Menopause & perimenopause
Red clover for menopausal symptoms
(Trifolium pratense L., Fabaceae)
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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 balance.
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.
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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.
© 2008 Women to Women
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The four principal isoflavones found in red clover are:
- biochanin A
- formononetin
- genistein
- daidzein
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 mechanism.
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 reading page.
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 regimen.
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!
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements, our exclusive endocrine support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at 1-800-798-7902. We're here to listen and help.
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Related to this article:
References & further reading on red clover for menopausal symptoms
Original Publication Date: 04/21/2008
Last Modified: 08/17/2009
Principal Author: Marcella Sweet