Perimenopause Support
Best-in-class: Perimenopause Complete
Thorne Perimenopause Complete. Per two-capsule daily serving: EstroG-100 botanical blend 514 mg (Angelica gigas root, Cynanchum wilfordii root and Phlomoides umbrosa root), hops flower extract 85 mg and vitamin B6 30 mg as pyridoxal 5'-phosphate. The product is not filed in the NIH Dietary Supplement Label Database, so this list is read off Thorne's own Supplement Facts panel.
Perimenopause Support quick facts
| Suggested dose | As directed. |
| How often | Daily |
| Who it's for | Women navigating perimenopause symptoms naturally. |
The multi-mechanism approach fits a multi-symptom problem better than a single agent. Check whether it contains black cohosh, which carries the hepatic caution, or isoflavones, which matter in hormone-sensitive conditions. It is worth saying that hormone therapy is considerably more effective for vasomotor symptoms than anything here, and the risk picture has been substantially revised since the original WHI reporting.
How Perimenopause Support actually works
Perimenopause involves progesterone falling first while estrogen swings, so the symptoms are erratic and multi-system. This formula answers that with one 514 mg botanical blend, EstroG-100 — Angelica gigas, Cynanchum wilfordii and Phlomoides umbrosa root — plus 85 mg of hops flower extract and 30 mg of vitamin B6. EstroG-100 is the unit the trials were run on, and the hops is where the estrogenic activity in this bottle sits: an 8-prenylnaringenin story, not an isoflavone one.
Where to get Perimenopause Support
Buy Perimenopause Complete at Thorne →The evidence for Perimenopause Support
Graded by what exists behind each claim.
✅ Clinically validated
- Component botanicals (e.g., black cohosh, adaptogens) have RCT support for menopausal symptom relief, with mixed results overall.
- Supportive nutrients aid mood, sleep and stress during the transition.
📊 Correlative data
- Perimenopausal hormone shifts track with sleep, mood and vasomotor symptoms.
🧪 Theoretical / extrapolated benefits
- Blend-level outcomes are inferred from individual ingredients rather than whole-formula trials.
How to read these tiers: they say how much human evidence exists, not how well something works — and ✗ flags harm, never a disappointing trial. How the evidence tiers work →
What Perimenopause Support actually does
What is actually in it, because the card describes a different bottle. The card's safety note says the blend is “typically black cohosh, red clover, dong quai or sage” and warns about the black cohosh liver signal. Thorne's Perimenopause Complete contains none of those four. Per two-capsule daily serving it carries vitamin B6 30 mg as pyridoxal 5'-phosphate, EstroG-100 botanical blend 514 mg — Angelica gigas root, Cynanchum wilfordii root and Phlomoides umbrosa root — and 85 mg of hops flower extract. It is not filed in the NIH Dietary Supplement Label Database at all; the single-ingredient EstroG-100 unit that is filed there is 500 mg once daily Office of Dietary Supplements 2019. Everything below is written against those three ingredients.
The surprise is that the botanical blend is not a phytoestrogen, and it was tested specifically to find out. The three-herb mixture of Cynanchum wilfordii, Phlomis umbrosa and Angelica gigas was put through the standard estrogenicity panel: it did not show estrogenic activity, did not significantly induce MCF-7 breast cancer cell proliferation, and did not increase uterine weight in ovariectomized rats Kim 2017. Cell assay, and the century-old uterotrophic bioassay, both negative.
That single result reorganizes the whole page. A menopause botanical that is not estrogenic is not acting through the estrogen receptor, which means its mechanism is unidentified — and it also means the standard hormone-sensitive-cancer warning that the card applies to this product is aimed at a mechanism the product does not appear to have. Both halves of that are worth saying: the mechanism is missing, and so is the reason for the specific fear.
The hops is the ingredient with the potent estrogen in it, and nobody puts it on the front of the box. Hops contain 8-prenylnaringenin, among the most potent plant estrogens identified. It is also extensively metabolized: human liver microsomes convert 8-prenylnaringenin into twelve identified metabolites Nikolic 2004, so first-pass handling is substantial and the molecule that reaches tissue is not simply the molecule that was swallowed. The estrogenic risk in this bottle, such as it is, lives in the 85 mg of hops rather than in the 514 mg the label leads with.
