Perimenopause, the years of hormonal change leading up to menopause, brings a long list of supplements marketed at it. The evidence supports a much shorter list. The most useful approach is to cover the basics that genuinely matter for this stage of life, and to be sceptical of products promising to fix hot flushes or hormones outright.
Bone and heart basics
The years around menopause are when bone density falls fastest, as falling oestrogen stops protecting it. That makes vitamin D (with vitamin K2) and adequate calcium, ideally from food first, genuinely worthwhile. Magnesium supports both bone and sleep, and omega-3 is a reasonable general addition for heart health. These are not exciting, but they are the ones with real backing for this stage.
Iron, if your periods are heavy
Perimenopausal periods can become heavier and less predictable, which can quietly drain iron stores. If you are getting more tired than usual, a ferritin test is worth it, since low iron is both common here and easily missed. Iron is one supplement not to take on guesswork.
Sleep and mood
Disrupted sleep is one of the most common perimenopausal complaints. Magnesium and the options in the sleep guide are reasonable starting points, and the stress guide covers the mood side.
A note on HRT and phytoestrogens
If you are on or considering HRT, that interacts with a couple of supplements, covered in the HRT guide. Plant oestrogens like soy isoflavones and red clover are heavily marketed for perimenopause; the evidence for symptom relief is mixed and modest, and they are largely redundant if you are already on HRT. To check any supplement against a medication you take, the free checker will show you the result and the reasoning.