Natural Supplements For 7 Common Women’s Health Issues
By Dr. Michael Murray, ND
In this article:
The female body is truly a wonder capable of bringing new life into the world and nurturing it during its critical early months. But this amazing gift can come at a price, as the hormonal tides necessary for reproductive function can also lead to health challenges. Here is a quick overview of the top seven health issues women need to be aware of and key dietary supplements to consider for nutritional support.
It is critical that women avoid low nutritional status, yet based upon dietary and nutritional surveys, nutritional inadequacy is common in women even in developed countries like the United States.1 In order for a woman’s body to run properly, it is essential that all of its nutritional needs are being met. Even a very mild deficiency of any single nutrient can greatly disrupt important body functions. For women, a mild nutrient deficiency may translate to common issues such as depression, premenstrual syndrome, and fatigue; higher risk for serious diseases such as breast cancer, heart disease, and osteoporosis; and an increased risk for birth defects in their offspring.
As a “nutritional insurance policy,” women should take a high-quality multiple vitamin and mineral supplement that provides the recommended dietary allowance (RDA). It is critical throughout a woman’s life, but especially at conception and during pregnancy. Extra vitamin D3 is also of importance. Take 2,000 to 4,000 IU daily. A high-quality fish oil supplement is also a key foundation supplement for optimal health. Take a dosage of fish oil sufficient to provide a combined total of 1000 to 2000 mg of EPA and DHA daily. Taking a plant-based, broad-spectrum antioxidant is also recommended. Grape seed extract is a great choice at a dosage of 100 to 300 mg daily.
Iron deficiency is the most common nutrient deficiency in the world and women during the reproductive years are by far at the highest risk due to blood loss during menstruation. Some estimates are that iron deficiency occurs in 35-58% of young, healthy women. During pregnancy, the number is even higher. Women who are vegans or vegetarian, or involved in endurance training such as long-distance running, triathlons, or swimming are at a very high risk of iron deficiency, with some studies showing low iron stores in up to 80% of these women.2,3
Iron deficiency is a spectrum, with early stages being characterized by fatigue, depression, cold hands, and feet, decreased physical capacity and thinning of the hair. All very common issues in women. All of these symptoms can occur prior to the last stage of iron deficiency, which is anemia, the lack of oxygen-carrying red blood cells in the body.4
Menstruating women should have a blood test to determine body iron stores known as serum ferritin. Ideally, the level should be at least 60 ng/ml. If it is not, increasing dietary iron intake as well as supplementation is recommended. The best supplemental forms of iron are ferric pyrophosphate and ferrous bisglycinate. These forms do not produce the gastrointestinal side effects associated with other iron supplements like ferrous sulfate and are well-absorbed, especially if taken on an empty stomach.
For general health, the usual recommendation is 18 to 30 mg of iron daily. For boosting iron levels due to low serum ferritin levels the dosage recommendation is 30 mg twice daily between meals using gentler forms. If this recommendation results in any abdominal discomfort, take 30 mg with meals three to four times daily.
Fluctuations in female hormones are often associated with feelings of depression or anxiety. These are most obvious in women with premenstrual issues (depression, irritability, mood swings, water retention, breast tenderness, etc.), or those passing through the time just after childbirth (postpartum) and the time just before or during menopause.
Nutritional deficiencies may play a role in increasing the risk of depression in women because of the critical role that vitamins (especially B vitamins), minerals (especially zinc and magnesium), and omega-3 fatty acids (i.e., fish oils) play in hormonal metabolism. In addition to these foundational nutritional supplements, here are some considerations for dietary supplements to elevate the mood-based upon where a woman is on the life cycle:
- Menstruating women: 5-Hydroxytryptophan (5-HTP) is the form of the amino acid tryptophan that is a closer step to the manufacture of the brain chemical serotonin. Low serotonin levels can lead to low mood, poor sleep quality, and carbohydrate cravings. 5-HTP has shown excellent results in improving signs of low serotonin in detailed clinical trials. Take 50 to 100 mg three times daily twenty minutes before meals.5
- Postpartum: Restoring iron levels after pregnancy is critical to avoiding iron deficiency, which can lead to depression after childbirth. In addition, S-adenosylmethionine (SAMe) is a great choice for women looking for mood support after child-birth. SAMe is a compound that is produced by the body. It is critical to the manufacture of many brain chemicals and is also involved in the breakdown of hormones by the liver. In addition to improving mood in women in general, SAMe also has been to produce significant effects specifically in postpartum (after pregnancy) women.6 The recommended dosage is 200 mg twice daily.
