement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extractsMaturitas.(2010 Mar)
    27. Anxiety Symptoms - Geller SE, Shulman LP, van Breemen RB, Banuvar S, Zhou Y, Epstein G, Hedayat S, Nikolic D, Krause EC, Piersen CE, Bolton JL, Pauli GF, Farnsworth NRSafety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trialMenopause.(2009 Nov-Dec)
    28. Hot Flash Symptoms - Tice JA, Ettinger B, Ensrud K, Wallace R, Blackwell T, Cummings SRPhytoestrogen supplements for the treatment of hot flashes: the Isoflavone Clover Extract (ICE) Study: a randomized controlled trialJAMA.(2003 Jul 9)
    29. Hot Flash Symptoms - Kanadys W, Barańska A, Błaszczuk A, Polz-Dacewicz M, Drop B, Kanecki K, Malm MEvaluation of Clinical Meaningfulness of Red Clover ( L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Nutrients.(2021-Apr-11)
    30. Hot Flash Symptoms - Myers SP, Vigar VEffects of a standardised extract of Trifolium pratense (Promensil) at a dosage of 80mg in the treatment of menopausal hot flushes: A systematic review and meta-analysis.Phytomedicine.(2017-Jan-15)
    31. Homocysteine - Samman S, Koh HS, Flood VM, Blakesmith SJ, Petocz P, Lyons-Wall PMRed clover (Trifolium pratense) isoflavones and serum homocysteine in premenopausal women: a pilot studyJ Womens Health (Larchmt).(2009 Nov)
    32. Testosterone - Nielsen FH, Hunt CD, Mullen LM, Hunt JREffect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal womenFASEB J.(1987 Nov)
    33. Estrogen - Nielsen F, Penland JBoron supplementation of peri‐menopausal women affects boron metabolism and indices associated with macromineral metabolism, hormonal status and immune functionJ Trace Elem Med Biol.()
    34. High-density lipoprotein (HDL) - Michelle L Asp, Angela L Collene, Leigh E Norris, Rachel M Cole, Michael B Stout, Szu-Yu Tang, Jason C Hsu, Martha A BeluryTime-dependent effects of safflower oil to improve glycemia, inflammation and blood lipids in obese, post-menopausal women with type 2 diabetes: a randomized, double-masked, crossover studyClin Nutr.(2011 Aug)
    35. High-density lipoprotein (HDL) - Meissner HO, Mscisz A, Reich-Bilinska H, Mrozikiewicz P, Bobkiewicz-Kozlowska T, Kedzia B, Lowicka A, Barchia IHormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (III) Clinical responses of early-postmenopausal women to Maca in double blind, randomized, Placebo-controlled, crossover configuration, outpatient studyInt J Biomed Sci.(2006 Dec)
    36. High-density lipoprotein (HDL) - Meissner HO, Mscisz A, Reich-Bilinska H, Kapczynski W, Mrozikiewicz P, Bobkiewicz-Kozlowska T, Kedzia B, Lowicka A, Barchia IHormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (II) Physiological and Symptomatic Responses of Early-Postmenopausal Women to Standardized doses of Maca in Double Blind, Randomized, Placebo-Controlled, Multi-Centre Clinical StudyInt J Biomed Sci.(2006 Dec)
    37. Menopausal Symptoms - Meissner HO, Kapczynski W, Mscisz A, Lutomski JUse of gelatinized maca (lepidium peruvianum) in early postmenopausal womenInt J Biomed Sci.(2005 Jun)
    38. Menopausal Symptoms - Tsuyoshi Takewaka, Kiyoshi HaraClinical Effect of Oral Administration of Maca (Lepidium meyenii) Extract on Japanese Peri-Menopausal Women Subjects: A Randomized, Double-Blind, Placebo-Controlled StudyInt J Biomed Sci.()
    39. High-density lipoprotein (HDL) - C Mellberg, S Sandberg, M Ryberg, M Eriksson, S Brage, C Larsson, T Olsson, B LindahlLong-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trialEur J Clin Nutr.(2014 Mar)
    40. High-density lipoprotein (HDL) - Woo J, Lau E, Ho SC, Cheng F, Chan C, Chan AS, Haines CJ, Chan TY, Li M, Sham AComparison of Pueraria lobata with hormone replacement therapy in treating the adverse health consequences of menopauseMenopause.(2003 Jul-Aug)
    41. High-density lipoprotein (HDL) - Georgiev DB, Metka M, Huber JC, Goudev AR, Manassiev NEffects of an herbal medication containing bee products on menopausal symptoms and cardiovascular risk markers: results of a pilot open-uncontrolled trialMedGenMed.(2004 Dec 16)
    42. High-density lipoprotein (HDL) - Ozuru R, Sugimoto T, Yamaguchi T, Chihara KTime-dependent effects of vitamin K2 (menatetrenone) on bone metabolism in postmenopausal womenEndocr J.(2002 Jun)
    43. Bone Mineral Density - Braam LA, Knapen MH, Geusens P, Brouns F, Hamulyák K, Gerichhausen MJ, Vermeer CVitamin K1 supplementation retards bone loss in postmenopausal women between 50 and 60 years of ageCalcif Tissue Int.(2003 Jul)
    44. Bone Mineral Density - Ushiroyama T, Ikeda A, Ueki MEffect of continuous combined therapy with vitamin K(2) and vitamin D(3) on bone mineral density and coagulofibrinolysis function in postmenopausal womenMaturitas.(2002 Mar 25)
    45. High-density lipoprotein (HDL) - Akazawa N, Choi Y, Miyaki A, Tanabe Y, Sugawara J, Ajisaka R, Maeda SCurcumin ingestion and exercise training improve vascular endothelial function in postmenopausal womenNutr Res.(2012 Oct)
    46. Blood Pressure - Sugawara J, Akazawa N, Miyaki A, Choi Y, Tanabe Y, Imai T, Maeda SEffect of endurance exercise training and curcumin intake on central arterial hemodynamics in postmenopausal women: pilot studyAm J Hypertens.(2012 Jun)
    47. High-density lipoprotein (HDL) - Chen JT, Kotani KEffects of Astaxanthin on Liver and Leukocyte Parameters in Healthy Climacteric Women: Preliminary DataJ Med Food.(2017 Jul)
    48. High-density lipoprotein (HDL) - Santamaria A, Giordano D, Corrado F, Pintaudi B, Interdonato ML, Vieste GD, Benedetto AD, D'Anna ROne-year effects of myo-inositol supplementation in postmenopausal women with metabolic syndromeClimacteric.(2012 Oct)
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