Women can get a lot of advice on which supplements to take from social media.Inside Creative House/iStockPhoto / Getty Images
If you’re a woman in your 40s to early 60s, you may be looking for “natural” ways to ease brain fog, mood swings, fatigue or weight gain.
Or perhaps you’re considering supplements that promise to reduce wrinkles or preserve muscle mass and strength.
There’s no shortage of supplement advice aimed at women in midlife, especially on social media.
Here are three common questions about supplements I’m often asked by women – plus what the science says they can, and can’t, do.
Do collagen supplements delay skin aging?
Collagen supplements are made from animal parts rich in connective tissue, including bovine (cow) hides and bones, chicken cartilage and fish scales.
They’re sold as hydrolyzed collagen peptides, smaller fragments of the collagen protein, and are widely marketed to promote smoother skin, fewer fine lines and a more youthful glow.
There’s strong evidence from randomized controlled trials lasting eight to 24 weeks that collagen supplements (2.5 to 10 g per day) can modestly reduce wrinkle measures (versus placebo) in middle-aged and older women.
Evidence also suggests that taking collagen supplements for more than eight weeks may improve skin elasticity.
Collagen peptides are thought to reduce wrinkles by stimulating fibroblasts, structural cells in the skin’s middle layer (dermis), to produce collagen, elastin and hyaluronic acid.
Studies measure wrinkles using high-resolution cameras and 3D imaging systems that detect subtle changes on the skin’s surface, many of which are not visible to the naked eye.
The evidence for collagen’s favourable skin effects is not definitive, though.
Many studies use different collagen products, varying doses and added ingredients rather than a standardized pure collagen supplement.
In other words, different collagen products may not work the same.
Collagen supplements are generally considered safe and are well tolerated by healthy adults.
Should I take creatine to build muscle? Improve memory?
Creatine is a natural substance produced mainly by our kidneys and liver. Most (95 per cent) is stored in skeletal muscle, with five per cent or less found in the brain.
Your cells use creatine to rapidly regenerate energy molecules called adenosine triphosphate (ATP), allowing muscles and the brain to keep working during bursts of high demand.
Since the early 1990s, randomized controlled trials, many conducted in men, have shown creatine supplementation when combined with resistance training improve high-intensity exercise performance and increase muscle mass.
More recently, though, research suggests that creatine supplements benefit women, too.
The evidence is strongest for older and postmenopausal women who are doing resistance training.
A 2021 review of 10 randomized controlled trials conducted in women aged 56 to 70 found that taking creatine significantly improved strength, especially upper-body strength, compared with resistance training alone. There was no consistent increase in muscle mass across the trials.
A review of seven randomized controlled trials published earlier this year found that, among 608 postmenopausal women with an average age of 62, creatine (5 g/day) combined with resistance training led to increases in muscle strength and small but meaningful gains in muscle mass.
The benefits appear more consistent in training studies lasting 12 weeks or longer.
The muscle benefits of creatine are less consistent in studies of younger women.
When it comes to cognition, the research is promising but still preliminary.
Findings from small, short-term studies suggest that creatine supplementation can modestly improve memory, attention and processing speed.
Cognitive benefits from creatine are thought to be more likely when the brain’s energy demands are high (e.g., mental fatigue, sleep deprivation) and in people with lower creatine levels.
Creatine is generally safe for healthy adults, but it’s usually not recommended for people with kidney disease. If you have high blood pressure or liver disease, check with your doctor first.
Can certain supplements balance my hormones during perimenopause?
The short answer is no. There’s no good evidence that supplements can “balance” hormones in perimenopause.
Perimenopausal symptoms such as hot flashes, sleep disturbances, fatigue and mood swings are caused by changes in ovarian hormone production, particularly fluctuating levels of estrogen and progesterone.
These hormonal fluctuations are a normal part of the transition to menopause. The idea of restoring hormones to a stable “balance” is biologically misleading.
When wellness influencers and supplement companies talk about “balancing hormones,” they’re usually referring to reducing your symptoms and feeling better, not restoring hormones to any defined or measurable range.
A 2022 analysis of 25 self-help books on “hormone balancing” found no clear definition of the term.
On social media, there’s also no consistent metric given for which hormones are being measured and what levels are considered balanced.
A few supplements may modestly improve certain perimenopausal symptoms. But they don’t do so by normalizing hormone levels.
Even so, major guidelines don’t recommend taking supplements to manage perimenopausal symptoms, such as hot flashes, due to low-quality and conflicting evidence.
The most effective way to manage perimenopausal symptoms and weight changes is a personalized, evidence-based approach – not supplements that claim to balance hormones.
A healthy diet, good sleep and regular exercise can support overall well-being and help you feel better. If symptoms are disruptive, women should consult their family physician or nurse practitioner.
Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan.