An advertisement from Forecast, the makers of the Foundation

The Forecast Journal · 8 minute read

Most “menopause” supplements are built for a woman ten years further along.

Walk down the aisle and nearly everything is a herbal blend for hot flushes. At 38 the questions are different, and so is the useful list.

What is in the aisle

Black cohosh, red clover, dong quai. These are herbs aimed at hot flushes and night sweats, usually sold as a blend of twenty or more ingredients with the individual doses hidden.


They are made for a woman around 52 who is already deep in symptoms. They can also interact with hormonal contraceptives, antidepressants and blood thinners, which the front of the box rarely mentions.

What is actually happening at 38

Perimenopause begins, on average, years before a last period. Progesterone tends to slide first. Estrogen swings for years before it falls. The early signs are about sleep, mood and cycle changes, and they usually get called stress.


So the useful question at 38 is not how to cool a hot flush. It is what estrogen has been quietly protecting, and how to look after it before it is missed.

Three things that are easier to keep than to get back

Bone. The clearest case. In the long-running SWAN study, bone density barely moved before the transition. Then, about a year before the final period, it began falling by roughly 2.5% a year at the spine, and kept that pace for about three years.


Muscle. Subtler. Lean mass went from a slight yearly gain to a slight yearly loss across the transition, while the rate of fat gain nearly doubled. Across ageing research in general, muscle mass falls by roughly 3 to 8% a decade after 30.


Collagen. It is in skin, and in every tendon and joint. One review reports that skin collagen is thought to fall by as much as 30% in the first five years after menopause, and by about 2% a year after that. The original studies were small and decades old, so treat that as a rough guide.

Short on time? Skip to what we would recommend ↓

What the long-running study found

SWAN, the Study of Women’s Health Across the Nation, has followed American women through midlife since the 1990s, measuring bone density and body composition year after year. Two of its findings explain why the years before matter.

Over ten years, women lost 10.6% of their bone density at the spine and 9.1% at the hip. Most of it went in the three years around the final period. Rates differed by ethnicity.

Body composition moved more quietly: about 6% more fat and about 0.5% less lean mass across a transition of roughly three and a half years, after which both levelled off. Small numbers, in the wrong direction, at the age when they are hardest to reverse.

The case for creatine

Creatine monohydrate is one of the most-studied supplements there is. It was never only for the weights room. It supports muscle strength, lean body mass and cellular energy production,* and it works best alongside strength training.

What the trials show: in a meta-analysis of 22 studies, adding creatine to resistance training built 1.37 kg more lean mass than training alone.


The honest limits: those trials were in adults aged 57 to 70, and the benefit came with the training, not instead of it. In the largest trial in postmenopausal women, 237 women over two years, creatine did not change bone density, although walking speed and lean mass improved. Trials often used weight-based doses above the usual 3 to 5 grams a day. No trial has yet been run in women aged 35 to 45. If you have kidney disease, ask your doctor first.

The smaller half of the answer

Two twenty-minute strength sessions a week will do more for muscle and bone than any powder. Add enough protein, enough fibre and protected sleep, and supplements become what they should be: support for a routine, not a substitute for one.

If you would rather see now what we make for these years, it is here. The rest of the article will still be waiting.

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The honest scorecard

Here is what published trials show for each ingredient, and where the evidence stops. We would rather you knew both.

Magnesium. A 2021 review pooled three small trials in older adults and found people fell asleep about 17 minutes faster. Its authors rated that evidence low to very low quality. Separately, US survey data found that about half of Americans get less magnesium from food than is recommended.


Collagen peptides. In a trial of 69 women aged 35 to 55, 2.5 to 5 grams a day improved skin elasticity over eight weeks, and a later analysis of 19 trials pointed the same way. Much of this research is funded by collagen makers, and the one trial on bone has not been independently repeated.


And the herbs. A Cochrane review of 16 trials in 2,027 women found insufficient evidence that black cohosh helps menopausal symptoms, and The Menopause Society’s 2023 position statement does not recommend herbal remedies for hot flushes. That is why they are not in the Foundation.

What to do this week, without buying anything

Lift something heavy twice a week.

Twenty minutes is enough. Squats, rows, presses, carries. Muscle and bone both respond to load, and it is the one thing in this article with the strongest evidence behind it.


Put protein in every meal.

