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Additions and alternatives to HRT – non-phytohormone supplements

A history of hormone-related cancer doesn’t mean you need to struggle with menopausal symptoms. Here pharmacist, herbalist and nutritional consultant Davide Ferrilli shares the best safe and effective alternative supplements to try.

While you may have been advised to avoid HRT and phytohormone supplements if you have or have had hormone-related cancer, such as some types of breast cancer, there’s another group of supplements that are both safe and effective: non-phytohormones.

Although suitable and very useful for all women to try, these natural remedies can be particularly helpful for those who have been advised to avoid any hormonal or phytohormonal treatment.

What menopause symptoms can be helped with non-phytohormone supplements?

Research has suggested that non-phytohormone supplements can improve a whole raft of menopausal symptoms without boosting oestrogen levels.

These supplements, which may take some months to become fully effective, can help ease different menopause-related symptoms over time, such as low mood, brain fog, vaginal dryness and hot flushes.

Speak to an expert

While generally considered safe for women with a history of cancer, these supplements can sometimes interfere with certain prescription medication or they may not be the most effective treatment for you. Therefore, I always recommend that if you’re considering taking these,  speak first with a supplement expert (such as a registered nutritional specialist, herbalist, naturopath, or a doctor or pharmacist with expertise in natural medicine). This is particularly important if you are thinking of taking a combination of supplements.

Which non-phytohormone supplements should I take? 

I recommend the following non-phytohormone supplements:


Vitamin D is one of the most studied supplements and is an important natural aid for women during the menopause. Firstly, it promotes bone health, helping to prevent osteoporosis, especially when taken in combination with calcium[1]. Secondly, vitamin D is a great mood booster and can help ease symptoms of mild depression during the menopause.

Low vitamin D levels have been implicated in an increased risk of some types of cancer[2]. Studies have indicated that vitamin D may be a contributory factor in helping prevent heart disease and stroke and may also have a role to play in the prevention of type 2 diabetes[3].

Vitamin D is usually completely safe for everyone, unless you have been diagnosed with high blood calcium levels (a condition usually likely to occur only as a consequence of parathyroid disease, sarcoidosis, or organ transplant).

Your recommended daily dose of Vitamin D depends on your current blood levels. However, generally speaking, an oral intake of  400 to 1000 IU (25 mcg) per day can be a good dose for women over 40.


Magnesium is a super important mineral in the human body and is involved in hundreds of biochemical reactions, especially in the nervous system. It can help reduce common menopausal symptoms for some women such as sleeping problems[4], depression, and anxiety, as well as helping regulate moods and lowering stress levels. Clinical studies have linked magnesium deficiency (very common in people over 40) to moderate depression[5]  and increased anxiety[6].  It can also contribute to reducing cardiovascular risk and the progression of osteoporosis[7].

To benefit from its mood-boosting properties you should take 300-400mg of Magnesium a day, preferably as magnesium bisglycinate or taurate. Magnesium is a safe supplement to take for most healthy women. Always check for interactions if you are taking other medication.


The oils from these two plants contain high amounts of the beneficial fat gamma-linolenic acid (GLA), which can help ease breast tenderness. Some women also find that it helps with hot flushes, sleep disruption, irritability and vaginal dryness, especially in early menopause[8][9]. Some research suggests that GLA can help stabilise hormone-related inflammatory symptoms[10].  Clinical studies have also shown that GLA may help reduce blood pressure in the short term, especially in post-menopausal women, though it is not taken for this reason[11].

To reap the benefits you need to take a high dose every day (between 200-1,000mg) for a long period of time. A dose of 320mg a day has been shown to be helpful in the management of breast tenderness.

Supplements containing GLA are usually safe to use for most, especially for women with hormone-related cancer history. However, GLA should be avoided if you are on a prescription anticoagulant therapy, due to the mild blood-thinning effect that GLA might have. Moreover, it is also thought that GLA can increase the risk of seizure for those with epilepsy and so should be avoided in this case.


Post-menopausal women usually need a lower iron intake than during their fertile life. Nevertheless, if you are going through the perimenopause, meaning those months or years before your last period, iron deficiency can be a really big problem. During this time, heavy bleeding can often occur, leaving you debilitated and very tired.

Symptoms of iron deficiency also include pale skin, cold hands and feet, soreness of the tongue, brittle nails, hair change and thinning, pallor, and headaches. If the levels are so low as to cause anaemia symptoms may also include feeling dizzy or breathless, palpitations and chest pain. Please see your doctor if you are concerned or experience any of these symptoms.

In this case, an effective iron supplement could be extremely beneficial to replenish your iron supplies and help treat fatigue and low energy [12]. The best way to take this important mineral is in an organic form (e.g. iron bisglycinate or fumarate) and in combination with vitamin C and folate, ingredients that enhance its absorption. However, please always double-check with a qualified health care practitioner to see if you really need iron before taking it, since too high levels of this mineral in your body can be harmful.


