Does red clover help with night sweats during perimenopause?

Red clover has meaningful evidence supporting its use for vasomotor symptoms, a category that includes both hot flashes and night sweats. For women seeking a non-hormonal approach to night sweats during perimenopause, red clover is one of the better-studied options.

What red clover contains and how it works

Red clover (Trifolium pratense) contains phytoestrogenic isoflavones, primarily formononetin, biochanin A, daidzein, and genistein. These compounds bind to estrogen receptors, particularly estrogen receptor beta (ER-beta), which is found in the hypothalamus. The hypothalamus acts as the body's thermostat, and its temperature set point becomes more volatile when estrogen levels drop or fluctuate during perimenopause. This instability is the direct cause of vasomotor symptoms including the hot flashes that occur during the day and the night sweats that disturb sleep.

By providing a low-level estrogenic signal through ER-beta, red clover isoflavones may help stabilize hypothalamic temperature regulation, reducing the frequency and intensity of these episodes.

What the research shows

Hidalgo et al. (2005) conducted a randomized, double-blind, placebo-controlled trial using 80mg of red clover isoflavones per day and found a 44% reduction in vasomotor symptom frequency compared to placebo. Night sweats were included in the vasomotor symptom assessment alongside hot flashes. Lipovac et al. (2012) found similarly significant improvements in vasomotor symptoms and overall quality of life in menopausal women taking 80mg of red clover isoflavones daily. Tice et al. (2003) found more modest benefits when comparing red clover to hormone replacement therapy directly, but did observe some benefit over placebo for vasomotor symptoms.

Chedraui et al. (2008) confirmed a broad reduction in the Kupperman symptom index, which includes night sweats as a component item.

While the evidence is not as strong as that for hormone replacement therapy, it is among the more consistent of the non-hormonal supplement options.

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.

Red clover contains coumarin compounds that can mildly inhibit blood clotting. Women taking anticoagulants such as warfarin should check with their provider before use. Women taking tamoxifen or other hormonal medications should also discuss potential interactions with their prescriber.

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

Tracking your response

Night sweats are a trackable symptom with a natural baseline and variation. Before starting red clover, use PeriPlan to log the frequency and intensity of your night sweats each morning for at least one to two weeks. Continue logging consistently after starting. Looking at weekly averages over 6 to 8 weeks will give you a clearer picture of whether the frequency or severity is changing compared to baseline.

For some women, night sweats improve significantly within four to six weeks. Others notice a more gradual change, or find red clover does not provide enough benefit on its own. In those cases, discussing combination approaches with your healthcare provider is reasonable.

Complementary strategies worth considering alongside red clover include keeping the bedroom cool, using moisture-wicking bedding, avoiding known triggers such as alcohol and spicy foods in the evening, and practicing a consistent wind-down routine to support sleep quality.

When to see a doctor

If night sweats are severe enough to disrupt sleep consistently, soak your bedding, or leave you exhausted and unable to function during the day, discuss this with your healthcare provider. Severe vasomotor symptoms can respond well to hormone replacement therapy or other prescription options that may be more effective than supplements. Night sweats can also occasionally signal conditions unrelated to menopause, including thyroid disorders or infections, which require proper medical evaluation.

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