And the vitamin B6 is at a pharmacological dose that the card never mentions. Thirty milligrams of pyridoxal 5'-phosphate is roughly twenty times an adult requirement. P5P is the active coenzyme for aromatic L-amino acid decarboxylase and for the transaminases, so it has a real place in monoamine synthesis — and high-dose vitamin B6 from supplements carries a recognized sensory neuropathy signal, documented in a spontaneous-report case series van Hunsel 2018. That is the ingredient in this product with the clearest dose-related harm, and it is the one nobody discusses.
Cell, rodent, human — and where it stops
There is no trial of this blend. There are trials of two of its three parts, and the dose arithmetic works out differently for each.
EstroG-100: a real randomized trial, and the capsule carries the studied amount. Sixty-four women were randomized to EstroG-100 (n = 31) or placebo (n = 33) for 12 weeks. The modified Kupperman Menopause Index fell from 29.5 ± 7.4 to 11.3 ± 5.8 on the extract (p < 0.01), against 29.2 ± 6.6 to 23.7 ± 7.7 on placebo Chang 2012. An 18-point fall against a 5.5-point placebo fall is a large separation. And unlike almost every blend on this site, the dose in the bottle is not a fraction of the trial dose: 514 mg a day is the same order as the 500 mg single-ingredient unit filed with the NIH database Office of Dietary Supplements 2019. That is worth crediting explicitly, because eight earlier cohorts on this site found the opposite.
Hops: a real trial too, and the label cannot be compared with it. Sixty-seven menopausal women took a hop extract standardized on 8-prenylnaringenin at 100 or 250 micrograms for 12 weeks. The 100 mcg arm was significantly superior to placebo at six weeks (P = 0.023) and not at twelve (P = 0.086); both treatment groups showed a significant fall in hot flush score at six weeks (P < 0.01) Heyerick 2006. Note the shape of that: the effect was measurable early and had faded by the endpoint, and the lower dose was the one that reached significance.
Now the arithmetic that cannot be done, which is the point. That trial's dose is expressed in micrograms of 8-prenylnaringenin. The Perimenopause Complete label states 85 mg of hops extract with no 8-prenylnaringenin content. A hop extract standardized at the 0.1% used to make the trial material would put 85 mg at roughly 85 micrograms of 8-PN — just under the effective arm — but an unstandardized extract could carry a tenth of that or none. The comparison is impossible from the label, and that is a formulation criticism rather than a speculation: the trial defined its dose in the unit the label omits, and the arithmetic above is explicitly conditional on an assumption the manufacturer has not published.
So the specific obstacle here is not dose and not species. It is that the blend's two active parts fail in opposite directions. The botanical is dosed correctly and has no identified mechanism Kim 2017; the hops has a well-characterized mechanism and an uncheckable dose Heyerick 2006 Nikolic 2004. A blend cannot inherit the strengths of two ingredients while carrying the weakness of each.
And the obstacle they share is the trial design problem this whole field has. The Cochrane review of phytoestrogens for vasomotor symptoms covers 43 randomized trials and 4,364 participants and is unable to demonstrate a consistent effect Lethaby 2013. Any 12-week open experiment on yourself sits inside that noise.
Perimenopause Support — which form, and does it matter
EstroG-100 is a defined, branded, three-root extract, and that is genuinely useful. Naming it means the trial Chang 2012 and the mechanistic assay Kim 2017 both refer to the same material as the capsule. A blend listing ‘Angelica gigas, Cynanchum wilfordii, Phlomoides umbrosa’ without the brand name is not necessarily the same extract at the same ratio, and there is no generic specification to fall back on.
The identity risk in this blend is Cynanchum wilfordii, and it is documented. A review exists for the specific purpose of discriminating Polygoni Multiflori Radix, Cynanchi Wilfordii Radix and Cynanchi Auriculati Radix and setting out their proper use in Korea Lee 2015. A published review whose subject is telling three roots apart is evidence that they are, in practice, confused — and the botanical in this capsule is the middle one of the three. A purchaser is relying on an identification step that the primary literature says is difficult in the root's own domestic market.
The hops specification that should be on the label and is not. Hop extracts for menopause are made by standardizing on 8-prenylnaringenin, and the trial expressed its dose in micrograms of it Heyerick 2006. A label stating milligrams of hops extract states the weight of the powder. Because 8-PN is a minor constituent that varies with hop variety and processing, and because it is extensively metabolized once absorbed Nikolic 2004, ‘85 mg of hops’ is not a dose of anything. Ask for the 8-PN figure; if the manufacturer cannot supply it, the ingredient is decorative.
