CoQ10 vs PQQ for Perimenopause: Which Supports Energy and Mitochondria Better?
Comparing CoQ10 and PQQ for perimenopause fatigue and mitochondrial support. Evidence, dosing, combination strategies, and statin interactions explained.
Why Mitochondria Matter in Perimenopause
Mitochondria are the energy-producing structures inside every cell in the body. During perimenopause, falling oestrogen levels affect mitochondrial function directly. Oestrogen plays a role in regulating mitochondrial biogenesis (the creation of new mitochondria), antioxidant defences within mitochondria, and the efficiency of the electron transport chain that produces ATP, the cellular currency of energy. As oestrogen fluctuates and declines, many women experience fatigue that feels qualitatively different from ordinary tiredness: a deep, cellular exhaustion that does not respond well to extra sleep. Supporting mitochondrial function through targeted supplementation is one strategy some women explore alongside lifestyle changes.
What CoQ10 Does in the Body
Coenzyme Q10 (CoQ10), also called ubiquinone in its oxidised form and ubiquinol in its active reduced form, is a fat-soluble compound found naturally in every cell. It sits within the mitochondrial inner membrane and is essential for the electron transport chain to function. Without adequate CoQ10, ATP production slows. CoQ10 also acts as an antioxidant, protecting mitochondria and cell membranes from oxidative damage. Natural CoQ10 levels decline with age; by the mid-40s, tissue levels are measurably lower than in younger adults. This decline overlaps directly with perimenopause and may partly explain why fatigue worsens at this life stage. Ubiquinol is the form that is directly usable by the body and is generally considered better absorbed than ubiquinone, particularly in women over 40.
What PQQ Does in the Body
Pyrroloquinoline quinone (PQQ) is a micronutrient found in small amounts in foods such as kiwi fruit, green peppers, and fermented soy. Its most distinctive property is the ability to stimulate mitochondrial biogenesis: the growth of new mitochondria within cells. While CoQ10 supports the function of existing mitochondria, PQQ promotes the creation of more of them. PQQ also acts as an antioxidant and has shown neuroprotective properties in animal studies. The evidence base for PQQ in humans is smaller than for CoQ10 and is not perimenopause-specific, but preliminary findings on cognition and energy are promising. It activates PGC-1 alpha, a key regulator of mitochondrial growth, which is the same pathway that exercise targets.
Evidence Levels: How They Compare
CoQ10 has a substantially larger clinical evidence base. It has been studied in cardiovascular disease, heart failure, statin-induced myopathy, fertility, and general fatigue, with consistent evidence for benefit in many of these areas. The evidence for its specific role in perimenopausal energy is inferred rather than directly proven, but the mechanistic case is strong. PQQ's evidence base is smaller and more preliminary. Studies suggest benefits for cognitive function and self-reported energy levels, but most trials are short-term, small, and not focused on perimenopause specifically. Neither supplement has strong perimenopause-specific RCT data, but CoQ10 has the broader support base.
Statins and CoQ10: A Key Interaction
Women who take statin medications (prescribed for high cholesterol or cardiovascular risk) should be aware that statins inhibit HMG-CoA reductase, the same enzyme pathway involved in CoQ10 synthesis. This means statins reduce the body's natural CoQ10 production. Statin-induced muscle pain and fatigue may partly reflect CoQ10 depletion. If you are on a statin and experiencing fatigue or muscle aching, discussing CoQ10 supplementation with your GP is worthwhile. This is one clinical scenario where CoQ10 supplementation has a clear, mechanistic rationale rather than being purely speculative.
Combining CoQ10 and PQQ
Because CoQ10 and PQQ act through different mechanisms, they can be taken together without overlap or competition. CoQ10 supports existing mitochondria; PQQ encourages new ones. Some supplement formulations combine both compounds in a single capsule for this reason. A reasonable approach for women exploring this area is to start with CoQ10 alone (200 to 300 mg of ubiquinol per day with food), assess response over six to eight weeks, and then add PQQ (10 to 20 mg per day) if further benefit is wanted. Both are fat-soluble and best absorbed when taken with a meal containing some fat. Side effects are uncommon but can include mild digestive discomfort.
Tracking Energy to Assess Whether They Work
Fatigue is notoriously difficult to assess objectively, which is why systematic self-tracking is valuable when trialling supplements. Logging your energy levels consistently before and after starting a new supplement, alongside sleep quality, exercise, and stress, lets you see whether any change is real or coincidental. PeriPlan lets you log symptoms and track patterns over time, which is useful for evaluating interventions like CoQ10 or PQQ. If energy levels do not improve after eight weeks at an adequate dose, that is useful information too; it suggests the driver of fatigue may be something other than mitochondrial function, such as thyroid dysfunction, anaemia, or sleep disruption.
Related reading
Get your personalized daily plan
Track symptoms, match workouts to your day type, and build a routine that adapts with you through every phase of perimenopause.