title: Effects of red clover on hot flash and circulating hormone concentrations in menopausal women: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To critically evaluate the effect of red clover on hot flash, endometrial thickness, and hormones status in postmenopausal and peri- and post-menopausal women.
  
  
  METHODS
  MEDLINE (1966 to July 2014), Scopus (1990 to July 2014), and the Cochrane Central Register of Controlled Trials (The Cochrane Library issue 1, 2014) were searched for published randomized controlled Trials (RCTs).
  
  
  RESULTS
  Of 183 relevant publication trials, 11 RCTs met the inclusion criteria. The mean hot flashes frequency in red clover was lower than the control groups (MD -1.99; p=0.067). There was larger decrease in FSH (SMD -0.812; CI: -1.93 to 0.312; p=0.157) and SHBG (SMD -0.128; CI-0.425 to 0.170; P=0.4) in red clover group, compared with placebo, which was not however statistically significant. LH (SMD 0.144; CI-0.097 to 0.384, p=0.242), estradiol (SMD 0.240; CI-0.001 to 0.482, p=0.051), testosterone (MD 0.083; CI: -0.560 to 0.726; p=0.901), and endometrial thickness (SDM 0.022; CI: -0.380 to 0.424, p=0.915) showed greater increase in red clover, compared with placebo, although the effect of estradiol was only significant.
  
  
  CONCLUSIONS
  Red clover had a positive effect of alleviating hot flash in menopausal women. Our data, however, suggested very slight changes in FSH, LH, testosterone, and SHBG and significant effect in estrogen status by red clover consumption. However, the interpretation of results of the current study is limited due to methodological flaws of the included studies, menopause status, and large heterogeneity among them. Further trials are still needed to confirm the current finding.
authors.affiliation: Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Masumeh
authors.initials: M
authors.lastname: Ghazanfarpour
authors.affiliation: Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Sadeghi
authors.affiliation: Evidence-Based Care Research Centre, Department of Midwifery, School of Nursing and Midwifery, MashhadUniversity of Medical Sciences, Mashhad, Iran.
authors.forename: Robab
authors.initials: R
authors.lastname: Latifnejad Roudsari
authors.affiliation: Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Khadijeh
authors.initials: K
authors.lastname: Mirzaii Najmabadi
authors.affiliation: Department of community of Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Mousavi Bazaz
authors.affiliation: Department of Midwifery, Islamic Azad University, Firuzabad, Fars, Iran.
authors.forename: Somayeh
authors.initials: S
authors.lastname: Abdolahian
authors.affiliation: Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Talat
authors.initials: T
authors.lastname: Khadivzadeh
keywords: Circulating hormone concentrations; Hotflashes; Menopause; Meta-analysis; Red clover; Systematic review