The B6 form is the right one and the amount is the question. Pyridoxal 5'-phosphate is the active coenzyme rather than pyridoxine hydrochloride, which is a defensible formulation choice. Thirty milligrams a day, indefinitely, is the part worth thinking about: the neuropathy case series is about supplemental B6 rather than dietary B6 van Hunsel 2018, and this product is a daily supplement with no stop date. Anyone also taking a B-complex, an energy drink or a multivitamin is adding to it without noticing.
What a better label would say. Milligrams of EstroG-100 — already there. Micrograms of 8-prenylnaringenin — missing. A certificate of botanical identity for the Cynanchum — missing Lee 2015. And a filed Supplement Facts panel in the public database, which for this product does not exist Office of Dietary Supplements 2019.
What would have to be true, and how you would know it was not
1. The Kupperman index or a menopause symptom score, with the trial's own number. Score yourself before starting and at 12 weeks. Predict a fall of the order of 15 to 18 points from a baseline near 30, of which the trial's placebo arm accounted for about 5.5 points Chang 2012. Anything less than roughly a ten-point separation from where you started is inside what placebo produced in that study.
2. Hot flush frequency, timed to the hops rather than to the botanical. If the hops is contributing, predict the change is visible at six weeks and possibly smaller at twelve, because that is the shape the hop trial reported — significant at six weeks, not significant at twelve Heyerick 2006. A product whose benefit fades between weeks six and twelve is not failing; it is reproducing its own evidence, and knowing that in advance stops you raising the dose.
3. estradiol, fsh and shbg — the prediction that cuts against the product, and it follows from the assay rather than from skepticism. Predict all three unchanged at 12 weeks. The botanical showed no estrogenic activity in cells or in ovariectomized rats Kim 2017, so there is no reason to expect an estrogenic signal at the axis. If estradiol or SHBG does move, the most likely source is the hops, not the 514 mg on the front of the label — and that would be worth knowing, because it would mean the ingredient with the estrogen is the one nobody dosed.
4. alt and ast, drawn once at baseline for a reason specific to this bottle. The card warns about black cohosh hepatotoxicity in a product that contains no black cohosh. The real reason to have baseline liver enzymes here is the Cynanchum identity question Lee 2015: if the material in your capsule is not the root on the label, you cannot know what it is, and transaminases are the cheapest general detector of a botanical going wrong. Predict them unchanged; the value is in having the before.
5. Peripheral sensation, which needs no lab at all. On 30 mg of B6 a day van Hunsel 2018, watch for numbness, pins and needles or burning in the feet and hands. Predict none — the case series concerns higher and longer exposures — but this is the one symptom on the page where the correct response is to stop the product immediately and see somebody, because B6 neuropathy is slow to recover.
What nobody has tested yet
Nobody knows how this blend works, and the negative assay is why that is a real question rather than a rhetorical one. EstroG-100 produced an 18-point fall in a randomized trial Chang 2012 and showed no estrogenic activity in the standard panel Kim 2017. A botanical with a clinical effect and no identified receptor is the most interesting thing in this cohort. Bioassay-guided fractionation against a non-estrogenic thermoregulatory endpoint would find the target; nobody has published it.
Nobody has measured the 8-prenylnaringenin content of this product. One assay of one bottle answers whether the hops in it is at, above or below the 100 microgram arm that worked at six weeks Heyerick 2006. It is a single HPLC run. Until somebody does it, the arithmetic in the section above stays conditional.
Nobody has run the blend against its own parts. Three arms — EstroG-100 alone, hops alone, both — over 12 weeks with a symptom score would tell a buyer whether the hops is doing anything at 85 mg. The product has been designed around the assumption that it does, and the assumption has never been tested.
And nobody has followed these women past three months. The trial is 12 weeks Chang 2012; the hop trial is 12 weeks Heyerick 2006; perimenopause runs for years. A product taken daily for four years has no safety data set of that length, and the B6 signal in particular is one that accumulates van Hunsel 2018.
Perimenopause Support — its own safety story, not its category's
The card's central warning does not apply to this product, and saying so is more useful than repeating it. The black cohosh liver signal is real and it belongs on a black cohosh page. Perimenopause Complete contains no black cohosh, no red clover, no dong quai and no sage. Its three ingredients are a three-root Korean botanical blend, hops and vitamin B6, and each has its own story.
