Kate Street

Menopause is a significant systemic hormonal shift that can influence a woman's quality of life and long-term wellbeing.1As clinical interest in menopause continues to grow, so too does interest in evidence-based strategies to help support women through this life stage.2 Alongside lifestyle interventions and conventional therapies, several botanicals are gaining attention for their supportive role in menopausal health. One such botanical is fenugreek (Trigonella foenum-graecum), a herb with a long history of traditional use in women's health and a growing evidence base supporting its use during the menopausal transition.3 <h3>Menopause: A hormonal transition with system-wide effects</h3>Perimenopause is characterised by a decline in ovarian function and reproductive hormone production, particularly oestrogen (see Figure 1),4,5 with the eventual complete cessation of menstruation for at least 12 months defined as menopause.6
<img src="https://images.contentstack.io/v3/assets/blt948bd74310fc0ad0/blt0cf268dc5865c846/6ab4aab958e0682078882828/fenugreek_hormones.png" alt="fenugreek_hormones.png" class="embedded-asset" />Figure 1. Hormonal fluctuations during menopause.Most women experience menopause between 45 and 55 years of age, although hormonal changes often begin 2–10 years earlier during perimenopause.7 These hormonal changes influence multiple physiological systems, underpinning many of the symptoms experienced during the menopausal transition.8Many menopausal symptoms can be traced back to declining oestrogen concentrations. Oestrogen plays a key role in regulating thermoregulation, mood, sleep, and vaginal tissue health.4 As concentrations decline, disruption to these pathways can contribute to the characteristic physical and psychological symptoms experienced.4 <h3>The impact of vasomotor symptoms</h3>Vasomotor symptoms (VMS) associated with menopausal hormone changes such as hot flushes and night sweats affect up to 80% of women.6 For some women, symptoms can persist for an average of seven years,8 while VMS are often among the longest lasting, with around one in five women continuing to experience symptoms up to 15 years after menopause.8 This can negatively impact a woman's quality of life, with evidence showing that women who frequently experience VMS report higher rates of anxiety, depression, and sleep disturbances, and have an increased risk of cardiovascular disease, bone disease, and cognitive concerns.6


Hot flushesOne of the most recognised menopausal symptoms is the hot flush. As oestrogen levels decrease, changes in hypothalamic signalling narrow the body's thermoregulatory zone, meaning small increases in core body temperature may trigger sweating and vasodilation (see Figure 2).4
<img src="https://images.contentstack.io/v3/assets/blt948bd74310fc0ad0/blt56ec6386df55ef58/6ab4abcc7c5f027d6a6f3b32/Screenshot_2026-08-11_124819.png" alt="Screenshot_2026-08-11_124819.png" class="embedded-asset" />Figure 2. Declining oestrogen levels lead to hypothalamic hypersensitivity.4


