A Guide To The Best Supplements To Balance Hormones (2024)

When women have too much or too little of key hormones or when these hormones aren’t signaling body functions properly, they may experience hormonal imbalances or fluctuations that can lead to unwanted symptoms or related health conditions. These women may consider taking supplements with the goal of restoring hormone balance.

Hormones that affect women’s menstrual cycles, sexual function and reproductive health include:

• Estrogen, which regulates the menstrual cycle
• Progesterone, which affects the menstrual cycle and fertility
• Testosterone, which affects sex drive, bone density and muscular strength
• Follicle stimulating hormone (FSH), which affects fertility by helping regulate estradiol synthesis (helping the ovaries to produce estradiol, a hormone important for reproduction), the menstrual cycle and the production of eggs in the ovaries
• Cortisol, the stress hormone that leads to increases in heart rate and blood pressure and interferes with digestion and reproduction

The following health conditions can stem from hormonal imbalances in women.

Premenstrual Syndrome (PMS)

PMS is a combination of physical and emotional symptoms, including bloating, headaches and moodiness, that some women experience after they ovulate (when a mature egg is released from an ovary) and before they start their menstrual period. In women who aren’t pregnant, estrogen and progesterone levels begin falling dramatically after ovulation, which may trigger PMS. As many as three in four women say they have experienced PMS symptoms, and fewer than 5% of women of childbearing age experience a more severe form of PMS called premenstrual dysphoric disorder (PMDD)^[1]Premenstrual Syndrome (PMS). US Department of Health & Human Services Office on Women’s Health. Accessed 10/5/23. . PMS symptoms for most women are mild and can include tender breasts, constipation, bloating, cramping, depression, sleep problems and mood swings.

Polycystic Ovary Syndrome (PCOS)

At least one in 15 women of reproductive age experience PCOS, a reproductive hormone disorder affecting ovulation in women of reproductive age^[2]Trivax B, Azziz R. Diagnosis of polycystic ovary syndrome. Clinical Obstetric Gynecology. 2007 Mar;50(1):168-77. . Their eggs don’t develop normally or aren’t released during ovulation as they should, which results in a range of symptoms including irregular periods, acne, excess facial hair, weight gain and infertility. The cause of PCOS isn’t known, but it might be related to a number of factors working together, including insulin resistance and increased levels of hormones called androgens.

Endometriosis

Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside of the uterus. It may affect over 11% of U.S. women between the ages of 15 and 44^[3]Endometriosis. Office on Women’s Health. US Department of Health and Human Services. Accessed 10/18/2023. . Any menstruating woman may develop endometriosis, but it’s especially common among women in their 30s and 40s and may make it harder for them to become pregnant. Endometriosis can cause painful cramps, low back pain, pain during sex, bleeding or spotting between periods and stomach problems, such as diarrhea, bloating or nausea. Researchers aren’t sure what causes endometriosis, but they’re investigating genetic causes and whether immune system dysfunction might contribute to its development.

Menopause

When a woman’s ovaries stop making estrogen (on average at about age 51), her monthly menstrual periods eventually stop, a transition known as menopause. Perimenopause, the period of time prior to menopause, can begin when women are in their 30s and 40s; the amount of estrogen produced by the ovaries begins to fluctuate, causing changes to the menstrual cycle. Periods can become longer or shorter in length than usual and menstrual blood flow can increase or decrease. Some women experience hot flashes, sleep problems and other symptoms during this time.

Fertility Problems

Infertility is defined as an inability to get pregnant after one year of trying (or six months if a woman is at least 35 years old). Women who can get pregnant but are unable to stay pregnant may also be infertile. Infertility affects about 10% of women (6.1 million) in the U.S^[4]Reproductive Health. Centers for Disease Control and Prevention. Accessed 11/7/23.. . Most of the time, the cause relates to problems with ovulation, but difficulty getting or staying pregnant can also be caused by PCOS. Stress, poor diet and smoking can also affect a woman’s ability to conceive.

FEATURED PARTNER OFFER

Partner Offers feature brands who paid Forbes Health to appear at the top of our list. While this may influence where their products or services appear on our site, it in no way affects our ratings, which are based on thorough research, solid methodologies and expert advice. Our partners cannot pay us to guarantee favorable reviews of their products or services

Enjoy 20% Off With Code FORBES20

Ritual Omega-3 DHA & EPA

• Gluten and Major Allergen Free, Vegan
• No Artificial Colorants, Made Traceable
• Omega-3 DHA & EPA support brain and heart health
• Omega-3 oil infused with natural citrus oil
• Get 40% off traceable essentials

Shop Now

On Ritual's Website

Consult a health care provider before taking any supplements listed below or otherwise, recommends Dr. Arena, as some medications or supplements might not mix safely with a new one.

Vitamin D

Vitamin D is important for overall health and particularly for immunity and gut health, says Conner. It can be obtained from exposure to the sun, certain fortified foods and supplementation.

“We track vitamin D levels on every patient because it’s such a vital nutrient,” she says. “If [vitamin] D is low, so many things don’t function correctly. Someone low in vitamin D [doesn’t] absorb calcium correctly, so bone health suffers.”

