"Where do I even begin?"
It's the question I hear more than any other. A woman reads one article that says magnesium, another that says collagen. Her best friend swears by fish oil. Suddenly her kitchen counter looks like a pharmacy, and she still doesn't feel like herself.
Here's the short answer. You don't need more supplements. You need the right few, started in the right order, taken consistently, and given enough time to work.
In this article, I'm going to walk you through the exact order I give my patients, when to take each piece, and how to know if it's working, so you can stop guessing and start building a routine that fits your body.
In this article, you will learn
Why more isn't better
When you're exhausted, foggy, and not sleeping, it's tempting to throw everything at it at once. I understand. But starting five things on the same day creates two problems.
First, if you feel better, you won't know what helped. If you feel worse, you won't know what to stop.
Second, it's hard to stay consistent with a routine that's complicated. And consistency is where the results live. Vitamin D takes about three months to level out in your blood, and research from University College London found that new habits take an average of 66 days to stick. (1)(2)
So the goal is simple. A few foundations, added one at a time, taken every day.
Before you start: what I check first
I never want a woman guessing in the dark. Before building a routine, I like to know:
Her hormone picture. Where she is in the transition and what her body is working with.
Her vitamin D. Low levels are common in midlife and affect bones, mood, and energy. Ask for a 25-OH vitamin D test. I explain why I pair D3 with K2 in the truth about D3, K2, and menopause.
Her iron and thyroid. Both can mimic perimenopause symptoms like fatigue and brain fog.
Her biggest complaint. Sleep? Energy? Weight? Comfort down there? The routine should start where she feels it most.
If you're not sure where you'd start, my symptom quiz can point you in the right direction.
The order I give my patients
This is the sequence I come back to again and again. Each step builds on the one before it.
Step 1. Your daily foundation
I start with something that supports energy and helps the body adapt to stress, because stress touches everything in midlife. For me, that's Mighty Maca Plus. I take it every morning.
Step 2. Your daily foundation
In midlife you're losing muscle, and most women eat far less protein than they need. Starting the day with protein helps steady your energy and protect your muscle. My Keto-Green Shake makes it easy on rushed mornings. Read more in my protein guide for women over 40.
Step 3. Your microbiome
As estrogen falls, the healthy bacteria that keep your vaginal and urinary health in balance can shift too. That's why I add VB Probiotics, with targeted Lactobacillus strains and cranberry PACs to support a balanced vaginal microbiome and everyday urinary comfort.
Step 4. Daily care for delicate skin
The skin down there changes in midlife too, and it deserves the same care as your face. Julva is the anti-aging feminine cream I formulated with DHEA to moisturize and nourish delicate skin.
Step 5. Comfort, when you want it
Velvé is my pH-balanced, water-based personal lubricant, free of silicone and glycerin, for everyday comfort and intimacy.
When to take each piece
Morning. Your foundation (Mighty Maca Plus) and your protein (Keto-Green Shake). Pairing them with breakfast makes them easy to remember.
Once a day, same time. VB Probiotics. Follow the directions on the label, and pick a time you'll stick with.
Daily, as directed. Julva. Many women make it part of their evening routine.
As needed. Velvé.
The best time to take something is the time you'll take it every day. Tie each step to something you already do, like your morning coffee or brushing your teeth.
How to add each step, and how long to give it
Add one new step every two weeks. That gives your body time to adjust and gives you a clear sense of what each one does for you.
Then give the whole routine 90 days before you decide. Hormone-related changes don't happen in a week, and most women who tell me a supplement didn't work stopped before it had a fair chance.
Keep a simple note on your phone. How you slept. Your energy at 3pm. Your mood. Small changes add up, and you'll see them more clearly when you look back.
The mistakes I see most
Starting everything at once. You lose track of what's working.
Quitting at three weeks. Most changes take longer.
Running out. A missed week resets your progress. A subscription keeps your foundation from running out.
Copying someone else's routine. Your friend's body isn't yours. Start where you feel it most.
For a deeper look at specific supplements, read my guide to the best supplements for perimenopause.
Dr. Anna's complete routine
These are the pieces I build every routine around. They support your body's own systems and never replace medical care.
Mighty Maca Plus
My daily foundation. Certified organic Peruvian maca with turmeric, green tea, digestive enzymes, and more than 30 superfoods, made to support energy and stamina and to help your body adapt to stress.
Keto-Green Shake
A clean protein shake to help you hit your protein goals and protect your muscle, starting at breakfast.
VB Probiotics
Targeted Lactobacillus strains plus cranberry PACs to support a balanced vaginal microbiome and everyday urinary comfort.
Julva
My anti-aging feminine cream with DHEA, formulated to moisturize and nourish delicate skin.
Velvé
A pH-balanced, water-based personal lubricant, free of silicone and glycerin, in a glass bottle.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
Frequently asked questions
What supplement should I start first in menopause?
Start where you feel it most, and start with one foundation. For most of my patients, that's something taken daily that supports energy and the body's response to stress, followed by protein at breakfast.
How many supplements should I take in perimenopause?
Fewer than you think. A few well-chosen foundations, taken consistently, usually do more than a long list taken on and off.
When is the best time to take supplements?
The time you'll remember every day. Tie each one to a habit you already have, like breakfast or brushing your teeth, and follow each label's directions.
How long until I notice a difference?
Give a routine about 90 days. Vitamin D alone takes about three months to level out in your blood. (1)
Should I start everything at once?
No. Add one new step every two weeks so you can tell what each one is doing for you.
Do I need to test before starting?
Testing your vitamin D, iron, thyroid, and hormones gives you and your doctor a clearer starting point. Talk with your doctor before starting any new supplement, especially if you take medication.
Final thoughts
You don't need a pharmacy on your counter. You need a plan.
Start with one foundation. Add one step at a time. Take it every day. And give your body enough time to show you what it can do.
You deserve a routine that feels simple and works with your body, not against it. That isn't too much to ask.
Not sure where to start? Take the quiz.
Answer a few questions and I'll point you toward what your body is asking for.
Or if you're ready to start today
References
Heaney RP, et al. Vitamin D3 is more potent than vitamin D2 in humans. Pharmacokinetic data on time to steady state. Journal of Clinical Endocrinology & Metabolism (2011).
Lally P, et al. How are habits formed: modelling habit formation in the real world. European Journal of Social Psychology (2010). University College London.
* The information provided is for educational purposes only and should not be construed as medical advice. Always consult with your healthcare professional before starting any supplement program.
