What is happening
Perimenopause is the run-up to menopause, often starting in the 40s, when hormone levels swing. Menopause is the point 12 months after the last period. Postmenopause is everything after.
Falling estrogen drives most symptoms: hot flashes and night sweats, poor sleep, low mood, joint pain, brain fog, vaginal dryness and lower libido. Testosterone falls too, and plays a part in energy, muscle and desire.
What helps
- Strength training protects muscle and bone.
- Sleep routines ease the effect of night sweats.
- Steady blood sugar, from regular meals with protein and fiber, helps energy and mood.
- People. Talking to friends, partners and colleagues makes symptoms easier to manage.
- Medical options. Hormone therapy and other treatments are worth discussing with a doctor.
- Supplements with human research behind them.
What the Tongkat Ali research found
In 138 women aged 40 to 55 taking 50mg or 100mg a day for 12 weeks, total menopause symptom scores fell 33.9% at 100mg, against 23.3% on placebo. Physical symptoms fell 36.4% and sexual symptoms 36.3%. Muniandy et al. 2025, World Journal of Clinical Cases
A 24-week study gave 119 women Tongkat Ali with Kacip Fatimah, a Malaysian herb traditionally used by women. Hot flashes improved 73%, but placebo improved 66%, so that result was not significant. Joint pain fell 68%, against 47% on placebo. LH and FSH, hormones that rise as the ovaries slow down at menopause, fell in the active group only. Chinnappan et al. 2020, Food and Nutrition Research
Who should check first
Avoid Tongkat Ali during pregnancy and while breastfeeding. Speak to a doctor first if you have a hormone-sensitive condition, such as a history of breast cancer, or take any medication.
Questions
Is Tongkat Ali only for men? No. It has been studied in women for menopause symptoms and quality of life.
How much did the studies use? 50 to 100mg a day of a standardized water extract.
Does it replace hormone therapy? No. It is a supplement with human research behind it. Discuss treatment options with a doctor.