Nicotinamide riboside and pterostilbene linked to reduced severity, frequency of menopause symptoms

A 7-day supplementation course of nicotinamide riboside and pterostilbene (Basis; Elysium Health, Inc) was associated with significant reductions in the frequency and severity of common menopause symptoms and a favorable shift in estrogen balance, according to an open-label pilot clinical trial published in Frontiers in Aging.¹

The trial enrolled 40 healthy women over 35 years of age, of whom 32 self-reported symptoms associated with the menopause transition (MS group) and 8 reported no or minimal symptoms (No-MS group).^1,2 All participants received the recommended daily dose of nicotinamide riboside and pterostilbene, containing 250 mg nicotinamide riboside and 50 mg pterostilbene, for 7 days.¹ A menopausal symptom survey was administered at baseline and at the end of the intervention, and urine was collected at both time points to assess levels of estrone (E1), estradiol (E2), and changes in the vitamin B3 catabolome.¹

How did nicotinamide riboside and pterostilbene affect menopause symptoms?

At the end of the 7-day intervention, participants in the MS group self-reported significant reductions of 50% or more in the frequency and severity of hot flashes, bloating, and poor sleep compared with baseline.^1,2 No significant changes in these endpoints were observed in the No-MS group.¹

The trial's rationale centers on the relationship between nicotinamide adenine dinucleotide (NAD+) and estradiol production. Both NAD+ and estradiol levels decline with age, and reduced estradiol has been associated with the undesirable symptoms of the menopause transition. Previous clinical trials have established that oral supplementation with nicotinamide riboside and pterostilbene significantly increases NAD+ levels.¹

What did the study find about estrogen balance?

Among the most notable biological findings was a significant increase in the E2/E1 ratio in the MS group, reflecting a more favorable balance between estradiol and estrone, 2 key forms of estrogen in women.^1,2 Shifts in the E2/E1 ratio are a recognized hallmark of menopause, and the finding suggests a potential connection between NAD+ metabolism and estrogen regulation.²

“This study stemmed from my own experience with Basis helping with menopausal symptoms,” said Marie Migaud, PhD, study co-author and Brian Metcalf Chair in Chemical Biology at The University of Western Australia. “From that experience, we hypothesized that supporting NAD+ metabolism could help promote a healthier balance between estradiol and estrone during menopause. We were encouraged to see improvements in estradiol-to-estrone ratios alongside meaningful reductions in the frequency and severity of menopausal symptoms reported by participants.”²

What new insights into NAD+ metabolism emerged?

The study also characterized a previously unreported NAD+ metabolite, identified as N-methyl-nicotinuric acid (Me-NUA).¹ Nicotinamide riboside and pterostilbene intake significantly increased urinary levels of methyl-nicotinamide and methylated pyridone carboxamides across all groups, and a significant time-by-menopausal-status interaction was observed for nicotinuric acid.¹

“The identification of a previously unreported NAD+ metabolite in this study broadens our understanding of how NAD+ precursors are processed and utilized in humans,” said Ryan Dellinger, PhD, study co-author and VP of Scientific Affairs at Elysium. “As the field moves beyond simply measuring NAD+ levels, a more complete understanding of NAD+ metabolism will yield more insights into healthy aging.”²

“Women’s health, reproductive aging, and longevity are deeply interconnected, yet they remain underrepresented in aging research,” said Yousin Suh, PhD, Charles and Marie Robertson Professor of Reproductive Sciences in Obstetrics and Gynecology at Columbia University and new member of the Elysium Scientific Advisory Board. “These findings are encouraging and suggest a potential link between NAD+ metabolism, estrogen balance, and symptoms experienced during the menopausal transition. While further studies are needed, this work underscores the importance of expanding research into the biological mechanisms underlying reproductive aging.”²

References:

1. Migaud M, et al. NRPT supplementation reduces menopausal symptoms and increases the estradiol-to-estrone ratio. Front Aging. 2026. doi:10.3389/fragi.2026.1773667
2. Elysium Health, Inc. Elysium Health research demonstrates improvements in menopause symptoms and estrogen balance with Basis and reveals new insights into NAD+ metabolism. PR Newswire. Published 2026. Accessed July 9, 2026. https://prnmedia.prnewswire.com/news-releases/elysium-health-research-demonstrates-improvements-in-menopause-symptoms-and-estrogen-balance-with-basis-and-reveals-new-insights-into-nad-metabolism-302821437.html