- Perimenopause and menopause: St. John’s wort (SJW) extract may be the best choice during the time just before menopause (perimenopause) and during menopause. Not only does SJW extract produce mood-elevating effects, it also reduces the frequency and severity of hot flashes.7 Take 900 to 1,800 mg daily of the SJW extract standardized to contain 0.3% hypericin.
Preserving bone health requires a comprehensive approach based upon diet, lifestyle, and proper supplementation. Calcium combined with vitamin D3 has received the most attention, and it is certainly important to bone health. There have been many studies with calcium and vitamin D3 supplementation for bone health. From these studies, it appears that an effective dosage for supplemental calcium is 600 to 1,000 mg per day for most women.8 The dosage for vitamin D3 being recommended by most experts for bone health is 2,000 to 4,000 IU per day.
Magnesium is also required for proper bone mineralization as well as in aiding in the activity of vitamin D.9 Taking large doses of calcium can impair the absorption of magnesium and that might not be good for bone health. To ensure the proper balance of calcium to magnesium, many nutritionally-oriented physicians recommend taking half as much of magnesium as calcium or in other words a 2:1 ratio of calcium to magnesium. So, the recommended dosage is 300 to 500 mg daily.
Silica is another important mineral for bone health. Biosil, a highly bioavailable form of silica, has shown positive clinical effects in improving bone density and the collagen content of the bone.10 By increasing the collagen content of the bone by 22% within one year of use, BioSil increases the number of bone mineral binding sites. Supplementing at a dosage of 6 mg per day increased bone mineral density by 2% within one year – safely and without side effects.
Another key supplement for bone health is a form of vitamin K2 known as MK-7. Vitamin K2 plays an important role in bone health as it is responsible for converting the bone protein osteocalcin from its inactive form to its active form. Active osteocalcin literally anchors calcium into place within the bone. In a landmark major clinical study, MK-7 at a dosage of 180 mcg daily significantly improved vitamin K status and active osteocalcin levels, and decreased the age-related decline in bone mineral concentration (BMC) and bone mineral density.11 What this study showed is that it is not a matter of how much calcium you take, it is how much calcium gets anchored into the bone matrix. MK-7 can help.
Heart disease affects men and women equally. In the United States, one in every four deaths in women occurs due to heart disease.
One of the most important dietary supplements for heart function is CoQ10. It is an essential component of the mitochondria - the energy-producing unit of the cells of our body. Its role in the mitochondria is similar to the role of a spark plug in a car engine. Just as the car cannot function without that initial spark, the mitochondria cannot produce energy without CoQ10.
Although the body makes some of its own CoQ10, considerable research shows significant benefits with supplementation especially in those with any condition associated with decreased cardiovascular function or those taking cholesterol-lowering drugs are known to have low CoQ10 levels. In addition, the elderly in general may have increased CoQ10 requirements as CoQ10 levels are known to decline with advancing age.12
CoQ10 exists in two interchangeable chemical forms – ubiquinone and ubiquinol. The dosage for ubiquinol is 50 to 100 mg per day while the dosage for ubiquinone is generally 100 to 300 mg per day. My recommendation is to use the higher dosage levels if the goal is to improve heart function.
The top concern regarding breast health for women is breast cancer, however, another concern is fibrocystic breast disease (FBD), a benign breast condition associated with the presence of multiple cysts in the breast tissue. Diet is a critical aspect of breast health, both in terms of breast cancer prevention and FBD.
Diet should emphasize whole, unprocessed foods: whole grains, legumes, vegetables, fruits, nuts, and seeds. These recommendations can help promote regular bowel movements. Women who have fewer than three bowel movements per week have a 4.5 times greater rate of FBD than women who have at least one bowel movement a day.
One of the key dietary factors for breast health is a higher omega-3 fatty acid to omega-6 fatty acid ratios. This ratio is achieved by increasing the intake of fish rich in omega-3 fatty acids like salmon, mackerel, anchovies, and herring, as well as by taking high-quality fish oil (1,000 to 2,000 mg EPA+DHA), while also reducing the intake of omega-6 fatty acids found in most meat and dairy, as well as in certain vegetable oils such as corn, safflower, and soy. In one detailed study, women with the highest ratio of the long-chain omega-3 fatty acids EPA+DHA to omega-6 fatty acids (the omega-3:omega-6 ratio) had a 67% reduced risk of chronic breast diseases.13
Ground flaxseeds promote breast health because they provide special fiber compounds known as lignans.14 These compounds can bind to estrogen receptors and interfere with the detrimental effects that estrogen can exert on breast tissue. Lignans also increase sex hormone-binding globulin or SHBG. This protein regulates estrogen levels by escorting excess estrogen from the body. Ground flaxseed makes lignans more bioavailable. Take one or two tablespoons daily by mouth or added to foods such as hot cereals, salads, or smoothies.
