Red clover for menopause symptoms: what the NHS says

Red clover is a plant that is sold as tablets, capsules and teas, often marketed for symptoms of the menopause such as hot flushes and night sweats. The NHS lists it, alongside black cohosh, as one of the herbal remedies and complementary medicines sometimes sold for symptoms of menopause or perimenopause.

The NHS treats such products as a general category rather than endorsing particular ones. Its separate page on herbal medicines states that herbal medicines are not available on the NHS, and its menopause treatment page says evidence on how well these remedies work, and how safe they are, is very limited.

The NHS wording is cautious: there is very little evidence to show how well red clover and black cohosh work, or how safe they are. It does not say that they definitely fail, only that evidence is lacking in both directions.

It also warns that some herbal remedies and complementary medicines may cause serious side effects when taken with other medicines. This general advice matters because many women reaching menopause already take regular medicines, such as blood pressure tablets, statins or antidepressants. Its separate guidance on herbal medicines says these are not tested in the same way as standard medicines, and that people who are pregnant, breastfeeding or have kidney or liver problems should not take them.

According to the NHS, if you have symptoms of perimenopause or menopause you should talk to a doctor, nurse or pharmacist about HRT and other options. The type of HRT depends on whether you still have periods or have had your womb removed. Oestrogen is the main type and can be taken as tablets, patches, spray or gel; if you have not had a hysterectomy you also need progestogen to protect the womb. Testosterone may help low libido for some.

If HRT does not work, you cannot take it or do not want to, other types of treatment are available. The NHS says you may be offered antidepressants for low mood or anxiety caused by the menopause. For hot flushes and night sweats, you may be offered cognitive behavioural therapy (CBT) and, if that does not help, a doctor may suggest clonidine or an antidepressant.

The NHS recommends several checks before using a herbal medicine. Look for the THR mark and product code from the MHRA, which shows that it is licensed for use in England and meets safety standards. Do not buy unlicensed herbal medicines online. Ask a pharmacist first if you take other medicines, including those you buy without a prescription.

The NHS lists some medicines that do not mix well with herbal medicines, including statins, antidepressants, diabetes medicines, blood pressure medicines, warfarin and hormonal contraception. Tell the doctor or nurse treating you that you are using a herbal medicine, and do not stop a prescribed medicine without talking to your doctor.

Menopausal symptoms can overlap with other conditions. The NHS advises seeing a GP about symptoms that do not go away or keep coming back rather than relying on a therapist or a product alone.

Menopause symptoms vary and many people look for ways to cope that do not involve hormones. The NHS advice is to talk to a doctor, nurse or pharmacist about the options that suit you, and it notes that other treatments are available if HRT does not work for you, cannot be taken or is not wanted.

Keeping a note of symptoms, when they occur and how much they affect sleep, mood and work can make a consultation more productive. It can also help you judge whether a product you try makes any difference, rather than relying on impressions over weeks or months.

If symptoms are severe, keep coming back or are not improving, the NHS advises seeing a GP rather than relying on a product or a therapist alone, because the menopause is not the only possible explanation.