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This unregistered medicine has not been evaluated by SAHPRA for its quality, safety, or intended use.
Factors such as the menstrual cycle, oral contraceptive use, hormonal shifts with ageing, and conditions such as polycystic ovary syndrome play a crucial role in overall health, well-being, and the ability to stay active. Understanding these changes is essential for providing targeted support throughout a woman’s life.
Research highlights the benefits of female-specific nutrients and bioactive compounds in optimising body composition, reducing fatigue, and enhancing both mental and physical health [3]. As the field of women’s health continues to evolve, future research and product development must prioritise inclusivity across all life stages, addressing the distinct nutritional and physiological needs of women to improve overall health, quality of life, and athletic performance.
While vitamin D is best known for its essential role in calcium absorption, it also plays a critical part in regulating both innate and adaptive immune function, supporting skeletal muscle performance, promoting bone health, and potentially reducing disease risk [17]. Research indicates that vitamin D levels tend to decline with age, with postmenopausal women being the most affected by deficiency. Low vitamin D levels in women are associated with a range of health issues, including an increased risk of cardiovascular disease, acute illness, stress fractures, muscle pain or weakness, and inflammatory injuries [18].
For active women, vitamin D levels are particularly important, as they can directly influence muscle strength, exercise performance, recovery, and bone density. Additionally, vitamin D deficiency has been linked to a higher risk of anaemia, a condition that is especially common among physically active women. Given its wide-ranging benefits, vitamin D supplementation is recommended for women of all ages and activity levels. Alongside supplementation, incorporating dietary sources of vitamin D, such as fish, cheese, and fortified cereals, can help maintain adequate levels [1] [17].
Growing evidence supports the benefits of creatine supplementation for women, particularly in areas such as strength, muscle growth, exercise performance, energy production, and cognitive function [14]. Differences in endogenous hormone levels may contribute to variations in creatine metabolism between men and women. Women tend to have 70–80% lower natural creatine stores and consume significantly less dietary creatine.
Additionally, fluctuations in creatine kinase levels have been linked to the menstrual cycle, aligning with oestrogen’s cyclical pattern. Postpartum women may particularly benefit from creatine supplementation due to the cellular energy depletion associated with childbirth. Furthermore, creatine has shown promise in mitigating declines in muscle mass, bone density, and strength caused by oestrogen reduction during menopause [3].
Beyond physical performance, creatine may also positively influence mood and mental health. Studies have found a correlation between creatine and phosphocreatine levels in the brain and reduced severity of depressive episodes. It may also help combat mental fatigue and enhance cognitive function, particularly during periods of high stress or sleep deprivation [3].
Nootropics, a growing category of dietary supplements, are designed to enhance cognition and memory, with some also offering benefits for exercise performance. Their popularity has surged among active women, particularly during the COVID-19 pandemic, as research highlighted increased stress levels, sleep disturbances, and cognitive impairments experienced by women during this period. Many have also reported experiencing a form of cognitive “fog” (or brain fog). Given that women often engage in high levels of multitasking and invisible labour, nootropics may help support cognitive function and memory [3].
The following nature-based supplements show promise in supporting cognitive function for active women:
Including nootropic ingredients in dietary supplements for active women is increasingly supported by evidence, particularly for those experiencing sleep deprivation, anxiety, or brain fog. These compounds may provide valuable cognitive support, enhancing focus, memory, and overall mental clarity [3].
Omega-3 essential fatty acids play a crucial role in regulating cell function, supporting the absorption of fat-soluble vitamins, and maintaining lipid metabolism. Strong evidence has shown that increasing omega-3 intake significantly reduces the risk of cardiovascular disease, a particularly important consideration for women, as their risk rises during the menopausal transition. The two most biologically active eicosanoids derived from omega-3 – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – are essential for immune function, growth, and development [3].
Research indicates that omega-3 supplementation helps create a more favourable inflammatory environment, with benefits observed in conditions such as arthritis, inflammatory bowel disease, and asthma. This may be especially useful during the follicular phase of the menstrual cycle when systemic inflammation tends to be elevated [3]. Higher omega-3 intake has also been linked to reduced muscle soreness due to its anti-inflammatory effects, enhanced muscle protein synthesis through activation of the mechanistic target of rapamycin complex 1 (mTORC1) pathway, and improved bone health [3].
Hormonal changes from puberty onward cause the female gastrointestinal (GI) tract to develop differently from the male GI tract. Research indicates that women typically exhibit lower intestinal permeability and greater microbial diversity, though their gut microbiome tends to be more vulnerable to disruptions. Additionally, women are more prone to inflammatory bowel conditions, particularly when exposed to physical stressors like exercise [3].
Probiotic supplementation has been shown to support gut health by promoting microbial diversity and enhancing overall digestive function. Studies suggest that probiotics can improve intestinal health, reduce inflammation, and help regulate inflammatory responses during the follicular phase of the menstrual cycle. They also enhance iron absorption when taken alongside iron supplements, which may reduce the risk of iron-deficiency anaemia. Beyond digestive health, probiotics have been linked to a reduced recurrence of urinary tract infections (UTIs) in women [3].
