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van de Weijer P, Barentsen R. Isoflavones from red clover (Promensil) significantly reduce menopausal hot flush symptoms compared with placebo. Maturitas 2002;42:187-93. View abstract.

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Baber R, Clifton Bligh P, Fulcher G, and et al. The effect of an isoflavone extract (PO81) on serum lipids, forearm bone density and endometrial thickness in postmenopausal women [Abstract]. Proceedings of the North American Menopause Society (New York, 1999).

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Blakesmith, S. J., Lyons-Wall, P. M., Joannou, G. E., Petocz, P., and Samman, S. Urinary isoflavonoid excretion is inversely associated with the ratio of protein to dietary fibre intake in young women. Eur.J Clin Nutr 2005;59(2):284-290. View abstract.

Burdette, J. E., Liu, J., Lantvit, D., Lim, E., Booth, N., Bhat, K. P., Hedayat, S., van Breemen, R. B., Constantinou, A. I., Pezzuto, J. M., Farnsworth, N. R., and Bolton, J. L. Trifolium pratense (red clover) exhibits estrogenic effects in vivo in ovariectomized Sprague-Dawley rats. J Nutr 2002;132(1):27-30. View abstract.

Chan, H. Y., Wang, H., and Leung, L. K. The red clover (Trifolium pratense) isoflavone biochanin A modulates the biotransformation pathways of 7,12-dimethylbenz[a]anthracene. Br J Nutr 2003;90(1):87-92. View abstract.

Domon, O. E., McGarrity, L. J., Bishop, M., Yoshioka, M., Chen, J. J., and Morris, S. M. Evaluation of the genotoxicity of the phytoestrogen, coumestrol, in AHH- 1 TK(+/-) human lymphoblastoid cells. Mutat.Res 3-1-2001;474(1-2):129-137. View abstract.

Finking, G., Wohlfrom, M., Lenz, C., Wolkenhauer, M., Eberle, C., and Hanke, H. The phytoestrogens Genistein and Daidzein, and 17 beta-estradiol inhibit development of neointima in aortas from male and female rabbits in vitro after injury. Coron.Artery Dis. 1999;10(8):607-615. View abstract.

Friedman, J. A., Taylor, S. A., McDermott, W., and Alikhani, P. Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins. Neurocrit.Care 2007;7(1):76-80. View abstract.

Gerber G, Lowe FC, and Spigelman S. The use of a standardized extract of red clover isoflavones for the alleviation of BPH symptoms. The Endocrine Society's 82nd Annual Meeting 2000;82:2359.

Hamilton-Reeves, J. M., Vazquez, G., Duval, S. J., Phipps, W. R., Kurzer, M. S., and Messina, M. J. Clinical studies show no effects of soy protein or isoflavones on reproductive hormones in men: results of a meta-analysis. Fertil.Steril. 2010;94(3):997-1007. View abstract.

Hooper, L., Madhavan, G., Tice, J. A., Leinster, S. J., and Cassidy, A. Effects of isoflavones on breast density in pre- and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials. Hum.Reprod.Update. 2010;16(6):745-760. View abstract.

Jarred, R. A., Keikha, M., Dowling, C., McPherson, S. J., Clare, A. M., Husband, A. J., Pedersen, J. S., Frydenberg, M., and Risbridger, G. P. Induction of apoptosis in low to moderate-grade human prostate carcinoma by red clover-derived dietary isoflavones. Cancer Epidemiol.Biomarkers Prev. 2002;11(12):1689-1696. View abstract.

Jeri AR. The effect of isoflavone phytoestrogens in relieving hot flushes in Peruvian post menopausal women. 9th International Menopause Society World Congress on the Menopause (1999).

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Kelley, K. W. and Carroll, D. G. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. J.Am.Pharm.Assoc.(2003.) 2010;50(5):e106-e115. View abstract.

Knight DC. The effect of Promensil, an isoflavone extract, on menopausal symptoms. Climacteric 1999;2:79-84.

Knight, D. C. and Eden, J. A. A review of the clinical effects of phytoestrogens. Obstet.Gynecol. 1996;87(5 Pt 2):897-904. View abstract.