Researchers are studying whether vitamin D supplementation can help women with PCOS become pregnant, producing promising yet inconclusive results.

Between 67% and 85% of women with PCOS have inadequate vitamin D levels, and vitamin D supplementation appears to help regulate their blood sugar and insulin sensitivity, according to a 2022 research review in the Journal of Preventive Medicine and Hygiene^[5]Kiani AK, Donato K, Dhuli K, Stuppia L, Bertelli M. Dietary supplements for polycystic ovary syndrome. Journal of Preventive Medicine and Hygiene. 2022;63(suppl.3):E206-E213. .

Meanwhile, a 2021 research review in Nutrients found that although vitamin D is involved in the regulation of ovarian function, women’s levels of vitamin D don’t seem to influence in vitro fertilization (IVF) outcomes^[6]Amerigo Vitagliano A, Cosmin Petre G, Francini-Pesenti F, et al.. Dietary Supplements for Female Infertility: A Critical Review of Their Composition. Nutrients. 2021;13(10): 3552. .

In order to reach optimal levels of Vitamin D (a range of 50 to 90 nanomoles per liter in the blood), you might need to take anywhere from 2,000 IUs to 4,000 IUs daily. Because people spend less time in the sun these days, and often wear sunblock, D deficiency is widespread and common.

Dr. Arena tends to recommend vitamin D supplementation during winter months when people have reduced sun exposure). However, too much vitamin D—intake exceeding 4,000 IUs daily—might cause nausea, vomiting and kidney damage.

B Vitamins

“B vitamins are impactful for hormone regulation,” says Conner. “The body needs them to make hormones. Women on birth control [can] be depleted of B vitamins, and most people don’t get enough of them in their diet.”

Vitamin B6 is found in many foods and may also help alleviate PMS symptoms, including moodiness, irritability, forgetfulness, bloating and anxiety. It can be found in fish, poultry, potatoes and fruit (except for citrus), among other foods. It can also be taken as a dietary supplement—but no more than 50 mg of B6 should be taken a day. Taking too much can cause permanent damage to the nervous system.

Even though some research shows that vitamin B6 may ease PMS symptoms, more studies are needed to prove the efficacy of B6 supplementation as a treatment for PMS.

B vitamins may also help address hormonal imbalances stemming from PCOS. A 2021 meta-analysis in Gynecological Endocrinology concluded that inositols (vitamin B8) might help control weight gain in women with PCOS^[7]Zhang J, Xing C, Han Zhao H, He B. The effectiveness of coenzyme Q10, vitamin E, inositols, and vitamin D in improving the endocrine and metabolic profiles in women with polycystic ovary syndrome: a network Meta-analysis. Gynecological Endocrinology. 2021;37(12):1063-1071. . In a separate 2022 study in the Journal of Preventive Medicine and Hygiene, inositol was one of four supplements that appeared to help restore hormonal balance by decreasing insulin sensitivity and reducing inflammation in women with PCOS^[8]Kiani AK, Donato K, Dhuli K, Stuppia L, Bertelli M. Dietary supplements for polycystic ovary syndrome. Journal of Preventive Medicine and Hygiene. 2022;63(suppl.3):E206-E213. .

Magnesium

Magnesium is a mineral that regulates muscle function, energy production in the cells, the nervous system and the structure of the cells. Low magnesium can cause cramping and weakness. In pregnant women specifically, a magnesium deficiency can be a sign of preeclampsia, a form of high blood pressure that can be dangerous if left untreated.

Women should aim to consume 310 to 320 milligrams of magnesium per day. Magnesium can be found in leafy green vegetables like spinach, as well as nuts, whole grains and fortified cereals. It can also be consumed as a dietary supplement. There are multiple formulations of magnesium supplements. Magnesium oxide has been shown to be best for migraines. Magnesium citrate helps muscle spasms and works as a gentle osmotic laxative.

Magnesium may help relieve some PMS symptoms, including migraines. Women who get menstrual migraines or who experience symptoms of menopause should talk to their health care providers to determine if they need more magnesium. Furtherresearch is needed to confirm that supplementation can help alleviate menopause symptoms.

Omega Fatty Acids

Omega 3 fatty acids are necessary for anti-inflammatory immune function (bringing inflammation down) as well as cellular communication and function. Inexpensive and effective sources of omega 3 are flaxseeds, chia seeds and flax oil.

The body doesn’t make omega fatty acids on its own so must get them from food or supplements. Research suggests taking a supplement containing 1 to 2 grams of polyunsaturated fatty acids (omega-3 and omega-6 fatty acids) may help reduce cramps and other PMS symptoms. A 2018 study in the Journal of Psychosomatic Obstetrics and Gynaecology found supplementing with fish oil relieved physical and mental menstrual symptoms in Iranian women enough to improve their quality of life^[9]Behboudi-Gandevani S, Hariri F-Z, Moghaddam-Banaem L. The effect of omega 3 fatty acid supplementation on premenstrual syndrome and health-related quality of life: a randomized clinical trial. Journal of Psychosomatic Obstetrics & Gynaecology. 2018;39(4):266-272. .