Most of us eat most of our protein at dinner. Spreading it across the day gives muscle more to work with.


Eat more fibre than you think you need.

Vegetables, beans, oats, whole grains. It is the cheapest thing you can do for your gut.


Guard the hours before bed.

A regular wake-up time does more than an early bedtime. Many women find that alcohol close to bedtime costs them more sleep than it used to.


Ask about a bone density baseline.

If you have risk factors, such as a family history of fractures, ask your doctor whether an earlier scan makes sense.

When the basics are in place, this is the box we built for the rest.

See the Foundation

What we would recommend

The Foundation: four plain products for the years before.

We make Forecast, so weigh this accordingly. It is the box we built for the years before: magnesium for the evening, creatine and collagen in a morning coffee, a gut health capsule with dinner. Every ingredient is named on the front of the label.

Night · magnesium glycinate. Three capsules before bed. Five things in the capsule, all five named on the front. Supports nervous system function.*


Frame · creatine monohydrate. Five grams in a morning coffee. One ingredient. Supports muscle strength, lean body mass and cellular energy production.*


Weave · collagen peptides. Half a scoop, dissolves clear. One ingredient. Supports skin, hair, muscle and bone health.*


Core · gut health. Two capsules with a meal. Four actives, all named. Promotes digestive health.*

What arrives

The 90-day box comes as one delivery: three Night, three Core, three Weave and two Frame. Frame holds 50 servings, so two tubs cover the three months. The monthly box is one of each. The routine takes about a minute a day.

One box holds all four. $397 for 90 days, which is about $132 a month, or $149 month to month. US shipping is free.

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If your sleep has not moved by day 30, we refund your first month. Keep the products.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Skeptical? Good.

You should be. These are the questions we would ask.

If the evidence has limits, why take any of it?

Because the limits are about how much, not whether. These are well-studied, inexpensive nutrients with good safety records, and none of them replaces training, protein or sleep. If that trade does not appeal, skip them and do the free list above.


Can I not just buy these four things separately?

Yes. They are all sold elsewhere, and if you already have brands you trust, keep them. Bought one by one from us they come to $171 a month. The box is $149, or about $132 a month on the 90-day plan.


I am 37 and I feel fine. Is this for me?

That is who it is for. The point of starting before you need it is that need arrives quietly.


Can I take it with birth control or an antidepressant?

The four Foundation products have no known interactions with hormonal contraceptives or SSRIs. As always, tell your doctor what you take. If you are pregnant or nursing, have kidney disease, or are under a doctor’s care, ask them first.


How does the guarantee work?

Take the Foundation for 30 days. If your sleep has not improved, email us and we refund your first month. Keep the products. On the 90-day box, that is the first month refunded, plus a refund for anything you return unopened.

See the Foundation

Sources

Greendale GA et al. Bone mineral density loss in relation to the final menstrual period. J Bone Miner Res 2012. Greendale GA et al. Changes in body composition and weight during the menopause transition. JCI Insight 2019. Volpi E et al. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care 2004. Thornton MJ. Estrogens and aging skin. Dermatoendocrinol 2013. Brincat M et al. Obstet Gynecol 1987. Chilibeck PD et al. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med 2017. Chilibeck PD et al. A 2-year randomized controlled trial on creatine supplementation during exercise for postmenopausal bone health. Med Sci Sports Exerc 2023. Kreider RB et al. ISSN position stand: safety and efficacy of creatine supplementation. J Int Soc Sports Nutr 2017. Mah J, Pitre T. Oral magnesium supplementation for insomnia in older adults. BMC Complement Med Ther 2021. Rosanoff A et al. Suboptimal magnesium status in the United States. Nutr Rev 2012. Proksch E et al. Oral supplementation of specific collagen peptides has beneficial effects on human skin physiology. Skin Pharmacol Physiol 2014. de Miranda RB et al. Effects of hydrolyzed collagen supplementation on skin aging. Int J Dermatol 2021. König D et al. Specific collagen peptides improve bone mineral density in postmenopausal women. Nutrients 2018. Leach MJ, Moore V. Black cohosh for menopausal symptoms. Cochrane Database Syst Rev 2012. The Menopause Society. 2023 nonhormone therapy position statement. Menopause 2023.


This page is for general education and is not medical advice. Talk to a clinician about your own situation.