The study, conducted by Susanne Mitschke of Harvard T.H. Chan School of Public Health, recruited 226 perimenopausal or postmenopausal participants aged 45 to 65 through online health forums, social media platforms, menopause support groups, and email newsletters between July 21 and August 12, 2024. All participants reported experiencing menopausal or perimenopausal symptoms, and women with a history of breast cancer, heart disease, or blood clots were excluded because those conditions are established contraindications to hormone therapy. The survey, administered through the Qualtrics platform, took a median of 2.8 minutes to complete and captured sociodemographic characteristics, supplement use, perceived effectiveness, information sources, and perceptions of menopausal hormone therapy, commonly abbreviated MHT.

The headline numbers reveal a striking gap between general supplement consumption and symptom-targeted use. Current use of at least one dietary supplement for any purpose was reported by 138 participants, or 61.1 percent of the sample, with a 95 percent confidence interval of 54.6 to 67.2 percent. But when asked directly whether they were using supplements to manage menopause symptoms, only 65 participants, or 28.9 percent, answered yes. Of the 138 current supplement users, 72 answered no to the menopause-specific question, indicating that their supplement use was driven by motivations other than symptom relief. The two survey items, the study notes, measure different constructs and should not be read as bounds on a single quantity.

The product profile among users further underscores this distinction. Multivitamins led the list at 55.8 percent of supplement users, followed by vitamin D at 52.9 percent, magnesium at 51.4 percent, and probiotics at 41.3 percent. By contrast, botanical products with a more menopause-specific evidence base, such as black cohosh, soy isoflavones, red clover, and evening primrose oil, were reported far less frequently. Black cohosh, for instance, was used by just 10.1 percent of supplement users, while soy isoflavones and St. John’s Wort each registered at 1.4 percent. Notably, participants who reported menopause-targeted use were significantly more likely to take black cohosh, any herbal or botanical product, and probiotics, whereas general users more often reported multivitamins and calcium, products typically associated with overall health maintenance or bone support.

Usage patterns among supplement users were remarkably consistent. Of the 110 users who answered the duration question, 53.6 percent had been taking supplements for more than a year, and of the 125 who answered the frequency question, 88.8 percent reported daily use. Users reported a median of three supplement types. Yet perceived effectiveness was decidedly mixed: among the 115 users who rated their supplements, 47.0 percent described them as somewhat or very effective, 27.8 percent were neutral, and 25.2 percent rated them as somewhat or very ineffective. Perceived effectiveness was significantly higher among those using supplements specifically for menopause symptoms, at 56.2 percent, compared with 35.3 percent among general users, a difference the study suggests may simply reflect that the latter group was not seeking symptom relief in the first place.

On the hormone therapy front, awareness was high but enthusiasm tempered by lingering fears. Some 82.7 percent of participants were aware of MHT, and 11.5 percent were currently using it. Perceptions leaned neutral or positive, with 45.1 percent neutral and 36.7 percent somewhat or very positive. However, concerns about specific risks were widespread: 47.8 percent cited increased breast cancer risk, 44.7 percent cited blood clotting, 40.7 percent cited stroke, and 37.2 percent cited heart disease. Only 36.3 percent reported no concerns at all. These figures echo the enduring influence of the initial Women’s Health Initiative findings, even though subsequent analyses have nuanced the original results, suggesting that for women younger than 60 or within 10 years of menopause onset without contraindications, the benefits of MHT often outweigh the risks.

The study also uncovered significant demographic disparities in MHT awareness. Awareness rose monotonically with income, reaching 100 percent among participants earning $200,000 or more, compared with 66.2 percent among those earning less than $50,000. Awareness was lowest among participants identifying as Black or African American, at 38.5 percent, those with a high school diploma or GED, at 69.2 percent, and current smokers, at 67.6 percent. Current MHT use was associated with income alone, ranging from 4.2 percent among the lowest earners to 33.3 percent among the highest. Because several racial and ethnic groups were represented by very few participants, the authors caution that these comparisons rest on small numbers and call for larger, more diverse studies to confirm the patterns.

In the multivariable logistic regression, smoking status emerged as the only participant characteristic significantly associated with any supplement use. Former smokers had 2.98 times the odds of supplement use compared with current smokers, and never smokers had 3.92 times the odds, with the overall smoking effect reaching statistical significance at p equals 0.012. Participants aged 61 to 65 also showed higher odds, though that estimate was based on just 17 users and 2 non-users and carried a correspondingly wide confidence interval. Critically, when the analysis was repeated with menopause-targeted use as the outcome, none of the covariates was associated with the result, suggesting the smoking association reflects general wellness-oriented behavior rather than menopause-specific self-treatment. The overall model explained little of the variation in supplement use, with a McFadden pseudo-R-squared of just 0.075.

Information-seeking patterns revealed a clear hierarchy of trust. Healthcare providers were the most commonly cited source of information about menopause symptom management, at 69.0 percent of all participants, closely followed by the internet, online articles, blogs, and websites at 67.7 percent. When asked to rate trustworthiness on a scale, 75.3 percent of those rating healthcare providers judged them trustworthy or extremely trustworthy. Social media influencers, by contrast, were rated extremely untrustworthy by 47.1 percent of the 206 respondents who evaluated that source, making them the least trusted information channel by a wide margin. Among supplement users themselves, personal research was the leading factor influencing product choice at 42.5 percent, followed by recommendations from healthcare providers at 29.2 percent, while social media influencers and marketing each influenced just 0.9 percent of users.

The authors are careful to frame the findings within the study’s limitations. The voluntary response sampling means the prevalence estimates describe a self-selected sample of women with a particular interest in menopause and wellness, not the broader population of midlife women. The sample was also predominantly white, at nearly 80 percent, and highly educated, with 87.6 percent holding credentials above a high school diploma. The questionnaire was developed for the study and not formally validated, and it did not measure symptom severity with a validated instrument or distinguish perimenopausal from postmenopausal participants. Because the supplement list item did not ask the purpose of each product, the study cannot establish which specific supplements were taken exclusively for menopause symptoms. Despite these constraints, the findings highlight a clear clinical imperative: healthcare providers, who remain the most trusted source of information, have a significant opportunity to proactively ask about supplement use, provide balanced counseling on both evidence-based hormone therapy and the heterogeneous evidence behind popular supplements, and help women make informed, individualized decisions about managing this consequential life transition.

Subject of Research: Dietary supplement use and perceptions of menopausal hormone therapy among symptomatic menopausal women aged 45 to 65

Article Title: Dietary supplements are commonly used for menopause symptoms amid concerns about hormone therapy: a cross-sectional study

Article References: Dietary supplements are commonly used for menopause symptoms amid concerns about hormone therapy: a cross-sectional study. (n.d.). https://doi.org/10.3389/fgwh.2026.1924461

Image Credits: AI Generated

DOI: 10.3389/fgwh.2026.1924461

Keywords: menopause, dietary supplements, menopausal hormone therapy, women's health, black cohosh, vitamin D, magnesium, probiotics, Women's Health Initiative, cross-sectional study, health information sources, perimenopause