Omega-3 fatty acids also appear to provide some women relief from endometriosis pain.

A 2018 study in the International Journal of Molecular Sciences reported some evidence that omega-3 fatty acids might be useful in relieving menopause symptoms, such as hot flashes, depression and cognitive issues but concluded that further research is needed^[10]Ciappolino V, Mazzocchi A, Enrico P, et al. P. N-3 Polyunsaturated Fatty Acids in Menopausal Transition: A Systematic Review of Depressive and Cognitive Disorders with Accompanying Vasomotor Symptoms. International Journal of Molecular Sciences. 2018;19(7), 1849.. N-3 Polyunsaturated Fatty Acids in Menopausal Transition: A Systematic Review of Depressive and Cognitive Disorders with Accompanying Vasomotor Symptoms. International Journal of Molecular Sciences. 2018;19(7), 1849. . A separate review and meta-analysis regarding omega-3 fatty acids and menopause symptoms concluded that omega-3 fatty acid supplements could help relieve the severity and frequency of night sweats but are unlikely to help reduce hot flashes or improve sleep or quality of life^[11]Mohammady M, Janani L, Jahanfar S, Mousavi, M. Effect of omega-3 supplements on vasomotor symptoms in menopausal women: A systematic review and meta-analysis. European Journal of Obstetrics, Gynecology & Reproductive Biology. 2018;228:295-302. .

Evening primrose oil (which contains omega-6 fatty acids) is a specific supplement often used to help reduce breast pain in women with PMS, according to Conner. Some studies suggest it can help with menopause symptoms as well. While research regarding its efficacy for PMS is mixed, evening primrose oil is generally well tolerated, adds Conner.

Adaptogens

Adaptogens are edible plant extracts that are thought to help relieve stress and help restore balance in the body, says Dr. Arena. However, it’s important for health practitioners to identify the root cause of a person’s symptoms before prescribing adaptogenic herbs to make sure they’re the best remedy for their specific hormone imbalance.

Functional medicine practitioners often evaluate a person’s cortisol levels to confirm that their body is overly stressed, explains Conner. Someone with high cortisol levels might not be sleeping well, feel irritable and/or experience other symptoms of PMS. Taking an adaptogen before bed might ensure better sleep, which can then help elevate mood during the day.

“Ashwagandha is an adaptogen studied and used for years,” says Conner. “It [helps] calm the nervous system and the production of cortisol, which allows [one] to produce more needed hormones.”

In one small 2019 study, ashwagandha root aqueous extract help improved sleep quality and reduce cortisol stress levels among both male and female participants^[12]Salve J, Pate S, Debnath K, Langade D. Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study. Cureus. 2019;11(12):e6466. . Another 2021 study of perimenopausal women specifically found ashwagandha supplementation effective in reducing the experience of hot flashes and increasing estradiol levels (the form of estrogen made by the ovaries)^[13]Gopal S, Ajgaonkar A, Kanchi P, Kaundinya A, Thakare V, Chauhan S, Langade, D. Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study. The Journal of Obstetrics and Gynaecology Research. 2021; 47(12):4414-4425. .

Ashwagandha contains naturally occurring chemicals that might help calm the brain, reduce swelling, lower blood pressure and alter the immune system. However, more research is needed to support its use as an adaptogen.

Ashwagandha is not considered safe to use during pregnancy, and it remains unclear whether it’s safe to use while breastfeeding. It shouldn’t be taken by people with thyroid disease, and because it might increase immune system activity, people with autoimmune diseases like multiple sclerosis, lupus and rheumatoid arthritis shouldn’t take ashwagandha.

Chasteberry

Chasteberry, a plant native to the Mediterranean region and Asia, is a generally safe and well-tolerated alternative, second-line treatment for PMS and PMDD (antidepressants are the first-line treatment). Although some research supports the efficacy of chasteberry in relieving PMS symptoms, especially breast pain, evidence is inconclusive.

“Estrogen dominance, or too much estrogen, is a common hormonal issue, and chasteberry can help balance it by boosting progesterone levels,” says Conner.” Side effects of consuming chasteberry are generally mild and may include nausea, headache, gastrointestinal disturbances or itchiness.

As a starting point, taking a multivitamin can help a person make sure they’re getting all the nutrients they need, as many people don’t get as much as they should from food, says Conner.

When considering specific supplements, start by researching them on the National Institutes of Health’s Office of Dietary Supplements’ dietary supplement fact sheets for information regarding research-backed uses, health conditions that can render certain supplements unsafe and which medications and supplements should not be mixed. Dr. Arena recommends talking to a health care provider knowledgeable about supplements who can provide guidance for safety and personalized recommendations that might improve your health.

“Supplements can be very helpful, but it’s not a one-size-fits-all approach,” she says. “I recommend working with a provider to test—not guess—and create a plan that works best for the individual. We all are different, carry different inherent genetic predispositions and are surrounded by different environmental triggers and exposures.”

It’s also important to research how supplements are made, where they’re sourced and whether they’re third-party tested by independent laboratories, she adds. Prioritize supplements that are certified by independent bodies like the U.S. Pharmacopeia (USP), NSF or ConsumerLab.