Formulation Traps: Why Perimenopause Needs More Than a Kitchen Sink Approach

In this first episode of the Nutritional Outlook Peer Exchange, “Understanding Perimenopause: Addressing Gaps for Better Formulation,” moderator Jacqueline Jacques, ND, convenes three women's health experts to examine how the supplement industry can formulate more effectively for women in perimenopause. The panel includes Ayla Barmmer, MS, RD, LDN, founder and CEO of Fullwell; Arzoo Fatima, PharmD, MPH, founder of ZFR Nexus; and Karin Hermoni, PhD, founder of Imagine Health.

Jacques opens with the market context. According to the Menopause Society, about 2 million women enter perimenopause each year, and the transition can last four to eight years. Reported symptoms range from as few as 30 to as many as 100. That variability, she notes, makes it tough to build a single product around every complaint.

Hermoni frames perimenopause as a phase defined by volatility, where symptoms can change daily or even hourly. Unlike menopause, where estrogen is reliably low, formulation here should help the body adapt and return to center. She argues the industry relies too heavily on averages and calls for research that accounts for ethnicity, genetics, and symptom changes over time, using ingredients tested in women during hormonal change.

Fatima warns against "kitchen sink" products that claim to address 34 symptoms with token doses. Her principle is indication first, formulation second, and claim last. She advocates phenotype-led formulations that target one or two priority outcomes, such as sleep and anxiety or vasomotor and sexual symptoms, using clinically studied doses and validated endpoints.

Barmmer offers a different angle, cautioning against an allopathic mindset in which supplements try to act like medications. Supplements, she says, should restore balance and fill nutrient gaps rather than make hormonal shifts disappear. She emphasizes comprehensive vitamins and minerals, antioxidants and phytonutrients, and nervous system and brain support, so brands can see what remains once the basics are covered.

Jacques closes this portion of the conversation by highlighting overlooked foundations, including methylation cofactors, bone health nutrition ahead of the rapid bone loss that follows menopause, and iron stores for women with heavy periods.

Watch the full episode for practical guidance on building perimenopause products women can trust, grounded in evidence rather than symptom checklists.