Is red clover the same as the clover in my lawn?

It is a close relative. White clover is the lawn species, and red clover is the taller plant of meadows and field margins. Check the Latin name when buying.

Does red clover work for hot flushes?

The trials disagree. The 2021 meta-analysis found a modest average reduction and also a high level of disagreement between studies. Some women report a benefit, and I would not promise one.

Can I take red clover with HRT?

Please speak to your GP or pharmacist first. The EarthWise guidance asks anyone on HRT or other hormone-related medication to check before using MenoEase.

Can I take red clover after breast cancer?

This is a decision for your oncology team. Red clover contains plant oestrogens, and the EarthWise guidance asks anyone with an oestrogen-sensitive condition to seek medical guidance first.

Is red clover safe in pregnancy?

NCCIH says it may be unsafe, and the EarthWise guidance advises against MenoEase in pregnancy and breastfeeding.

Red Clover: What It Is, How It Works, and When to Use It

Sarah Burt

Oct 14

6 min read

Red clover (Trifolium pratense) grows in almost every British meadow and verge, and its pink-purple flower heads are one of the best-known herbs for the menopause. It is traditionally used to support women through that transition, mostly because it is rich in plant oestrogens called isoflavones. The trial evidence is mixed, and the same plant oestrogens are the reason some people need to speak to a doctor first. It is one of the five herbs in the EarthWise MenoEase Day tonic.

Red clover bouquet tied with twine on a rustic wooden table, with green leaves and soft natural light.

What it is

Red clover belongs to the pea family (Fabaceae), and it is a short-lived perennial that grows 20 to 80 cm tall, with leaves in threes, often marked with a pale crescent, and round flower heads that bees visit all summer. It is native to Europe, western Asia and north-west Africa, and it has been grown for centuries as a forage crop because, like other legumes, it adds nitrogen to the soil.

The part used in herbal medicine is the flower head, picked in full bloom and dried. Western herbal tradition has used it as a general cleansing tonic, and for skin complaints and coughs, long before it became a menopause herb. I regard those older uses as part of the plant's history and not as evidence for modern claims.

A buyer's note worth reading. Check that the label names the flower heads (blossoms) and gives the Latin name Trifolium pratense. Many supplements are standardised to a set amount of isoflavones, and the number on the label tells you about concentration and not about how well the product will work. A standardised isoflavone extract is a different thing from a whole flower tincture or tea, and the trial results below come from the extracts.

The active compounds

Red clover flowers are unusually rich in isoflavones, chiefly biochanin A and formononetin, which the body converts to the better-known genistein and daidzein. The plant also contains coumarins, phenolic acids, flavonoids and saponins.

The main proposed mechanism: plant oestrogens. Isoflavones are structurally similar to human oestrogen, and they can attach to oestrogen receptors in laboratory studies, usually with a much weaker effect than the body's own hormone. This is why they are called phyto-oestrogens, and it is the reason red clover is studied in the menopause, when natural oestrogen levels fall. It is also the reason for the cautions about hormone-sensitive conditions below.

How it is traditionally used

I do not know of an EU herbal monograph for red clover flower, which means there is no formal European assessment of traditional use, doses or safety for me to point to. That is one reason I regard the information on this plant as less settled than for herbs that have one.

In Western herbal practice, red clover has two main traditional roles. The older one is as an "alterative", a term for herbs traditionally used to support the body's routes of elimination, with a reputation for the skin. The newer one is as a menopause herb, which developed as researchers identified the isoflavones. It is usually taken as an infusion of the dried flower heads, as a tincture or as a standardised tablet.

In MenoEase Day, red clover sits with Sage, Shatavari, Turmeric and Rosemary, and I think of it as the plant-oestrogen element of the formula.

What the research shows

Here is how the evidence reads.

Traditional evidence: menopause support and general tonic use. This is the main basis for the herb's use in a formula, and it rests on practitioner experience and not on controlled trials.

Promising evidence: hot flushes. A 2021 meta-analysis in the journal Nutrients (Kanadys and colleagues) pooled 12 randomised controlled trials, with 1,179 women randomised. For hot flushes, it analysed 751 participants and found that red clover reduced the number by about 1.7 a day compared with placebo (a range of roughly 0.2 to 3.3 fewer a day). The trials disagreed with each other strongly, which the authors measured at an I² of 87%, and when it looked at a broader menopause symptom scale (the Greene Climacteric Scale), it found no benefit. The authors called for better-designed studies.

