Does red clover help with low libido during perimenopause?

Red clover (Trifolium pratense) may offer modest indirect support for low libido during perimenopause, though the evidence is not as direct or strong as it is for hot flashes. Understanding how red clover works helps set realistic expectations.

What red clover contains and how it works

Red clover is rich in isoflavones, specifically formononetin, biochanin A, daidzein, and genistein. These compounds are phytoestrogens, meaning they have a weak estrogen-like effect in the body. They bind preferentially to estrogen receptor beta (ER-beta), which is found throughout the body including in vaginal tissue. As estrogen declines during perimenopause, vaginal tissue can become thinner and drier, which is one of the main physical contributors to reduced libido and painful intercourse. By providing a mild estrogenic signal through ER-beta, red clover may help support tissue health in a modest way.

What the research shows

No clinical trials have examined red clover specifically for low libido as a primary outcome. However, Chedraui et al. (2008) found that red clover isoflavones reduced the overall Kupperman symptom index score in perimenopausal women, and the Kupperman index includes sexual dysfunction as a component. This suggests a broad symptom-reducing effect rather than a targeted libido benefit. Lipovac et al. (2012) similarly found improved quality of life in women using red clover isoflavones at 80mg per day, which could reflect improvements in overall wellbeing including sexual interest.

Hormonal balance matters for libido more broadly. Low libido in perimenopause is rarely caused by one single factor. Vaginal dryness, fatigue, mood changes, poor sleep, and relationship stress all contribute. Addressing the overall symptom burden, which is where red clover has more evidence, can have a downstream effect on sexual interest and comfort.

Important safety information

If you have or have had a hormone-sensitive condition such as breast cancer, endometriosis, or uterine fibroids, discuss red clover with your healthcare provider before using it. Because red clover acts on estrogen receptors, it is not appropriate for everyone without medical guidance.

Red clover also contains coumarin compounds and may have mild blood-thinning effects. Women taking anticoagulants such as warfarin should check with their provider before use. Red clover may also interact with tamoxifen and other hormonal medications.

Studies on red clover isoflavones have generally used 40mg to 80mg per day. Talk to your healthcare provider about the right dose for your situation.

Tracking your response

Libido is influenced by many factors simultaneously, which makes it harder to isolate the effect of any single supplement. For the best insight, use PeriPlan to log your daily symptom levels before you start red clover, and continue tracking consistently for at least 6 to 8 weeks. This gives you objective data on whether your experience is changing, rather than relying on vague impressions over time.

Supplementing red clover alongside other supportive measures, including pelvic floor physical therapy, open communication with your partner, adequate sleep, and stress reduction, is likely to produce better results than red clover alone.

Complementary strategies worth discussing with your provider include vaginal moisturizers or lubricants for local tissue health, and if appropriate, localized estrogen therapy, which has a strong evidence base for vaginal symptoms specifically.

When to see a doctor

If low libido is significantly affecting your quality of life or relationship, discuss it with your healthcare provider. Sudden changes in sexual desire can sometimes reflect thyroid dysfunction, depression, or other treatable conditions. A provider can also assess whether localized estrogen therapy or other targeted treatments are appropriate for you.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.