Managing menopause: Industry experts highlight alternatives to outdated hormone replacement therapy

10 Jul 2024 --- Women around the globe are increasingly seeking natural solutions to common menopause symptoms, questioning the need for the much more invasive, traditionally prescribed Hormone Replacement Therapy (HRT). 

Nutrition Insight discusses current trends and solutions with experts from Gencor, Lycored, Kaneka Probiotics, Gnosis by Lesaffre and Stratum Nutrition.

“When women experience the many symptoms of menopause, some may turn to HRT for relief. However, this treatment has been known to have adverse side effects. Consequently, women increasingly seek safer alternatives like natural or plant-based products like dietary supplements,” Maggie McNamara, VP of marketing at Gencor, tells us. 

Dr. Elizabeth Tarshish, clinicals and claims substantiation lead at Lycored, comments: “Current trends focus on both traditional and alternative approaches, with an emphasis on individualized care.”

 “HRT remains a widely used option for alleviating menopausal symptoms, but due to rising concerns about the risks associated with long-term HRT use, many women are turning to complementary and alternative therapies. These include antioxidant-rich dietary supplements,” she explains. 

Jordi Riera, chief business officer at Kaneka Probiotics agrees: “There are a range of trending vitamins and supplements that are popular for alleviating common menopause symptoms, such as collagen, calcium and vitamin B. In line with this, we’ve seen a movement away from HRT for managing these menopause symptoms due to potentially serious side effects.”

He argues that the majority of women would not consider taking HRT to treat menopause symptoms, with the market declining over the past decades, leaving the door open for natural solutions.

Market magnitude
Gencor’s McNamara argues that the sheer size of the menopause product market calls for more extensive research and development. “There’s a clear need for more studies in this area,” she asserts.

Common natural solutions include black cohosh, ginseng, magnesium, red clover, omega-3s, probiotics, vitamins D and E, saffron and fenugreek.“A bill introduced (H.R.8774 Menopause Research Act of 2022) called for US$100 million for menopause research in 2023 and 2024, but it hasn’t moved forward. So, what is encouraging is that ingredient suppliers and dietary supplement companies are starting to realize the magnitude of the market.”

She states that most companies in the industry, especially Gencor, also realize there is a need for more clinical research in this area. “It is encouraging that menopause is receiving renewed attention and that people are noticing the need for that course correction.”

 Common ingredients she outlines are black cohosh, ginseng, magnesium, red clover, omega-3s, probiotics, vitamins D and E, saffron and Ayurvedic herbal extracts such as fenugreek.

“Even though the market has significant potential to grow, factors like a lack of awareness and stigma, regulatory hurdles and limited research and development may hinder it,” McNamara points out. “However, what many see as an additional hindrance, namely safety concerns, presents an opportunity for dietary supplements.” 

“Breast cancer and cardiovascular risks, such as heart disease, stroke and blood clots, have all been found to be higher in women who use HRT. As a result, there is a rising need for non-hormonal treatments.”

She argues that companies now need to formulate effective finished products to support perimenopause and menopause by using clinically researched ingredients that are proven to have real effects on women. 

Alternative therapies
Lycored’s Tarshish points to lycopene, phytosterols and other phytonutrients as organic ingredients in menopause management that present significant opportunities.

“Lycopene, a powerful antioxidant, has gained popularity due to its bone health benefits, particularly important during menopause when the risk of osteoporosis increases. Products incorporating lycopene help reduce oxidative stress and bone resorption, supporting overall bone density and reducing fracture risk.”

She highlights that herbal supplements, lifestyle changes and nutritional adjustments are also integral to the modern approach to menopause management.

“Lycopene is known for its powerful antioxidant properties, which helps reduce oxidative stress and bone resorption. This can significantly decrease the risk of osteoporosis, a major concern for postmenopausal women. Additionally, phytosterols contribute to cellular wellness by reducing cholesterol levels, which can improve cardiovascular health,” she details. 

“The combination of these ingredients offers a comprehensive, effective, safe and natural approach to bone health and overall cellular wellness management, making these products attractive to holistic health-conscious consumers.”

Tarshish argues that as consumer concerns over traditional hormone therapies increase, the menopause management market is shifting toward scientifically proven, natural solutions. 

“Personalized health and nutrition solutions that are individually tailored through genetic testing are also expected to become more prominent. Consumer education will continue to be vital, as companies must provide clear, evidence-based information to build trust and differentiate their products.” 

HRT may relieve some symptoms, but it is known to have adverse side effects.Hot flashes and cognition
Silvia Pisoni, global market manager with Gnosis by Lesaffre points out that according to The North American Menopause Society, menopausal women often deal with impaired memory performance — notably reduced verbal memory — which is directly correlated to hot flashes. 

“This dual symptom association reflects two trends in this category — the desire for protecting and improving cognitive performance and the need to tackle hot flashes without pharmaceutical intervention (such as HRT or antidepressants). Another growing trend is supporting a stable and healthy mood,” she outlines. 

“Gnosis offers proven ingredient solutions that can help them address these menopausal irritations. For example, Adonat Premium SAMe S-adenosyl methionine is a naturally occurring molecule in the human body. There is substantial evidence showing it supports healthy mood and emotional well-being, as it is directly involved in the synthesis of neurotransmitters serotonin, dopamine and norepinephrine.”

According to Pisoni, studies have also shown it to protect neural function and neurotransmission as well as neuroplasticity, all important elements for desirable cognitive function. 

“Quatrefolic is a folate or vitamin B9. It is essential in preserving cognitive functions and neural signaling. Supplementation with the proper form — folate — is critical to ensuring plasma levels are high enough to obtain benefits, such as reducing high homocysteine levels (a factor in cognitive dysfunction), as well as sustaining good mood.” 

She explains that it maximizes cognitive benefits, as it provides the active form of folate that does not need metabolization. 

Other common symptoms 
Alexis Collins, director of product and brand strategy at Stratum Nutrition lays out the most common complaints that come with hormonal fluctuations in this period of life: “Hot flashes, night sweats, higher stress and anxiety, vaginal dryness, mood swings and slower metabolism.”

“Products that provide support during perimenopause and menopause continue to focus on these major complaints. We have two ingredients that help provide support for managing symptoms: Sage extract and Nem. Both of these ingredients make unique additions to support formulations because they target aspects of peri/menopause that many formulations overlook.”

She explains that Stratum Nutrition’s Sage Extract is a standardized, traceable extract of Salvia officinalis. “A 2023 meta-analysis of four studies with 310 subjects total found that S. officinalis significantly reduced the frequency of hot flashes compared to placebo. In addition to this commonly sought benefit, our specific extract of S. officinalis provides targeted support for memory and attention, helping provide support for the ‘brain fog’ complaint of peri/menopause.” 

Gencor’s McNamara adds that it is also important to remember that “we can’t assume that every woman is perimenopausal when she becomes a particular age” because this can occur at a wide range of ages.

“Many women do not know when perimenopause starts, so education is critical for these stages of life that every woman will experience. It is also important to know that women have different manifestations of how they feel and react during these stages.” 

“Some women may get hot flashes, but others may not, so offering clinically backed ingredients to support a myriad of menopausal symptoms will bode well,” concludes McNamara.

By Milana Nikolova