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Navigating the changes that come with menopause often includes addressing shifts in libido and sexual function. Many women seek natural options to support their well-being during this transition. Among the botanicals frequently discussed are red clover isoflavones and maca root.
This article explores what is currently understood about how red clover isoflavones and maca root might relate to libido and sexual function during menopause. We will look at the available information to help you understand their potential roles and limitations.
Understanding Libido and Sexual Function Changes in Menopause
Menopause is a natural biological process marked by the cessation of menstruation, typically occurring between ages 45 and 55. This transition involves significant hormonal fluctuations, particularly a decline in estrogen levels. These changes can impact various aspects of a woman’s health, including her sexual well-being.
Decreased libido, vaginal dryness, discomfort during intercourse, and difficulty with arousal or orgasm are common experiences reported by women during perimenopause and postmenopause. These shifts are complex and can be influenced by hormonal changes, psychological factors, relationship dynamics, and overall health. Many women explore different avenues, including dietary supplements, to support their sexual health during this time.
Red Clover Isoflavones: Current Understanding for Menopausal Symptoms
Red clover (Trifolium pratense) is a legume rich in isoflavones, plant compounds that have a structure similar to estrogen. Because of this structural similarity, red clover isoflavones are sometimes referred to as phytoestrogens. They are often explored for their potential to help manage various menopausal symptoms.
Red clover isoflavones are most often discussed in the context of hot flashes and night sweats. Sexual function, however, has been measured directly, and the result is not the open question it is usually presented as. A 2018 systematic review and meta-analysis in Climacteric pooled two randomised trials of red clover and found no significant effect on sexual function (standardised mean difference -0.087, 95% CI -0.936 to 0.763, p = 0.842), with no statistical heterogeneity between the trials. Sexual satisfaction was likewise unchanged, and the review grouped red clover with soy, genistein and flaxseed as phytoestrogens that showed no promising effect on these outcomes[1].
One finding points the other way, and it is worth reporting precisely rather than in general terms. In a 90-day crossover trial in which 109 postmenopausal women took 80 mg of red clover extract daily, participants rated their libido, mood, sleep and tiredness as improved after the active phase compared with placebo[2]. Those were self-rated visual-analogue scores, collected alongside that study’s main focus on skin and hair rather than through a validated index of sexual function. The honest summary is that red clover has been tested on this endpoint rather than left untested, and the more formally measured evidence came out null.
Maca Root: Exploring its Role in Sexual Well-being
Maca (Lepidium meyenii) is a root vegetable native to the Andes Mountains of Peru. It has a long history of traditional use, including for its reported benefits related to energy, stamina, and fertility. In recent years, maca root has gained attention as a potential botanical for supporting sexual health, including libido.
Maca has been studied in postmenopausal women specifically, not only in general populations. In a randomised, double-blind, placebo-controlled crossover trial, 14 postmenopausal women took 3.5 g per day of powdered maca for six weeks and matching placebo for six weeks. Scores on the Greene Climacteric Scale fell significantly for psychological symptoms, including the anxiety and depression subscales, and for sexual dysfunction, compared with both baseline and placebo[3]. That trial also tested the mechanism rather than assuming it: serum estradiol, follicle-stimulating hormone, luteinising hormone and sex hormone-binding globulin were unchanged, and maca extracts showed no physiologically meaningful oestrogenic or androgenic activity in a yeast reporter assay. That is the concrete basis for describing maca as acting through a pathway other than the phytoestrogen one, rather than simply asserting that it does.
The size of that trial is the reason for caution. Fourteen participants over six weeks is a pilot, and a systematic review of maca for sexual function that searched 17 databases found only four randomised trials in total, judging the combined sample size and methodological quality too limited to draw firm conclusions[4]. Two of those four reported a significant benefit, one of them in healthy menopausal women. The direction of the evidence is favourable and the quantity of it is small. Those are two separate statements, and collapsing them into either optimism or dismissal misreports the position.
Red Clover Isoflavones vs. Maca Root: A Comparison for Libido and Sexual Function
When comparing red clover isoflavones and maca root for libido and sexual function during menopause, it’s important to recognize that they are distinct botanicals with different proposed mechanisms of action. Red clover isoflavones are phytoestrogens, and their potential benefits are often linked to their estrogen-like activity, primarily explored for symptoms like hot flashes. Maca root, on the other hand, is not considered a phytoestrogen and is believed to influence sexual function through other pathways, possibly related to mood, energy, or specific neurochemical interactions.
No trial has given one group red clover and another group maca and compared the two, so there is no direct comparative result to report. What does exist is a single review that assessed both against the same endpoint, and it did not find them equivalent: pooled red clover trials showed no significant effect on sexual function, while preparations of Lepidium meyenii were among the botanicals in that same review that did significantly improve it[1]. Treating the two as interchangeable options of equally unknown merit therefore understates what has already been measured. The evidence does separate them. It separates them through indirect comparison, which is weaker than a head-to-head trial and should be weighted as such, but it is not silence.
What We Don’t Know Yet: Gaps in Research
Real gaps remain, but they are not the same gap for each botanical. For red clover the targeted work has largely been done and was negative for sexual function, so the remaining question is narrower: whether the subjective libido improvement seen in the crossover trial reflects anything a validated instrument would detect, or whether it follows from better sleep and mood rather than from any direct effect on desire. For maca the gap is one of scale and duration, because the supporting trials are small and short, and optimal dosing for menopausal women and long-term safety are both genuinely unestablished.
There is still no head-to-head study assessing the efficacy and safety of red clover isoflavones against maca root for sexual function in menopausal women, and until one exists no confident ranking between them is available. That is not the same as having nothing to go on. Where sexual function is the specific reason a supplement is being considered, the formally measured evidence for red clover on that endpoint is null, and that is worth knowing before buying it for that particular purpose. Anyone weighing either option alongside prescribed treatment should discuss it with their own clinician, not least because red clover is oestrogenic and maca, on the evidence above, is not.
References
- Effect of phytoestrogens on sexual function in menopausal women: a systematic review and meta-analysis. Climacteric : the journal of the International Menopause Society, 2018
- Effect of Red Clover Isoflavones over Skin, Appendages, and Mucosal Status in Postmenopausal Women. Obstetrics and gynecology international, 2011
- Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content. Menopause (New York, N.Y.), 2008
- Maca (L. meyenii) for improving sexual function: a systematic review. BMC complementary and alternative medicine, 2010
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease. Content is for informational purposes only and is not medical advice; consult a qualified healthcare provider before starting any supplement. As an Amazon Associate we earn from qualifying purchases.