Women are more affected by joint issues than men. Low sulfur levels may be a factor. MSM (methyl-sulfonyl-methane) is the major form of sulfur in the human body and a popular dietary supplement for joint health. Sulfur is an especially important nutrient for joint tissue where it functions in the stabilization of the connective tissue matrix of cartilage, tendons, and ligaments. Clinical studies have validated the benefits of MSM in improving joint health when given on its own, but better results have been observed when glucosamine sulfate is combined with MSM. Glucosamine sulfate is utilized in joints in the building of cartilage and other structural components. Dosage for MSM is 1,200 to 2,000 mg per day, for glucosamine sulfate the dosage is 1,500 mg per day.
- Reider CA, Chung RY, Devarshi PP, et al. Inadequacy of Immune Health Nutrients: Intakes in US Adults, the 2005-2016 NHANES. Nutrients. 2020;12(6):1735.
- Coad J, Conlon C. Iron deficiency in women: assessment, causes and consequences. Curr Opin Clin Nutr Metab Care. 2011 Nov;14(6):625-34.
- McClung JP. Iron status and the female athlete. J Trace Elem Med Biol. 2012 Jun;26(2-3):124-6.
- Musallam KM, Taher AT. Iron deficiency beyond erythropoiesis: should we be concerned? Curr Med Res Opin. 2018 Jan;34(1):81-93.
- Poldinger W, Calanchini B, Schwarz W. A functional-dimensional approach to depression: serotonin deficiency as a target syndrome in a comparison of 5-hydroxytryptophan and fluvoxamine. Psychopathology 1991;24:53–81.5. SAMe
- Cerutti R, Sichel MP, Perin M, et al. Psychological distress during the puerperium: a novel therapeutic approach using S-adenosylmethionine. Curr. Ther. Res. 1993;53:701–716.
- Eatemadnia A, Ansari S, Abedi P, Najar S. The effect of Hypericum perforatum on postmenopausal symptoms and depression: A randomized controlled trial. Complement Ther Med. 2019;45:109-113.
- Tai V, Leung W, Grey A, Reid IR, Bolland MJ. Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ 2015;351:h4183.
- Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013 Jul 31;5(8):3022-33.
- Spector TD, Calomme MR, Anderson SH, et al. Choline-stabilized orthosilicic acid supplementation as an adjunct to calcium/vitamin D3 stimulates markers of bone formation in osteopenic females: a randomized, placebo-controlled trial. BMC Musculoskelet Disord. 2008 Jun 11;9:85.
- Knapen MH, Drummen NE, Smit E, Vermeer C, Theuwissen E. Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporos Int. 2013;24(9):2499-507.
- Akbari A, Mobini GR, Agah S, et al. Coenzyme Q10 supplementation and oxidative stress parameters: a systematic review and meta-analysis of clinical trials. Eur J Clin Pharmacol. 2020;10.1007/s00228-020-02919-8.
- Bougnoux P, Maillard V, Chajes V. Omega-6/omega-3 polyunsaturated fatty acids ratio and breast cancer. World Rev Nutr Diet. 2005;94:158-65.
- Calado A, Neves PM, Santos T, Ravasco P. The Effect of Flaxseed in Breast Cancer: A Literature Review. Front Nutr. 2018 Feb 7;5:4.
- Mokbel K, Mokbel K. Chemoprevention of Breast Cancer With Vitamins and Micronutrients: A Concise Review. In Vivo. 2019 Jul-Aug;33(4):983-997
- Ogata T, Ideno Y, Akai M, et al. Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis. Clin Rheumatol. 2018;37(9):2479-2487.
- Salazar J, Bello L, Chávez M, et al. Glucosamine for osteoarthritis: biological effects, clinical efficacy, and safety on glucose metabolism. Arthritis. 2014;2014:432463.
- Lubis AMT, Siagian C, Wonggokusuma E, Marsetyo AF, Setyohadi B. Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial. Acta Med Indones. 2017 Apr;49(2):105-111.