Red Clover for Hot Flushes

Red Clover for Hot Flushes: What the Clinical Evidence Shows

Hot flushes are a common feature of the menopause transition, but their frequency and intensity can vary considerably from woman to woman. This has led to interest in plant-based options such as red clover extracts, which contain naturally occurring compounds called isoflavones.

Red clover has been investigated in a number of clinical trials and systematic reviews, with results that have not always been consistent. So, what does the research actually show?

Red clover (Trifolium pratense) is a flowering plant that contains isoflavones, including formononetin and biochanin A, genistein and daidzein. These compounds are classified as phytoestrogens because their chemical structure is similar to oestrogen.

Red clover extracts have therefore been studied as a plant-based option for menopausal symptoms, including hot flushes.

Interest in red clover is particularly focused on whether its isoflavones may influence vasomotor symptoms such as hot flushes. However, the evidence is not uniform, and results can differ depending on the extract used, isoflavone dose, study population and length of treatment.

Clinical research on red clover and hot flushes has produced mixed results. An earlier systematic review and meta-analysis of five randomised trials found a small reduction in hot flush frequency with red clover isoflavones, but the result was only marginally statistically significant and the clinical importance of the effect was uncertain.

Other reviews have reached somewhat different conclusions. A 2016 systematic review and meta-analysis found that red clover was associated with a reduction in hot flush frequency, but the analysis showed substantial variation between studies and concluded that further trials were needed.

A 2021 systematic review and meta-analysis of eight trials found a statistically significant reduction in daily hot flush frequency compared with placebo, with greater effects seen in some subgroups, including studies using at least 80 mg of isoflavones daily. The authors nevertheless noted differences between formulations and study populations when interpreting the findings.

More recently, a 2026 GRADE-assessed systematic review and meta-analysis of nine randomised controlled trials reported a statistically significant reduction in hot flush frequency with red clover compared with placebo. The researchers described the overall effect as small to moderate, while also noting variation in doses, treatment durations and study characteristics.

Taken together, the evidence suggests that red clover may help reduce hot flush frequency for some women, but it would be too strong to describe the effect as established or guaranteed. Differences between red clover preparations and individual responses are important when interpreting the research.

There is no single dose that can be described as the standard dose for all red clover products. Clinical studies have used different extracts and different amounts of total isoflavones. Across the studies included in a recent systematic review, daily doses ranged from approximately 37 mg to 160 mg of red clover isoflavones, with treatment periods ranging from 12 weeks to 12 months.

Earlier research has commonly examined doses in the range of around 40–80 mg of isoflavones per day. For example, one randomised trial of a red clover preparation used 80 mg of isoflavones daily for 12 weeks, while another study used 80 mg daily for 90 days.

Importantly, these study doses should not automatically be interpreted as a recommended dose for every red clover product. Extract composition, isoflavone profile and product formulation can differ, so the directions for the specific product should be followed.

ERr 731® is a specific, standardised extract derived from red clover. It has been investigated separately in clinical research, so findings relating to this particular extract should not automatically be applied to every red clover product. For detailed information about ERr 731®, including its composition and research, see the dedicated ERr 731® ingredient page.

Red clover contains phytoestrogens, which have chemical structures similar to oestrogen. This is an important consideration for women with a history of hormone-sensitive cancer or another hormone-sensitive condition. If this applies to you, speak with your doctor or pharmacist before using red clover or other phytoestrogen-containing supplements. It is also sensible to discuss red clover with a healthcare professional if you take prescription medicines or have other health concerns, as herbal supplements can interact with medicines. Red clover supplements should not be assumed to be suitable for everyone simply because they are plant-based.

Red clover is one of several approaches that have been investigated for managing menopausal hot flushes. Other options include lifestyle measures, non-hormonal medicines and menopausal hormone therapy (MHT). The evidence and suitability of each option can vary, and treatment decisions depend on individual symptoms, medical history and preferences.

Red clover should therefore be considered as one option rather than a replacement for medical treatment. If hot flushes are frequent, disruptive or concerning, a healthcare professional can discuss the available approaches and help determine which may be appropriate for you.

Red clover has been studied extensively enough to provide a meaningful body of clinical evidence, but the findings are not completely consistent. Recent research suggests red clover isoflavones may reduce the frequency of hot flushes for some women, while earlier reviews have highlighted variation between studies and uncertainty about the size of the benefit.

Clinical studies have used a range of red clover isoflavone doses and formulations, so results from one product or extract should not automatically be applied to another. If you're considering red clover, look at the specific product, its ingredients and directions for use, and speak with a healthcare professional if you have health concerns or take medicines.

Does red clover actually reduce hot flushes?

The clinical evidence suggests that red clover may reduce the frequency of hot flushes in some women, but the findings have varied between studies. Some systematic reviews have reported a statistically significant reduction, while others have found smaller or less certain effects.

What dosage of red clover is typically studied?

Clinical studies have used a range of doses rather than one standard amount. A 2026 systematic review reported daily red clover isoflavone doses ranging from approximately 37 mg to 160 mg, while earlier trials commonly examined doses around 40–80 mg daily. The dose used in a study should not automatically be treated as the recommended dose for a different product.

Is red clover safe for everyone to take?

No supplement can be assumed to be suitable for everyone. Red clover contains phytoestrogens, so women with a history of hormone-sensitive cancer or another hormone-sensitive condition should speak with their doctor or pharmacist before using it. It is also important to discuss herbal supplements with a healthcare professional if you take medicines or have other health concerns.

What is ERr 731®?

ERr 731® is a specific, standardised red clover extract that has been investigated in clinical studies. Research involving ERr 731® relates to this particular extract and should not automatically be applied to all red clover products. For more information, see the dedicated ERr 731® ingredient page.

How does red clover compare to hormone replacement therapy?

Red clover and menopausal hormone therapy (MHT, also known as HRT) are different approaches and should not be considered equivalent. Red clover has been studied for menopausal symptoms, but the evidence is variable, while MHT is a medical treatment that may be appropriate for some women following individual assessment. If you're considering options for hot flushes, discuss the potential benefits, risks and suitability of different approaches with your healthcare professional.