Iron is crucial for women’s health as it is a key component of haemoglobin, the protein in red blood cells that carries oxygen throughout the body. Women are more prone to iron deficiency due to menstrual blood loss, which can significantly deplete their iron stores; this makes maintaining adequate iron levels especially important for their overall health and energy levels, particularly during menstruation and pregnancy [10].
Iron deficiency (ID), with or without anaemia, is common worldwide and affects the health and well-being of both pregnant and nonpregnant women. Symptoms such as fatigue, restless legs, poor concentration, increased infection risk, and cardiovascular stress can significantly impact quality of life. The causes of iron deficiency vary by region or diet and are typically caused by the lack of iron-rich foods in the diet. Furthermore, trouble absorbing iron can be due to a lack of Vitamin C in the diet.
Blood loss is also a major cause of low iron levels and is commonly depicted in women with heavy menstrual bleeding. Pregnant women’s blood levels increase, resulting in the need for iron supplementation. Gut disorders can also contribute to iron deficiency [9], [12], [13].
B vitamins, including B6, B12, and B9 (folate), play a vital role in hormone production and regulation. Vitamin B12 is particularly important for supporting haemoglobin production – the protein in red blood cells responsible for transporting oxygen throughout the body [16].
During periods of hormonal change, such as pregnancy, menstruation, or menopause, the body’s demand for red blood cells increases. Menstruation results in blood loss, requiring the body to replenish red blood cells, while pregnancy raises the need for oxygen and blood supply to support both the mother and the developing baby. Maintaining adequate B12 levels ensures the body can produce sufficient healthy red blood cells to meet these physiological demands [8].
Folic acid, the synthetic form of Vitamin B9 found in some food, is especially beneficial for women in their 30s who are trying to conceive, as it plays a crucial role in reproductive health and early pregnancy support. One of its key functions is maintaining hormonal balance by regulating homocysteine levels – an amino acid that, when elevated, can disrupt hormonal equilibrium and impact fertility. By keeping homocysteine within a normal range, folic acid helps create a more optimal environment for conception.
Additionally, folic acid has been shown to raise progesterone levels, promote regular ovulation, and reduce menopausal hot flashes [23].
Polycystic ovary syndrome (PCOS) is a prevalent and multifaceted endocrine disorder affecting 4–18% of women of reproductive age. It is primarily defined by irregular ovulation (anovulation) and elevated levels of ovarian androgens. PCOS is associated with various health challenges, including metabolic conditions like obesity, cardiovascular disease, and type 2 diabetes, alongside reproductive concerns such as infertility, miscarriage, and increased pregnancy complications. Additionally, women with PCOS often experience psychological issues, including stress, anxiety, and depression. Management strategies typically involve hormonal treatments, such as oral contraceptives or metformin, tailored to individual needs [1].
Recently, the use of natural compounds from nutritional supplements and herbal medicines in treating PCOS patients has shown promising results, with no reported side effects. By incorporating evidence-based supplements into a well-rounded approach, women with PCOS may find additional support in managing symptoms and enhancing overall well-being. Therapeutic supplements for PCOS include:
Curcumin, a dietary polyphenol derived from Curcuma longa (turmeric), functions as a powerful antioxidant, enhancing the activity of glutathione peroxidase, superoxide dismutase, and catalase, while also acting as a free radical scavenger. Additionally, curcumin regulates the Keap1-Nrf2/ARE signalling pathway, promoting the expression of detoxification and antioxidant genes. Notably, curcumin has been shown to induce ovulation and improve the biochemical profile of individuals with polycystic ovary syndrome [1].
Additionally, chronic inflammation plays a crucial role in the development of PCOS. Curcumin exerts anti-inflammatory effects by inhibiting the production of inflammatory mediators [1].
Insulin is a key regulator of metabolism, cell growth, and reproductive function. Its primary metabolic role is to maintain blood glucose levels within a normal range. Insulin resistance (IR), a condition affecting approximately 85% of women with polycystic ovary syndrome (PCOS) regardless of body mass index (BMI) occurs when higher-than-normal insulin levels are required to regulate blood glucose. In PCOS, pancreatic β cells increase insulin production to compensate for IR, but over time, this demand can lead to pancreatic exhaustion, resulting in glucose intolerance or type 2 diabetes [7].
The insulin receptor (InsR) plays a key role in how the body processes insulin. Berberine helps improve insulin function by increasing InsR activity and boosting the expression of protein kinase C-dependent InsR, which enhances glucose use and reduces insulin resistance. It also supports insulin sensitivity by increasing InsR gene expression in muscle and liver through a protein kinase D (PKD)-dependent process.
