4 Essential Nutrients to Prioritize During Menopause

By Genester Wilson-King, MD FACOG | Edited by Sarah Russo

Aging is inevitable. Maintaining muscle, staying energized, or recovering after exercise isn’t the same as it used to be. As women enter perimenopause and menopause, declining estrogen levels trigger changes throughout the body. These shifts can affect muscle strength, bone density, metabolism, cardiovascular health, and even cognitive function. Understanding menopause nutrition — and which nutrients matter most during this transition — can make this stage of life easier to navigate.

As estrogen levels decline, the body undergoes significant metabolic and physiological shifts. Many women also notice changes in energy, sleep, mood, and body composition during this transition. In fact, adults lose approximately 3–8% of their muscle mass each decade beginning around age 30, with muscle loss accelerating after menopause.¹ Women can also lose up to 20% of their bone density during the first five to seven years after menopause. This increases the risk of osteoporosis and fractures if preventative steps aren’t taken.

However, the way we age can be influenced by the choices we make every day. Recent recommendations from the International Menopause Society emphasize that nutrition, physical activity, and other healthy lifestyle habits work together to support healthy aging and improve quality of life during and after menopause.¹ Research continues to show that certain nutrients can help support healthy aging when combined with regular exercise, quality sleep, stress management, and personalized medical care.

Certain nutrients can be a helpful addition to your health toolkit. The right nutrients can help maintain strength, preserve bone health, protect cardiovascular function, and keep you active and independent. Nutritional supplements should never replace a healthy lifestyle. To be clear, no supplement can stop the aging process. But they can help fill nutritional gaps and support your body’s changing needs. Based on current research, here are the four essential evidence-based nutrients for menopause that can help perimenopausal and postmenopausal women maximize optimal wellbeing:

• Protein
• Vitamin D3
• Calcium
• Omega-3 fatty acids

Protein for Menopause: The Foundation of Healthy Aging

When people think about dietary supplements, protein isn’t one that generally comes to mind. Yet emerging research suggests it may be one of the most important nutritional priorities for women entering midlife. Understanding your protein needs after menopause starts with recognizing what drives them: beginning around menopause, declining estrogen contributes to a gradual loss of lean muscle mass, known as sarcopenia.¹ This natural process can lead to reduced strength, slower metabolism, decreased balance, impaired physical function, and an increased risk of falls and frailty over time.¹˙²

The 2025 International Menopause Society pinpointed a protein-rich diet as one of the most important nutritional strategies for healthy aging after menopause.¹ Adequate protein intake helps preserve muscle mass, support bone health, maintain strength, and improve physical function. These benefits can help maintain independence as we age.¹˙²˙³

Muscle remains remarkably responsive to lifestyle changes throughout life. Adequate protein provides the building blocks for muscle repair and maintenance. However, its benefits are greatest when paired with regular resistance training, which stimulates muscle protein synthesis and helps slow the progression of age-related muscle loss.¹˙³

Most experts recommend that healthy older adults consume approximately 1.0–1.2 grams of protein per kilogram of body weight each day.²˙³ Slightly higher intakes (1.2–1.5 g/kg/day) are recommended for women who exercise regularly, are recovering from illness, or are at greater risk of muscle loss and frailty.²˙&sup7; Rather than consuming most of your protein at dinner, try distributing it evenly throughout the day.

Good sources of protein include:

• Lean poultry
• Fish
• Eggs
• Dairy products
• Legumes
• Tofu
• Nuts and seeds

For women who struggle to meet their daily needs through food alone, a high-quality protein supplement may be appropriate after discussing their dietary needs with their healthcare provider.

