Does red clover help with weight gain during perimenopause?

Red clover does not have direct clinical evidence for preventing or reversing weight gain in perimenopause. However, understanding the hormonal drivers of midlife weight change and how phytoestrogens fit into that picture is useful context for women exploring this option.

Why weight changes during perimenopause

Perimenopausal weight gain, particularly increased abdominal fat, is strongly linked to declining estrogen. Estrogen helps regulate fat distribution by favoring subcutaneous (peripheral) fat storage over visceral (abdominal) fat. As estrogen declines, fat preferentially redistributes to the abdominal area. Estrogen also influences insulin sensitivity, appetite-regulating hormones such as leptin and ghrelin, and resting metabolic rate. Changes in sleep quality and increased cortisol from chronic stress compound these metabolic shifts. The result is that many women gain weight during perimenopause even without significant changes in diet or exercise.

How red clover might be relevant

Red clover (Trifolium pratense) contains isoflavones including formononetin, biochanin A, daidzein, and genistein. These phytoestrogens bind to estrogen receptor beta (ER-beta) and provide a mild estrogenic signal. In theory, this could partially offset some of the metabolic effects of estrogen decline. However, no clinical trials have investigated red clover specifically for weight management in perimenopausal or postmenopausal women as a primary outcome.

Chedraui et al. (2008) found improvements in the overall Kupperman symptom index with red clover isoflavones, suggesting a broad hormonal symptom benefit. Lipovac et al. (2012) noted improved quality of life. Neither study reported body weight or body composition as outcomes.

Some animal research has examined isoflavone effects on fat metabolism, and there is theoretical interest in the role of ER-beta activation in metabolic regulation. But this has not been translated into controlled clinical evidence for weight management in humans.

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 and may have mild blood-thinning effects. Women on anticoagulants such as warfarin, or taking tamoxifen or other hormonal medications, should discuss potential interactions with their prescriber before starting.

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.

What has stronger evidence for perimenopausal weight management

For weight management during perimenopause, several approaches have considerably stronger evidence than red clover. Resistance training helps preserve and build muscle mass, which supports a higher resting metabolic rate and combats the lean mass loss of this life stage. Adequate dietary protein (aiming for 1.2 to 1.6 grams per kilogram of body weight per day) supports muscle retention and reduces appetite. Reducing refined carbohydrates and alcohol can help with insulin sensitivity and caloric balance.

Addressing sleep quality is also important. Sleep deprivation increases cortisol and disrupts appetite hormones in ways that directly promote weight gain. If night sweats are disrupting sleep, addressing vasomotor symptoms, where red clover does have evidence, may have an indirect benefit for metabolic health by improving sleep.

Tracking your response

If you decide to try red clover alongside other lifestyle changes, use PeriPlan to track your symptoms and overall wellbeing. Weight can fluctuate significantly from day to day due to water retention, so tracking monthly trends rather than daily readings is more meaningful. Note whether overall energy, sleep, and mood improve, as these factors all influence eating behaviors and activity levels.

When to see a doctor

If weight gain is rapid, significant, or accompanied by fatigue, cold intolerance, or other symptoms, discuss this with your healthcare provider. Thyroid dysfunction is common in perimenopausal women and can contribute substantially to weight changes. Insulin resistance and other metabolic conditions also warrant evaluation. A provider can assess whether medical management, dietary counseling, or other interventions are appropriate for your situation.

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