The hormone-sensitive-cancer question, answered from the assay rather than the reflex. The botanical did not induce MCF-7 proliferation and did not increase uterine weight in ovariectomized rats Kim 2017 — the two experiments that would show estrogenic proliferation. That is genuinely reassuring for the 514 mg and it says nothing about the 85 mg of hops, whose 8-prenylnaringenin is a potent plant estrogen extensively metabolized in the liver Nikolic 2004. So the honest position is: the ingredient that would raise the question is present, undosed and unmeasured, and anyone with a history of breast, endometrial or ovarian cancer should treat that as an open question for their oncologist rather than as either a clearance or a prohibition.
The dose-related harm on this label is the vitamin B6, and it is the one nobody flags. Thirty milligrams a day of supplemental B6, taken indefinitely, sits in the exposure range that generates spontaneous reports of sensory neuropathy van Hunsel 2018. The presentation is symmetrical numbness and tingling in the feet and hands, it can progress while the person keeps taking the supplement because nobody connects the two, and recovery after stopping is slow and sometimes incomplete. Anyone stacking this with a B-complex or a multivitamin should add up the B6 across every bottle they own.
The identity risk, stated as what it is. Cynanchum wilfordii is one of three roots that a published review exists to help practitioners tell apart Lee 2015. Substitution in a botanical supply chain is not a hypothetical failure mode; it is the reason that review was written. The practical mitigation is to buy from a manufacturer that publishes botanical identity testing, and to have baseline liver enzymes so that an abnormal result later can be interpreted.
And the clinical point the card gets exactly right. Symptoms that start abruptly, and any bleeding after twelve months without a period, are not perimenopause until somebody has looked. The trials here ran 12 weeks in women already established as perimenopausal Chang 2012. A supplement taken instead of that assessment converts a diagnostic question into a delay, and the delay is the harm.
Sources read for this page
- Chang A, et al. The effect of herbal extract (EstroG-100) on pre-, peri- and post-menopausal women: a randomized double-blind, placebo-controlled study. Phytotherapy Research 2012;26(4):510-516 · PMID 21887807
- Kim MJ, et al. Evaluation of Estrogenic Activity of Extract from the Herbal Mixture Cynanchum wilfordii Hemsley, Phlomis umbrosa Turczaninow, and Angelica gigas Nakai. Toxicological Research 2017;33(1):71-77 · PMID 28133516
- Heyerick A, et al. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas 2006;54(2):164-175 · PMID 16321485
- Nikolic D, et al. Metabolism of 8-prenylnaringenin, a potent phytoestrogen from hops (Humulus lupulus), by human liver microsomes. Drug Metabolism and Disposition 2004;32(2):272-279 · PMID 14744951
- Lee JW, et al. Discrimination and Proper Use of Polygoni Multiflori Radix, Cynanchi Wilfordii Radix, and Cynanchi Auriculati Radix in Korea: A Descriptive Review. Evidence-Based Complementary and Alternative Medicine 2015;2015:827380 · PMID 26539235
- Office of Dietary Supplements, National Institutes of Health. EstroG-100 500 mg (Swanson Ultra) -- filed Supplement Facts panel: EstroG-100 proprietary blend 500 mg per capsule of Angelica gigas, Phlomis umbrosa and Cynanchum wilfordii standardized extracts, one capsule daily; on market. NIH Dietary Supplement Label Database, label recorded 2019
- van Hunsel F, et al. Vitamin B6 in Health Supplements and Neuropathy: Case Series Assessment of Spontaneously Reported Cases.. Drug Safety 2018 · PMID 29737502
- Lethaby A, et al. Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database of Systematic Reviews 2013;(12):CD001395 · PMID 24323914
How you would know if it worked
There is no blood test for this one. That is not a criticism — it is a fact about the effect, and it changes how you should judge it.
- What to watch: Hot flashes and night sweats, counted rather than remembered: a tally of daytime flushes and of nights that woke you, kept for two weeks before the first dose. Frequency is the endpoint the menopause trials use, because it is the one part of this transition that can be scored the same way twice — and a blend aiming at four symptoms at once cannot be judged on a general impression of the month.