Vitamin D3 for Menopause: More Than Just Bone Health

Vitamin D has long been recognized as one of the cornerstones of healthy aging, and vitamin D for bone health is especially critical during and after menopause. It is essential for calcium absorption, helping the body build and maintain strong bones throughout life. Vitamin D also supports normal bone remodeling and contributes to healthy muscle function. It plays an important role in immune regulation and may help reduce the risk of falls in individuals who are deficient.¹˙&sup4; Unlike most vitamins, vitamin D functions as a hormone. After it is produced in the skin or obtained through food or supplements, it is converted by the liver into 25-hydroxyvitamin D [25(OH)D], which is the form measured in blood tests. This is then activated by the kidneys to help regulate calcium metabolism, bone health, immune function, and other physiological processes.&sup4;˙&sup5;

A lack of vitamin D is one of the most common nutritional deficiencies worldwide.&sup4; As we age, our skin becomes less efficient at producing vitamin D from sunlight. Maintaining adequate vitamin D becomes increasingly important for women entering menopause. Declining estrogen accelerates bone loss, while aging reduces the skin’s ability to produce vitamin D naturally. Many older adults also spend less time outdoors or have changes in nutrient metabolism that further increase the likelihood of deficiency. People with darker skin are also at greater risk because higher levels of melanin reduce the skin’s ability to produce vitamin D from sunlight, often requiring longer UVB exposure to generate comparable amounts.&sup6; These collective factors put postmenopausal women at greater risk of inadequate vitamin D levels.¹˙&sup4;

Maintaining healthy vitamin D levels supports calcium absorption. Vitamin D helps preserve bone strength and muscle function as women age when combined with adequate calcium intake and regular weight-bearing exercise.¹ The Endocrine Society’s 2024 Clinical Practice Guideline recommends identifying and correcting vitamin D deficiency while avoiding routine high-dose supplementation in healthy adults.&sup4;

Vitamin D exists in two main forms. Vitamin D2 (ergocalciferol) is derived from plants and fungi. Vitamin D3 (cholecalciferol) is produced naturally in the skin following sun exposure and is also found in animal-based foods. Vitamin D3 is generally the preferred form for supplementation because it is more effective at raising and maintaining blood levels of vitamin D over time.&sup4; For many adults, 1,000–2,000 IU of vitamin D3 daily is commonly used to maintain healthy levels. The appropriate dose varies depending on an individual’s age, health history, diet, sun exposure, and baseline vitamin D status.&sup4;

More isn’t always better. While vitamin D is essential, taking high doses above what the body needs has not consistently been shown to provide additional health benefits in otherwise healthy adults. Excessive supplementation may increase the risk of adverse effects, including elevated blood calcium levels and kidney stones. Current clinical guidelines emphasize correcting deficiency and personalizing supplementation rather than routinely recommending high-dose vitamin D for everyone.&sup4;

When vitamin D deficiency is suspected, a simple blood test can help guide individualized treatment, particularly in patients with osteoporosis, malabsorption, or other conditions that affect vitamin D metabolism.&sup4; Because everyone’s health history and nutritional needs are different, working with your healthcare provider is the best way to determine the right amount for you. Vitamin D works best as part of a comprehensive healthy aging plan that includes regular physical activity, a nutrient-rich diet, and personalized medical care.

Calcium for Menopause: Why Food Comes First

Understanding your calcium intake after menopause starts with recognizing just how essential this nutrient is for protecting bone health. About 99% of the body’s calcium is stored in the bones and teeth, where it provides the structural framework that keeps our skeleton strong throughout life. Calcium also plays an important role in muscle contraction, nerve transmission, blood clotting, and normal heart function. When dietary calcium intake is too low, the body draws calcium from the bones to maintain these vital functions. This gradually weakens the skeleton.¹˙&sup7;

After menopause, estrogen levels continue to decline. Bone breakdown begins to outpace bone formation. This increases the risk of osteopenia, osteoporosis, and fractures. In fact, women can lose up to 20% of their bone density during the first five to seven years after menopause. This phase of life is a critical window for supporting long-term bone health.¹

Excellent whole-food sources of calcium include:

• Dairy products
• Fortified plant-based beverages
• Sardines with edible bones
• Tofu
• Leafy greens such as kale and bok choy
• Almonds and sesame seeds

These foods also contain protein, magnesium, phosphorus, vitamin K, and other nutrients that work together to support healthy bones. Food sources may offer advantages that isolated calcium supplements cannot fully replicate.&sup4;˙&sup7;

For women who are unable to meet their daily calcium needs through food alone, supplements can help fill nutritional gaps.&sup4;˙&sup7; Current clinical guidelines recommend that women 51 years and older consume approximately 1,200 mg of calcium per day from all sources, including food and supplements.¹˙&sup7; Supplement only enough to meet the recommended intake. Both the International Menopause Society and the Spanish Agency for Food Safety and Nutrition recommend a food-first approach.&sup7;˙&sup8; Research has not found additional benefits from consuming calcium above daily requirements.

