Many women approaching menopause look for natural ways to manage symptoms like hot flushes, night sweats, mood swings, and trouble sleeping. Phytoestrogens—plant compounds that act a bit like oestrogen—are a popular option. Three commonly-used supplements are red clover, black cohosh, and ashwagandha.
These supplements claim A LOT. But the evidence isn't always there to support the marketing messages. Why? Because the studies are often very small, not of high quality, and doses and regimens differ from study to study.
Here’s what the research actually shows:
1. Red Clover
- A high-quality systematic review showed that red clover can modestly reduce the number of hot flushes per day. For example, one review found women had about 1–2 fewer hot flushes daily compared to placebo [1].
2. Black Cohosh
- A high-quality meta-analysis of 22 randomised trials involving 2,310 women found that black cohosh extracts significantly improved overall menopausal symptoms, hot flushes, and somatic symptoms (joint pain, headache, fatigue) compared to placebo. However, it did not significantly alleviate anxiety or depressive symptoms. [2]
3. Ashwagandha
- One quality randomised controlled trial of 100 women showed Ashwagandha significantly relieved mild to moderate menopause symptoms, including mood changes, fatigue and genito-urinary problems [3].
References
- Kanadys W et al. Nutrients. 2021 Apr 11;13(4):1258
- Sadahir 2023 Jul 1;30(7):766-773.
- Gopal S et al. J Obstet Gynaecol Res. 2021 Dec;47(12):4414-4425.