- How long before it means anything: Twelve weeks. The botanical trials in this space run three months or longer, and the transition moves underneath you while you measure it: perimenopausal symptoms arrive and leave in waves without any help from a bottle, so a good fortnight proves nothing.
- What will fool you: Two things. Vasomotor symptoms respond strongly to placebo in controlled trials, which is precisely why the uncontrolled version — a bottle, a hope, a month — is such weak evidence. The second matters more: fatigue, low mood, broken sleep and heavy or erratic bleeding in your forties are also what thyroid disease and iron deficiency look like, and both are common and treatable. Get a TSH and a ferritin before you spend a season scoring symptoms, and take the bleeding to a doctor rather than to a supplement.
Run it one variable at a time. Starting three things in one week means a result you cannot attribute, which is the same as no result.
Perimenopause Support — safety & side effects
- Perimenopause Complete is EstroG-100 514 mg, hops flower extract 85 mg and vitamin B6 30 mg. There is no black cohosh in it, so the black cohosh liver signal does not apply — the estrogenic question in this bottle belongs to the 85 mg of hops, which the label leads away from rather than toward.
- Symptoms that start abruptly, or bleeding after 12 months without a period, are not perimenopause until someone has looked.
The same on every page it applies to. Read it here; it is not repeated research.
- This is one formula with several actives, and it carries the combined safety profile of everything on its panel — the risks do not average out, they add. Check the panel above against anything else you take, because the commonest way to overdose an ingredient is to meet it twice in one day under two different product names.
- Avoid if you have or have had a hormone-sensitive cancer (breast, ovarian, uterine, prostate) without oncology input. The mechanism that makes it useful is the mechanism that makes it a question in that setting.
Not medical advice. If you take prescription medication or have a diagnosed condition, check this against it with a pharmacist or doctor — pharmacists are underused and free.
- When to take it, and what to take it with
- Which form actually absorbs
- Who it's worth it for
- Best-in-class brand pick
- Coach Cam's stacks and notes
- Fasted or with food, and when in the day
- Morning or night, and why that window
- Around training, or deliberately away from it
- What it must not share a window with
Everything above is free and stays free. Skool is where it becomes a plan — Perimenopause Support in an order, with the rest of what you're running.
Unlock in Skool — $10/mo →Bloodwork to run alongside Perimenopause Support
Baseline first, then again at 8–12 weeks.
| Marker | What it’s watching for |
|---|---|
| TSH (Thyroid-Stimulating Hormone) | Thyroid sits upstream of most things labeled 'hormonal' |
| Free T4 (Thyroxine) | Distinguishes a real thyroid problem from a borderline TSH |
| Total Testosterone | The baseline, if any of this is aimed at androgens |
| Vitamin D (25-Hydroxy) | Behaves like a hormone and is commonly low |
The Basics — Start Here panel covers these in one order — 4 markers, $32.40 with the discount applied.
Check results you already have → · All 103 markers A–Z
Perimenopause Support — frequently asked questions
What is Perimenopause Support?
Thorne Perimenopause Complete. Per two-capsule daily serving: EstroG-100 botanical blend 514 mg (Angelica gigas root, Cynanchum wilfordii root and Phlomoides umbrosa root), hops flower extract 85 mg and vitamin B6 30 mg as pyridoxal 5'-phosphate. The product is not filed in the NIH Dietary Supplement Label Database, so this list is read off Thorne's own Supplement Facts panel.
What is the suggested dose of Perimenopause Support?
As directed. This is a general reference for education only — statements have not been evaluated by the FDA and this is not medical advice.
Where can I find Perimenopause Support dosing and the full breakdown?
The suggested dose and the full evidence — clinical, correlative and theoretical — are on this page. What's inside Skool is when to take it, which form actually absorbs, the brand worth buying and Coach Cam's stacks.
Where can I buy Perimenopause Support?
Coach Cam sources Perimenopause Support from Thorne, with 10% off auto-applied at checkout — use the buy link on this page.
Perimenopause Support inside a finished plan
One arm of 2 Protocol Blueprints, free to read in full.
What Perimenopause Support is used for
Perimenopause Support appears under 2 goals in the goal router.
Related Hormonal & Wellness supplements
Where this goes next
Perimenopause Support is the upstream-cause arm of this plan. The page above is the free breakdown of one compound; the plan it belongs to — the dosing, the order to correct things in, the week-by-week schedule and what to retest — is a lesson inside Skool.