Omega-3 Fatty Acids for Menopause: Supporting Heart, Brain, and Emotional Well-Being

As women transition through menopause, protecting cardiovascular health becomes increasingly important. Before menopause, estrogen provides some protection against heart disease by helping maintain healthy blood vessels and cholesterol metabolism. But the risk of cardiovascular disease gradually rises as estrogen levels decline.¹

Research suggests omega-3 for menopause symptoms may extend to brain health and emotional well-being during midlife. These essential fatty acids play an important role in maintaining cell membrane function throughout the body.&sup7; They have been widely studied for their effects on cardiovascular, metabolic, and brain health.

One of the strongest areas of evidence for omega-3s is their ability to lower elevated triglyceride levels, an important cardiovascular risk factor. Prescription-strength EPA and DHA are routinely used to treat hypertriglyceridemia under medical supervision. Moderate daily intakes may help support overall cardiovascular health in individuals who consume little oily fish.¹˙&sup9; Some studies suggest that women with low dietary omega-3 intake may experience modest improvements in mood and cognitive function during the menopausal transition.¹˙¹&sup0;˙¹¹ However, these benefits appear to vary among individuals and should be viewed as one component of a comprehensive healthy lifestyle rather than a stand-alone treatment.¹˙¹&sup0;˙¹¹ More research is needed.

Whenever possible, food should be your first source of omega-3s. Eating two servings of fatty fish each week is one of the best ways to obtain EPA and DHA naturally. Good options include:

• Salmon
• Sardines
• Trout
• Mackerel
• Herring
• Anchovies

These fish also provide high-quality protein, vitamin D, selenium, and other nutrients that work together to support healthy aging.¹˙¹&sup0;˙¹¹

For women who don’t regularly eat fish, a high-quality fish oil or algae-based omega-3 supplement may be an appropriate alternative. A dose of 500–1,000 mg of combined EPA and DHA per day is commonly used to support cardiovascular health. But individual needs may vary.¹˙&sup9; As with any supplement, choose one that has been independently tested for purity and potency.¹˙¹&sup0;˙¹¹

Like many areas of nutrition, the science surrounding omega-3s has become more nuanced in recent years. Current menopause guidelines no longer recommend routine supplementation for every woman. Instead, they support an individualized approach based on dietary intake, cardiovascular risk factors, triglyceride levels, and overall health goals.¹

Lifestyle Factors That Support a Healthy Menopause Transition

View dietary supplements as part of a comprehensive healthy aging strategy. They are not a replacement for healthy habits. The strongest scientific evidence consistently demonstrates the greatest benefits come from combining good nutrition with regular exercise. Resistance training is particularly important because it helps preserve muscle mass and supports bone density. It also improves balance and enhances many of the benefits provided by adequate nutrition. Finding exercise that you enjoy will help you stay motivated and make it easier to maintain over time. Restorative sleep, stress management, and routine preventive healthcare are also key ways to ensure a healthy transition during perimenopause and postmenopause.¹

Healthy aging is built on small, consistent choices made over time. A balanced diet, regular exercise, and personalized healthcare are the pillars of supporting yourself during menopause. And when needed, the right nutritional support can help you maintain your strength and quality of life for the long haul.

A personalized approach to menopause nutrition — combined with individualized hormone balance therapy and guidance from a provider who knows your health history — can help you feel your best through this transition. If you’d like to talk through your own nutrition and hormone health plan, Dr. Wilson-King and the team at Victory Rejuvenation Center are here to help.

Here’s to a beautiful process!

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