Menopause & perimenopause
Red clover for menopausal symptoms
(Trifolium pratense L., Fabaceae)
Here are the topics covered in this article:
When dreaming of a summer’s day, many of us naturally conjure up fields of
gently nodding heads of clover. But as plant researchers today are demonstrating,
there’s so much more to clover than just a pretty face. Aside from sweetening
the milk of dairy cattle, nourishing broods of honeybees, and enriching our soils
with its nitrogen-fixing roots, the clover plant has a long tradition of use as
a medicinal herb — particularly by women to treat symptoms of perimenopause
and menopause. And for good reason, as the research is now showing us. So let’s
explore some of these new findings, and learn how red clover can help restore hormonal
What is red clover used for?
Red clover has long been used by to quell symptoms of menopause, such as hot flashes
and night sweats. Though not as widely studied as soy for menopausal symptoms, red
clover has shown positive results in numerous smaller studies. In a 2007 review
of the literature, the authors found evidence that women getting between 40 and
80 mg of red clover isoflavones a day experienced relief from hot flashes.
In addition, there have been many studies designed to evaluate its ability to improve
bone health and cardiovascular function, as well as its anti-cancer properties,
all of which continue to show promise for women interested in healthy aging.
How does red clover work?
The science behind how red clover works is an emerging one, so what its various
constituents actually do in the body (this is termed its pharmacodynamics)
has not been fully explained. However, numerous studies on this herb’s medicinal
uses are in the works, and we do know a thing or two about the fate in the body
(this is what is known as pharmacokinetics) of its molecular components.
These studies are helping to better clarify how red clover works, and we expect
its mode of action in the body will be better understood with time.
We can say for now that red clover is rich in numerous bioactive compounds considered
beneficial in menopause, including lignans and phytoestrogens.
Scientists attribute much of red clover’s effect on menopausal symptoms to
its phytoestrogens — plant chemicals which can weakly bind to certain
estrogen receptors in our tissues to induce a gentle physiological response. Like
those found in clover’s cousins, soy and kudzu, the phytoestrogens in red
clover have been found to work in an adaptogenic way — that is, by
blocking, turning up, turning down, or otherwise modulating cellular responses to
diminish symptoms of hormonal imbalance. (See diagram below.)
Red clover contains several of the phytoestrogen classes known as coumestans
and isoflavones. At the present time it is the isoflavones found in red
clover that are believed to have the strongest effect on menopausal symptoms such
as hot flashes and night sweats, though both the coumestans and lignans also contribute
many health benefits.
The adaptogenic effect
By weakly binding to estrogen receptors (represented in orange), isoflavones
found in red clover (such as daidzein, shown R) can block negative effects
of excess estrogen. Alternately, when levels decline, they can “stand
in” for the estradiol molecule (shown L) to moderate negative effects
of low estrogen in the body.
The four principal isoflavones found in red clover are:
- biochanin A
While biochanin A and formononetin are its main isoflavone components, Trifolium
plants also contain lesser amounts of genistein and daidzein — the more well-known
isoflavones found abundantly in soy — but clover is special because it is
one of the few plants to have all four of these compounds.
Because certain aspects of the isoflavone molecules found in herbs such as red clover,
soy, and kudzu resemble estrogens at the molecular level, they can weakly bind to
the estrogen receptors found in different target tissues in the body. They are not,
however, the same as human estrogen; they are synthesized along different pathways
and, as a biochemical class, they are actually polyphenols, not steroids
like estradiol and other human hormones.
Studies show that certain types of estrogen receptors are more active in certain
tissues in the body. Scientists believe this has a bearing on the various balancing
and protective effects of phytoestrogens. These isoflavones are said to work in
an adaptogenic way, such that when estrogen levels are low or in decline,
such as in menopause or perimenopause, they exert weak estrogen-like, (up-regulating
or agonistic) actions, serving as a “stand-in” molecular substitute
or mimicking some of the effects of estrogen. A decrease in frequency and
severity of hot flashes is believed to be, at least in part, the result of this
In the setting of high levels of estrogen, on the other hand, phytoestrogens
such as red clover isoflavones are said to exert a down-regulating, or antagonistic
effect, by taking up the receptor sites and blocking the endogenous estrogen. This
is one way in which these phytoestrogens — in particular biochanin, the main
red clover isoflavone — appear to have antimutagenic/tumor inhibitory properties.
So you can see that, just as with all life systems, the way phytoestrogens work
is complex. Much of the wonder we experience in view of the natural world is in
recognition of this complexity and elegance. You may wish to read our article on
phytotherapy for further explanation
of how plant-based medicine can help restore hormonal balance in women. For more
specifics on the biochemistry of phytoestrogens such as those found in red clover,
we encourage you to visit some of the links listed on our references and further
Red clover preparations — what to look for and typical dosages
For perimenopausal and menopausal women, red clover is marketed in many different
forms containing varying amounts of the active constituents. This variation can
be quite wide as a result of growing conditions, time of harvest, and portion of
the plant used, among other variables.
If you choose to use a stand-alone red clover product, we encourage you to look
for capsules containing standardized extracts of organically grown red clover, with
at least 8% isoflavonoids or 40 mg isoflavones per capsule. In preparing herbal
extractions from red clover, the flowers can be mixed with the leaves to achieve
certain ratios of compounds in the plant observed to be most effective for menopause
symptoms. Standardized extracts of both leaves and flowers are available in the
form of tablets and capsules, as well as combination phytotherapeutic formulations.
At Women to Women, we believe there is strength in diversity. Our own
Herbal Equilibrium contains red clover in a carefully formulated, standardized
preparation based on the latest in phytotherapy research, as well as drawing on
the ethnobotanical wisdom embodied by Native American, Asian, and Ayurvedic cultures.
Teas, infusions, tinctures and dried powder extracts have also been made from the
blossoms of red clover since ancient times. You may also wish to discuss your specific
needs, choices, and dosage with a qualified herbalist, naturopath, or healthcare
provider versed in herbal medicine.
Side effects and safety of red clover
Though red clover has not undergone extensive testing in longer-term studies (over
12 months), there have been no adverse side effects reported in the shorter studies
to date. Nevertheless, variation among red clover formulations and extracts exists,
and there may be situations where it is wise for women to consult with their healthcare
providers before instituting the use of herbal remedies such as red clover.
For instance, chemicals in red clover known as coumestans may have blood-thinning
properties; for this reason, women on blood-thinning medications should have their
clotting time (prothrombin time) monitored while using it. In addition, women with
a history of breast cancer may want to consult with their oncologist or breast health
specialist beforehand. Women on hormones, even birth control, may also want to review
the use of red clover with a qualified naturopath before adding it or changing their
The good news is that concerns regarding red clover formulations are largely theoretical,
and the body of data regarding its safety continues to grow. We encourage you to
think it over; talk with an experienced herbalist, naturopath, or qualified healthcare
practitioner in determining whether red clover is a good choice for you, along with
an appropriate dose and form for your unique needs. Or give us a call — we’re
here for you!
Related to this article:
References & further reading on red
clover for menopausal symptoms
Last Modified Date: 06/02/2011
Principal Author: Marcella Sweet