Declining oestrogen concentrations can also affect vaginal tissue integrity, moisture, and elasticity, while alterations in neurotransmitter signalling may contribute to mood disturbances and impaired sleep quality.4
<h3>Fenugreek in menopause</h3>Fenugreek contains a range of bioactive constituents, including steroidal saponins, alkaloids, soluble fibres, amino acids, and polyphenols, which influence endocrine, metabolic, and inflammatory pathways.9,10 These diverse properties have contributed to the growing interest in fenugreek as a botanical strategy to support women through menopause.Among the most studied constituents are steroidal saponins, including diosgenin, which contribute to fenugreek's phytoestrogenic activity.3 These compounds may interact with oestrogen receptors and support symptom management through interactions with hormone-related pathways.4 Through these effects, fenugreek may help support pathways involved in thermoregulation, mood regulation, and vaginal health.<hr /><h3>Research highlight</h3>A randomised, double-blind, placebo-controlled study evaluated a standardised fenugreek seed extract in women aged 39–51 years experiencing perimenopausal symptoms.4 Compared with placebo, participants receiving fenugreek reported significant improvements in somatic, psychological, and urogenital symptom scores. Improvements were particularly evident for hot flushes, night sweats, depression, and insomnia.Hormonal assessment also demonstrated increases in oestradiol, progesterone, and free testosterone concentrations, alongside reductions in follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG). No adverse effects were reported.4<hr />
Research also suggests fenugreek may influence neuroendocrine pathways involved in sleep regulation.11 This is particularly relevant given that sleep disturbances are among the most commonly reported symptoms during menopause.4 In preclinical research investigating menopause-associated sleep disturbances, a standardised fenugreek seed extract improved sleep quality and duration through modulation of GABAergic, melatonergic, and adenosinergic signalling pathways.11 While these findings require confirmation in human studies, they provide a promising mechanistic explanation for the improvements in sleep-related symptoms observed in some clinical trials.Fenugreek's relevance may also extend beyond hormonal pathways alone. Its diverse phytochemical profile demonstrates antioxidant, anti-inflammatory, and metabolic activity,12,13 which may be particularly important given the metabolic changes increasingly recognised during and after menopause.14Furthermore, interest in fenugreek's effects on genitourinary health is also growing. In a double-blind clinical trial involving postmenopausal women with vaginal atrophy, a 5% fenugreek vaginal cream over eight weeks significantly improved symptoms and vaginal maturation measures compared with baseline, suggesting potential benefits for vaginal health during menopause.15
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We asked <a href="https://www.linkedin.com/in/gabrielle-covino-09608b32/">Gabrielle Covino</a>, naturopath, educator, and science communication consultant, for her thoughts on the growing body of research supporting traditional and complementary approaches to menopause care."Women navigating menopause have too often faced a healthcare landscape that has been slow to recognise the traditional and complementary approaches many have used for generations. So it's genuinely encouraging to see the complementary evidence base continuing to grow beyond the better-established botanicals like black cohosh and red clover.Traditional medicine has supported women through menopause for centuries, long before modern research had the tools to explore the mechanisms behind these practices. It's encouraging to see that tradition now being examined through rigorous scientific methods, with more options being developed and studied to give women greater choice in how they navigate this transition.Fenugreek is a good example of this convergence between tradition and science. With a long history of traditional use, it is now being evaluated in clinical research, and the early trial data on vasomotor symptoms and sleep is promising. While these findings need to be confirmed in larger, independent studies, they represent an important step in building the evidence base and expanding the options available to women. Fenugreek's story is part of a promising, broader shift, one in which traditional knowledge and modern evidence are increasingly working together rather than being seen as competing perspectives."