Mixed reviews elsewhere. The US National Center for Complementary and Integrative Health (NCCIH) describes the results of studies on red clover and menopausal symptoms as inconsistent but promising, and that with more stringent trials they expected efficacy to improve.

Safety evidence. NCCIH notes that red clover appears to be safe for up to two years of use in studies, and it may not be safe in pregnancy or breastfeeding. The longer-term effects of the isoflavones on tissue that responds to oestrogen are the main open question.

Sarah's clinical perspective

I use red clover in MenoEase Day as a tincture, alongside Sage, Shatavari, Turmeric and Rosemary. I include it for its isoflavone content, and I take the hormonal side of the picture seriously.

Red clover contains phyto-oestrogenic isoflavones, so I ask anyone with an oestrogen-sensitive condition to seek medical guidance before using MenoEase. I also ask anyone taking HRT, anticoagulants, hormone-related medication or medicines processed by the liver to check with their GP first. I do not recommend MenoEase in pregnancy or breastfeeding.

Practical guidance

Dose. There is no EU monograph to cite, and doses in trials relate to standardised extracts, so I will not offer a figure. This is not a dosing instruction for any particular product, including MenoEase.

Format. A tea of the dried flower heads, a tincture, or a standardised tablet. Most of the trials used standardised isoflavone tablets, which are a different product from a tea or tincture.

Time to effect. There is no clinical timeline for a tincture. The trials in the meta-analysis varied in length, and herbalists generally allow several weeks to judge a response.

Timing. There is no established timing.

What it does not replace. Red clover does not replace a conversation with your GP about the menopause, and it does not replace HRT where that is appropriate. Heavy or irregular bleeding, bleeding after the menopause, and symptoms that disrupt daily life need a GP.

For how to take the EarthWise tonic specifically, the dose and full safety information are on the product page.

Common questions

Is red clover the same as the clover in my lawn? It is a close relative. White clover is the lawn species, and red clover is the taller plant of meadows and field margins. Check the Latin name when buying.
Does red clover work for hot flushes? The trials disagree. The 2021 meta-analysis found a modest average reduction and also a high level of disagreement between studies. Some women report a benefit, and I would not promise one.
Can I take red clover with HRT? Please speak to your GP or pharmacist first. The EarthWise guidance asks anyone on HRT or other hormone-related medication to check before using MenoEase.
Can I take red clover after breast cancer? This is a decision for your oncology team. Red clover contains plant oestrogens, and the EarthWise guidance asks anyone with an oestrogen-sensitive condition to seek medical guidance first.
Is red clover safe in pregnancy? NCCIH says it may be unsafe, and the EarthWise guidance advises against MenoEase in pregnancy and breastfeeding.

Where red clover appears in the EarthWise range

Red clover is one of the five herbs in MenoEase Day, Sarah's formula for the menopause, where it sits with Sage, Shatavari, Turmeric and Rosemary.

If you are not sure which formula fits, the EarthWise health quiz is the best place to start. Full safety information is on each product page.

When to seek professional support

Red clover is generally well tolerated in studies, and the main reason for care is its hormonal activity. Check with a practitioner first in these situations:

An oestrogen-sensitive condition. Red clover contains phyto-oestrogenic isoflavones, so seek medical guidance first.
HRT, hormonal contraception or other hormone-related medication. Check with your GP or pharmacist.
Anticoagulants or other blood-thinning medicines. Check with your GP or pharmacist.
Medicines processed by the liver. Check with your GP or pharmacist.
Pregnancy and breastfeeding. Not recommended.
Bleeding after the menopause, or heavy or irregular bleeding. See a GP promptly, because this needs assessment.
Symptoms that disrupt daily life. Menopause support is available from your GP, and a herb is one option among several.

Sarah Burt is a registered naturopath, medical herbalist and iridologist with 25+ years of clinical experience. All EarthWise tonics are formulated by Sarah based on her clinical protocols.

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This article is for informational purposes only and is not intended to diagnose, treat or cure any health condition. Always consult a qualified health practitioner before making changes to your health regimen.