Does red clover help with perimenopause symptoms?

Red clover (Trifolium pratense) is one of the better-researched botanical options for perimenopause. It has meaningful clinical evidence for vasomotor symptoms such as hot flashes and night sweats, and broader evidence suggesting it can reduce overall symptom burden during the menopause transition.

What red clover contains and how it works

Red clover's active compounds are isoflavones: formononetin, biochanin A, daidzein, and genistein. These are phytoestrogens, meaning plant-derived compounds that bind to estrogen receptors in the body. Red clover isoflavones bind preferentially to estrogen receptor beta (ER-beta), which is distributed throughout the body including the brain, cardiovascular system, bone, and genitourinary tissue. This receptor profile gives red clover a range of potential effects during perimenopause, when estrogen levels become increasingly variable.

What the research shows

Hidalgo et al. (2005) found that 80mg of red clover isoflavones per day reduced hot flash frequency by 44% compared to placebo in a randomized controlled trial. This remains one of the most cited studies on red clover and vasomotor symptoms.

Lipovac et al. (2012) confirmed significant improvement in overall quality of life and vasomotor symptom scores with 80mg daily of a red clover isoflavone extract in menopausal women.

Chedraui et al. (2008) demonstrated a significant reduction in the Kupperman symptom index with red clover isoflavones. The Kupperman index covers a wide range of menopausal symptoms including hot flashes, sleep disturbance, irritability, anxiety, depressed mood, and physical symptoms. This suggests that the benefit extends beyond vasomotor symptoms alone.

Atkinson et al. (2004) found that red clover isoflavones improved bone mineral density in postmenopausal women, which is relevant to the longer-term bone health concerns of the menopause transition.

Tice et al. (2003) compared red clover to hormone replacement therapy and found more modest benefits, but confirmed that red clover produced greater improvement than placebo for vasomotor symptoms. This positions red clover as a reasonable option for women who cannot or choose not to use HRT.

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 affect blood clotting. Women on anticoagulants such as warfarin, or women taking tamoxifen or other hormonal medications, should discuss potential interactions with their provider before starting red clover.

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

Who may benefit most

Red clover is often considered by women who are looking for a non-hormonal approach to managing perimenopausal symptoms, particularly those with moderate vasomotor symptoms who are not candidates for hormone therapy or who prefer a plant-based option. It is not as potent as HRT, but for women with mild to moderate symptoms it may offer meaningful relief.

Tracking your response

Perimenopausal symptoms vary day to day, which makes objective tracking essential. Use PeriPlan to log your symptoms daily before starting red clover and throughout your trial period. Aim for at least 6 to 8 weeks of consistent use before evaluating the effect, since phytoestrogens typically take time to build their influence. Look for trends in frequency and intensity rather than individual good or bad days.

When to see a doctor

If your perimenopausal symptoms are severe, significantly disrupting your sleep, mood, or daily functioning, or if you have not had a recent hormonal evaluation, discuss your symptoms with your healthcare provider. A provider can help assess whether your symptoms are hormone-related, rule out other contributing conditions, and help you decide whether red clover, hormone therapy, or another approach is the best fit for your health profile and goals.

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