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Perimenopause typically begins in a woman’s mid-40s and lasts at least four years leading up to menopause, when menstruation subsides for a full 12 months. This in-between phase is characterized by hormonal fluctuations that often bring fatigue, mood changes and insomnia.
A randomized, double-blind, placebo-controlled trial of 100 women ages 40 to 55 published in the journal Bioinformation (March 31, 2026) found that vitamin D provided relief from fatigue and mood swings associated with perimenopause for a significant number of subjects. The women in the study had:
Low or low-normal vitamin D levels (below 30 ng/mL, which is the case in 60 to 70 percent of American adults, particularly women).
Fatigue or mood changes.
Half the subjects were given two months of higher dose vitamin D to replace deficits, followed by 2000 units of vitamin D daily. The other half received placebo. Supplementation continued for a total of 6 months. The group receiving vitamin D had a dramatic 30 percent decrease in fatigue and 39 percent improvement in mood.
This placebo-controlled study is noteworthy because it highlights the effectiveness of vitamin D in providing balance and relief during a sustained period of hormonal fluctuations. And it’s a low-cost, safe treatment that’s readily available.
In general, we should be concerned that two-thirds of Americans are deficient in vitamin D, which may lead to osteopenia, osteoporosis and ultimately bone deterioration and fractures –especially in women. Also of concern is the fear of contracting skin cancer through sun exposure since sunrays are the best natural source of vitamin D.
The Recommended Dietary Allowance for vitamin D for adults age 19 to 70 years requires 15 micrograms per day, and adults 71 years and older require 20 micrograms per day (600 to 800 IU). This is set by the Food and Nutrition Board at the National Academies of Sciences, Engineering and Medicine.
In my opinion, these long-standing RDAs are no longer applicable because of the high rates of medication use and chronic illness, which can significantly deplete important nutrients including vitamin D.
Vitamin D deficiency, in particular, is implicated in a wide range of health conditions, and research shows that it may help reduce chronic pain, menstrual pain, diabetic nerve pain, metabolic syndrome and diabetes, obesity and even heart attack risk. A Johns Hopkins study that followed 13,000 subjects over a 12-year period found that low levels of vitamin D correlated with a 26 percent increase in early death.
Therefore, for those in perimenopause and for everyone, it’s good to get 1,000 to 2,000 units of vitamin D per day. And since 90 percent of our vitamin D comes from sunshine, get out in the sun. Avoid sunburn, not sunshine!”
Get more information about menopause.
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