Berberine further enhances insulin sensitivity by activating the AMP-activated protein kinase (AMPK) pathway, which helps regulate the body’s energy balance. It does this in two main ways: first, by inhibiting mitochondrial respiratory complex I, which triggers AMPK activation, and second, by increasing sirtuin 1 (SIRT1) levels in fat tissue, further stimulating AMPK. These actions help improve glucose regulation and insulin function, making berberine a valuable supplement for supporting metabolic health and insulin resistance in women with PCOS [7].
Coenzyme Q10 (CoQ10) is a fat-soluble antioxidant that supports cell growth, maintenance, and energy production. It acts as an electron carrier and protects lipids, proteins, and DNA from oxidative damage. Research has shown that CoQ10 supplementation offers several health benefits, including its role as a supportive therapy for PCOS.
Women with PCOS often experience chronic inflammation, with high levels of inflammatory markers which contribute to blood vessel dysfunction. Studies suggest that CoQ10 can help reduce this inflammation. For example, a study found that 12 weeks of CoQ10 supplementation lowered C-reactive protein and TNF-α levels in individuals with non-alcoholic fatty liver disease. Another study showed that taking 200 mg of CoQ10 daily for eight weeks reduced inflammation and markers of blood vessel dysfunction in overweight women with PCOS compared to a placebo [1].
Magnesium is an essential mineral that plays a vital role in numerous metabolic processes, including protein synthesis, ATP (adenosine triphosphate) production – the cell’s energy currency – and energy metabolism. During prolonged moderate-to-high-intensity exercise, acute fluctuations in plasma magnesium levels can occur. Growing evidence supports magnesium’s critical role in various physiological functions, particularly as women age. While magnesium deficiency is rare in healthy individuals consuming a balanced diet, requirements may fluctuate due to hormonal changes and training adaptations. Specific life stages and physiological conditions –such as oral contraceptive (OC) use, pregnancy, and menopause – may increase magnesium needs.
In peri- and postmenopausal women, magnesium may support bone health by optimising vitamin D metabolism. Additionally, as women transition through menopause, their risk of hypertension increases. Emerging research indicates an inverse relationship between magnesium intake and hypertension risk, suggesting that supplementation may offer cardioprotective benefits, particularly for women [3].
Ashwagandha is beneficial for women going through perimenopause due to its adaptogenic properties, which help the body modulate stress and maintain hormonal balance. During perimenopause, fluctuating oestrogen and progesterone levels can lead to increased stress, anxiety, mood swings, and disrupted sleep [19]. Ashwagandha helps regulate cortisol, the body’s primary stress hormone, which can become elevated during this phase and further disrupt hormonal balance [20]. Additionally, Ashwagandha supports adrenal health, which is crucial as after menopause the adrenal glands become the primary source of sex hormones [4], [21].
Sulforaphane, a bioactive compound found in cruciferous vegetables like broccoli, has shown promise in supporting hormone balance. As women transition through menopause, hormonal fluctuations, especially a decline in oestrogen, can lead to a range of symptoms, including hot flashes, night sweats, mood swings, and cognitive disturbances. Sulforaphane appears to play a beneficial role in mitigating these symptoms through its oestrogen-modulating effects. It supports the liver’s detoxification processes, enhancing the metabolism of oestrogen and promoting the elimination of excess or potentially harmful forms of the hormone, thus reducing the risk of oestrogen dominance, a condition causing symptoms like heavy periods and mood swings.
The compound’s antioxidant properties help reduce oxidative stress, which is implicated in many age-related diseases. Furthermore, sulforaphane has been linked to improved insulin sensitivity, which is particularly important for menopausal women who are at increased risk of developing insulin resistance and type 2 diabetes. Additionally, sulforaphane may support bone health by protecting against oestrogen-related bone loss, which can increase the risk of osteoporosis in postmenopausal women [5].
Vitamin D aids in calcium absorption which is crucial for bone strength and formation and works synergistically with oestrogen to support bone health. Without adequate vitamin D, the body cannot absorb enough calcium, which can impair bone health [11]. Oestrogen is important for maintaining bone density, so during menopause when oestrogen levels significantly decline, bone resorption outpaces bone formation [22]. This results in bone loss and an increased risk of developing osteoporosis, a condition characterised by weakened bones that are more susceptible to fractures. In this way, adequate vitamin D levels ensure that bones remain strong as oestrogen levels fluctuate during perimenopause or decline in menopause [22].
In every stage of life – from menstruation and PCOS to pregnancy and menopause – women’s health is influenced by hormonal changes that impact metabolism, energy levels, and overall well-being. Key supplements such as magnesium, iron, berberine, vitamin D, and probiotics, play essential roles in supporting hormonal balance, reproductive health, and metabolic function. As women transition through different life stages, targeted supplementation can help address specific health concerns, improving quality of life and long-term well-being.
Always consult with your healthcare practitioner before starting a new supplement or supplement regime, especially when experiencing chronic conditions such as PCOS and insulin resistance.
This unregistered medicine has not been evaluated by SAHPRA for its quality, safety, or intended use. Please always consult with your healthcare practitioner before starting a new supplement regimen.
Read our article on Essential Supplements for Hormonal Health Throughout Your Years here.
