There are no known contraindications for the flower head extracts. Concentrated isoflavone extracts should only be used by people with oestrogen-sensitive cancers under professional supervision because of the possible proliferative effects. Additionally, people with conditions that may be aggravated by increased oestrogen levels, such as endometriosis or uterine fibroids, should use this herb under professional supervision only.
srv PREGNANCY USE
VÎ/ Scientific evidence for the use of red clover during pregnancy has not been established. No teratogenicity data are available. Use is not recommended.
PRACTICE POINTS/PATIENT COUNSELLING
• Red clover flower heads are traditionally considered a dermatological agent, mild antispasmodic and expectorant and specifically used for eczema and psoriasis. In practice, it is often combined with yellow dock for treatment of chronic skin disease.
• In recent years, red clover isoflavones have been studied and shown to have an affinity for oestrogen alpha- and beta-receptors and may act as both agonists and antagonists, depending on the level of endogenous oestrogens.
• Evidence that red clover-derived isoflavones reduce hot flush frequency in menopause is unconvincing.
• Preliminary evidence suggests a possible preventative role in osteoporosis; however, further research is required.
• Concentrated isoflavone extracts from red clover are used in cardiovascular disease as there is weak evidence that it may reduce arterial stiffness.
• Evidence from animal studies and case series suggests a potential role in BPH.
• Cancer (there is weak evidence that red clover isoflavone extracts may reduce risk of hormone-sensitive cancers and that they may be beneficial in the treatment of prostate cancer).
ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS
What will this herb do for me?
Red clover is traditionally used for skin disorders. In recent years, concentrated red clover isoflavone extracts have been promoted for use in the treatment of menopausal symptoms, although clinical studies have produced inconsistent results. When will it start to work?
Red clover tea or extract for skin diseases requires long-term use. Improvement may occur within several weeks with the condition continuing to improvewith long-term
use. Improvement In menopausal symptoms from the use of concentrated Isoflavone extracts may take 2-3 months, although results are Inconsistent. Are there any safety issues?
Short- or long-term use of red clover tea or flower head extract is not thought to be associated with any adverse reactions and its use is considered safe. Concentrated red clover isoflavone extracts may have subtle oestrogenic activity and little is known about drug interactions or long-term use. As a result, they should not be used by people with oestrogen-sensitive tumours or conditions that may be aggravated by increased oestrogen levels such as endometriosis, unless under professional super-
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