01

Where saffron fits

Saffron (Crocus sativus) contains bioactive compounds, including crocin and safranal, that have been studied for their effects on mood, anxiety, and sleep. The most relevant evidence for perimenopause comes from a 2021 randomised controlled trial conducted in Australia².

In that trial, 86 perimenopausal women received either a standardised saffron extract or a placebo for 12 weeks. The saffron group showed a 33% reduction in anxiety scores and a 32% reduction in depression scores compared to baseline. The effect was specific to psychological symptoms. Saffron did not produce significant improvements in vasomotor symptoms such as hot flushes or night sweats².

A broader body of research supports saffron's role in mood. A 2019 systematic review and meta-analysis of 23 randomised controlled trials found that saffron had a large positive effect on depressive and anxiety symptoms compared to placebo³. More recently, a 2025 meta-analysis comparing saffron directly to SSRIs (a common class of antidepressant) found no significant difference in effectiveness for depression or anxiety, with saffron producing fewer adverse events⁴.

This is worth noting: saffron is not a replacement for prescribed medication, and it is not appropriate for everyone. But for women in perimenopause whose primary complaints are mood-related, the clinical evidence is building.

02

Where shatavari fits

Shatavari (Asparagus racemosus) is an Ayurvedic herb that has been used for centuries in traditional medicine for female reproductive health. Its bioactive compounds, known as steroidal saponins, are thought to interact with hormonal pathways and support the body during hormonal transitions.

Clinical research on shatavari for menopause is newer than saffron, but the early trial data is encouraging. A 2024 double-blind, multicentre randomised controlled trial of 70 women found that shatavari root extract produced significant reductions in hot flushes, night sweats, insomnia, anxiety, and vaginal dryness compared to placebo⁵.

A 2025 trial went further. In a study of 80 perimenopausal women, those taking 300 mg of shatavari root extract daily for eight weeks showed significant improvements across somatic, psychological, and urogenital symptom domains, including hot flushes, fatigue, mood, and perceived stress, with no adverse effects on liver or kidney function⁶.

Shatavari's strongest and most consistent evidence is for vasomotor symptoms like hot flushes and night sweats, but recent trials also show meaningful improvements in mood and psychological wellbeing. It appears to work more broadly across symptom categories than was initially assumed.

03

Two ingredients, two systems

This is the distinction that matters. As Sarah Gray explains, saffron and shatavari work on different parts of the picture: "Saffron works primarily on the brain and nervous system, influencing mood, emotional regulation, and potentially sleep. Shatavari works more on the physiological and hormonal side, supporting physical symptoms like hot flushes and night sweats."¹

This does not mean you need both. It means you need to start by identifying which symptoms are affecting you most, and then choose accordingly. If your main issue is anxiety and disrupted sleep, the evidence for saffron is well established. If hot flushes and night sweats are leading, shatavari has strong trial data for vasomotor relief, with growing evidence that it supports mood as well.

Some women experience both clusters of symptoms. In that case, there is no clinical conflict between using both ingredients, as they target different pathways. But this is worth discussing with your GP or a menopause-trained practitioner, particularly if you are taking other medications.

04

What to expect from supplements

One of the most common sources of disappointment with supplements is timing. As Sarah Gray puts it: "Supplements are not a quick fix."¹

Most of the clinical trials for both saffron and shatavari ran for 8 to 12 weeks before showing meaningful results. That means consistent daily use for at least two months before deciding whether something is working.

It is also worth being clear about what supplements can and cannot do. They are not a substitute for medical treatment. For women with severe symptoms, menopausal hormone therapy (MHT) remains the most effective option and should be discussed with your doctor. Supplements may be most useful for women with mild to moderate symptoms, or as part of a broader management plan that includes nutrition, exercise, sleep strategies, and medical care.

05

Where to start

If you are unsure which symptoms to prioritise, write them down and rank them. Which ones are affecting your daily life the most? That ranking should guide what you try first.

Talk to your GP or pharmacist before starting any new supplement, especially if you are taking medication. Not all supplements are appropriate for all women, and quality varies significantly between products.

06

Matching ingredients to symptoms

The mismatch between symptom and ingredient is the most common reason perimenopause supplements disappoint. Saffron has the strongest trial evidence for mood, anxiety, and sleep². Shatavari has the strongest trial evidence for hot flushes and night sweats, with growing support for mood as well⁵. A 2025 trial extended that finding across psychological and somatic symptom domains⁶. Identifying which symptoms are most disruptive, then choosing an ingredient with clinical data for that specific cluster, gives a protocol the best chance of working.

Talk to your GP or a menopause-trained pharmacist before starting anything, especially if you are already taking medication. For broader context on when supplement symptoms tend to begin, see When Does Perimenopause Start?