If vaginal dryness and dry skin are a problem, then this oil could help. It’s rich in Omega 7, fatty acids that help moisturise tissues from within. The best effects are achieved over time by taking between 2 – 5 grams of this natural remedy orally (as soft gel capsules or pure oil). However, the local application of this oil on dry body parts, such as the skin or vagina, can be very beneficial as well. 


Ginkgo biloba is an herbal supplement made from the leaves of the ginkgo tree, also known as the maidenhair tree.  This natural remedy seems to help improve the well-being of small blood vessels and protect brain cells from damage. Studies suggest that the extract of this plant might improve the health of the nervous system and so may help boost memory and mental performance[13]. To gain this effect, a dose of at least 240 mg per day of Gingko extract taken orally is usually recommended. Although usually safe if you had a hormone-related cancer, Gingko is a quite strong blood thinner and must not be used if you are on prescription anticoagulant medication, especially Warfarin.


In addition to these remedies, supplementing with omega 3 (fish oil) and a good multivitamin can support your overall wellness, and may help you boost your mood. In particular, taking at least 1 gram of omega 3 (fish oil) every day could help you sustain your nervous system and decrease your inflammation markers, helping you ease chronic pain as a result. Nevertheless, check with your doctor before taking omega 3 if you are on prescription anticoagulants, as they can increase the blood-thinning effect of these drugs.


Speaking more specifically about mood, ashwagandha and rhodiola are herbal remedies that can help you feel better in terms of energy, low mood and anxiety. And they are claimed to be safe to take if you have a history of hormone-related cancer. For further information on natural remedies for your mental well-being head to my blog on ‘Supplements for your mental well-being’ here 


Taking probiotic supplements, containing good bacteria for your tummy, will help you improve your gut health, a crucial factor for your general well-being. To appreciate strong benefits on your digestive system, you should take a high dose of probiotics every day (at least 10 – 20 billion per day), either in capsules or liquid form. Please be aware that, in terms of gut health, eating yoghurt or lots of fermented food is absolutely not the same as taking a good probiotic supplement every day.

Some nutritional tips

Lastly, when it comes to nutrition, a diet rich in vegetables, seeds (especially flax seeds), nuts and water, and low in refined carbohydrates and alcohol, will help you to better manage your menopausal symptoms, as well as help reduce the long-term health risks of the menopause.

Always speak to a qualified healthcare practitioner

Every woman is different –  some supplements might be very beneficial for some women and less effective for others. Therefore, an individual consultation with a healthcare professional who is an expert in supplements should always be the first step – as well as assessing which natural remedies are right for you they will look at ways to improve your diet and lifestyle.


Davide Ferrilli  (MSc Pharm, PG Master in Herbal Medicine, MGPhC, MANP, MGNC) is a Registered Pharmacist, Nutritional Consultant, Herbalist and member of the Association of Naturopathic Practitioners. Davide strongly promotes a holistic vision of health, especially for chronic disorders. Whilst practicing as a pharmacist, he studied Herbal Medicine, gained a Diploma as Nutritional Consultant and attended a 2 year course in Bioenergetic Nutrition according to Chinese Medicine. He runs HealisticYou, where he offers personalized holistic consultations and promotes his original nutritional method (PEF). Davide also collaborates with like-minded psychotherapists and healthcare professionals both in Italy and in the UK. His science-based approach is focused on personalized nutrition, supplementation and lifestyle, combining Western and Eastern medicine. 

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  3. Lesia Aungst, MSN, FNP; Sharon Rainer, MSN, CRNP. Importance of Vitamin D to Postmenopausal Women’s Health. DOI:

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  5. Emily K TarletonBenjamin Littenberg. Magnesium intake and depression in adults. J Am Board Fam Med. 2015 Mar-Apr;28(2):249-56. doi: 10.3122/jabfm.2015.02.140176.

  6. Neil Bernard Boyle, Clare Lawton, Louise Dye. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review. Nutrients. 2017 May; 9(5): 429.

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  8. Farah FarzanehSetareh FatehiMohammad-Reza SohrabiKamyab Alizadeh. The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial.  Arch Gynecol Obstet. 2013 Nov;288(5):1075-9. doi: 10.1007/s00404-013-2852-6. Epub 2013 Apr 27.

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  12. Anne Firquet Wolf Kirschner Johannes Bitzer. Forty to fifty-five-year-old women and iron deficiency: clinical considerations and quality of life.  Gynecol Endocrinol. 2017 Jul;33(7):503-509. doi:10.1080/09513590.2017.1306736. Epub 2017 Mar 28.

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