<hr /><h3>Conclusion</h3>Fenugreek's long history of traditional use in women's health is increasingly being supported by modern clinical research. Current evidence suggests that standardised fenugreek extracts may offer a promising complementary approach for supporting women experiencing menopausal symptoms, particularly hot flushes, mood disturbances, sleep-related concerns, and overall quality of life. <h3>References</h3>1. Davis SR, Pinkerton J, Santoro N, Simoncini T. Menopause-Biology, consequences, supportive care, and therapeutic options. Cell. 2023;186(19):4038–58. doi:10.1016/j.cell.2023.08.0162. Delanerolle G, Phiri P, Elneil S, Talaulikar V, Eleje GU, Kareem R, et al. Menopause: a global health and wellbeing issue that needs urgent attention. Lancet Glob Health. 2025;13(2):e196–8. doi:10.1016/S2214-109X(24)00528-X3. Akhtari E, Ram M, Zaidi SMA, Marques AM, Rahimi R, Bahramsoltani R. Fenugreek (Trigonella foenum-graecum L.) in women's health: A review of clinical evidence and traditional use. J Herb Med. 2024;43(100816):100816. doi:10.1016/j.hermed.2023.1008164. Khanna A, John F, Das S, Thomas J, Rao J, Maliakel B, et al. Efficacy of a novel extract of fenugreek seeds in alleviating vasomotor symptoms and depression in perimenopausal women: A randomized, double-blinded, placebo-controlled study. J Food Biochem. 2020;44(12). doi:10.1111/jfbc.135075. Khanna A, Thomas J, John F, Maliakel B, Krishnakumar IM. Safety and influence of a novel extract of fenugreek on healthy young women: a randomized, double-blinded, placebo-controlled study. Clin Phytoscience. 2021;7(1). doi:10.1186/s40816-021-00296-y6. Khan SJ, Kapoor E, Faubion SS, Kling JM. Vasomotor symptoms during menopause: A practical guide on current treatments and future perspectives. Int J Womens Health. 2023;15:273–87. doi:10.2147/IJWH.S3658087. Australian Government. Department of Health. Disability and Ageing. Perimenopause. 2026. Available from: <a href="https://www.health.gov.au/perimenopause/understanding/perimenopause">https://www.health.gov.au/perimenopause/understanding/perimenopause</a>8. Gatenby C, Simpson P. Menopause: Physiology, definitions, and symptoms. Best Pract Res Clin Endocrinol Metab. 2024;38(1):101855. doi:10.1016/j.beem.2023.1018559. Shawky E, Nassra RA, Aliaa MT El-Alkamy, Sallam SM, El M. Unraveling the mechanisms of fenugreek seed for managing different gynecological disorders: steroidal saponins and isoflavones revealed as key bioactive metabolites. J Pharm Biomed Anal. 2023;238:115865. doi:10.1016/j.jpba.2023.11586510. Naika MBN, Sathyanarayanan N, Sajeevan RS, Bhattacharyya T, Ghosh P, Iyer MS, et al. Exploring the medicinally important secondary metabolites landscape through the lens of transcriptome data in fenugreek (Trigonella foenum-graecum L.). Sci Rep. 2022;12(1). doi:10.1038/s41598-022-17779-811. Lee H, Kim H, Suh HJ, Choi HS. Standardized fenugreek seed extract alleviates menopausal sleep disturbances via GABAA, melatonin, and adenosine receptors in ovariectomized (OVX) rodents. Food Funct. 2025;16(23):9174–90. doi:10.1039/d5fo03393d12. Johansson E, Svensson K, Lindgren A. Current perspectives on fenugreek bioactive compounds and their applications. Int J Biol Sci. 2025;7(8):203–7. Available from: <a href="https://www.biologyjournal.net/archives/2025/vol7issue8/PartC/7-9-11-611.pdf">View PDF</a>13. Haxhiraj M, White K, Terry C. The role of fenugreek in the management of type 2 diabetes. Int J Mol Sci. 2024;25(13):6987. doi:10.3390/ijms2513698714. Bermingham KM, Linenberg I, Hall WL, Kadé K, Franks PW, Davies R, et al. Menopause is associated with postprandial metabolism, metabolic health and lifestyle: The ZOE PREDICT study. EBioMedicine. 2022;85:104303. doi:10.1016/j.ebiom.2022.10430315. Mazalzadeh F, Hekmat K, Namjouyan F, Saki A. Effect of Trigonella foenum (fenugreek) vaginal cream on vaginal atrophy in postmenopausal women. J Fam Med Prim Care. 2020;9(6):2714–9. doi:10.4103/jfmpc.jfmpc_1220_19

<h3>Key highlights
</h3><ul><li>Fenugreek (Trigonella foenum-graecum) has a long history of traditional use in women's health and is increasingly being investigated for its role in menopause.</li><li>Fenugreek contains bioactive compounds that may support hormone-responsive pathways involved in thermoregulation, mood, and vaginal health.</li><li>Menopausal symptoms such as hot flushes, night sweats, sleep disturbances, and mood changes are linked to declining oestrogen concentrations and altered neuroendocrine signalling.</li><li>Clinical studies suggest standardised fenugreek extracts may improve vasomotor, psychological, and urogenital symptoms in women experiencing perimenopause.</li><li>Beyond its phytoestrogenic activity, fenugreek demonstrates antioxidant, anti-inflammatory, and metabolic effects that may support overall health during the menopausal transition.</li></ul>

Key highlights

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