Kolodziejczyk-Czepas, J. Trifolium species-derived substances and extracts--biological activity and prospects for medicinal applications. J.Ethnopharmacol. 8-30-2012;143(1):14-23. View abstract.

Leach, M. J. and Moore, V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane.Database.Syst.Rev. 2012;9:CD007244. View abstract.

Lee, C. C., Bloem, C. J., Kasa-Vubu, J. Z., and Liang, L. J. Effect of oral phytoestrogen on androgenicity and insulin sensitivity in postmenopausal women. Diabetes Obes.Metab 2012;14(4):315-319. View abstract.

Lipovac, M., Chedraui, P., Gruenhut, C., Gocan, A., Kurz, C., Neuber, B., and Imhof, M. The effect of red clover isoflavone supplementation over vasomotor and menopausal symptoms in postmenopausal women. Gynecol.Endocrinol. 2012;28(3):203-207. View abstract.

Lovati, M. R., Manzoni, C., Canavesi, A., Sirtori, M., Vaccarino, V., Marchi, M., Gaddi, G., and Sirtori, C. R. Soybean protein diet increases low density lipoprotein receptor activity in mononuclear cells from hypercholesterolemic patients. J Clin Invest 1987;80(5):1498-1502. View abstract.

Ma, H., Sullivan-Halley, J., Smith, A. W., Neuhouser, M. L., Alfano, C. M., Meeske, K., George, S. M., McTiernan, A., McKean-Cowdin, R., Baumgartner, K. B., Ballard-Barbash, R., and Bernstein, L. Estrogenic botanical supplements, health-related quality of life, fatigue, and hormone-related symptoms in breast cancer survivors: a HEAL study report. BMC.Complement Altern.Med. 2011;11:109. View abstract.

Medjakovic, S. and Jungbauer, A. Red clover isoflavones biochanin A and formononetin are potent ligands of the human aryl hydrocarbon receptor. J.Steroid Biochem.Mol.Biol. 2008;108(1-2):171-177. View abstract.

Nachtigall LB, La Grega L, Lee WW, and et al. The effects of isoflavones derived from red clover on vasomotor symptoms and endometrial thickness. 9th International Menopause Society World Congress on the Menopause. 1999;331-336.

Nissan, H. P., Lu, J., Booth, N. L., Yamamura, H. I., Farnsworth, N. R., and Wang, Z. J. A red clover (Trifolium pratense) phase II clinical extract possesses opiate activity. J Ethnopharmacol 5-30-2007;112(1):207-210. View abstract.

Peterson, G. and Barnes, S. Genistein and biochanin A inhibit the growth of human prostate cancer cells but not epidermal growth factor receptor tyrosine autophosphorylation. Prostate 1993;22(4):335-345. View abstract.

Peterson, G. and Barnes, S. Genistein inhibition of the growth of human breast cancer cells: independence from estrogen receptors and the multi-drug resistance gene. Biochem.Biophys.Res.Commun. 8-30-1991;179(1):661-667. View abstract.

Pitkin, J. Alternative and complementary therapies for the menopause. Menopause.Int. 2012;18(1):20-27. View abstract.

Posadzki, P., Watson, L. K., and Ernst, E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med 2013;13(1):7-12. View abstract.

Reiter, E., Beck, V., Medjakovic, S., Mueller, M., and Jungbauer, A. Comparison of hormonal activity of isoflavone-containing supplements used to treat menopausal complaints. Menopause. 2009;16(5):1049-1060. View abstract.

Rosenberg Zand, R. S., Jenkins, D. J., and Diamandis, E. P. Effects of natural products and nutraceuticals on steroid hormone-regulated gene expression. Clin Chim.Acta 2001;312(1-2):213-219. View abstract.

Samman, S., Koh, H. S., Flood, V. M., Blakesmith, S. J., Petocz, P., and Lyons-Wall, P. M. Red clover (Trifolium pratense) isoflavones and serum homocysteine in premenopausal women: a pilot study. J.Womens Health (Larchmt.) 2009;18(11):1813-1816. View abstract.

Shulman, L. P., Banuvar, S., Fong, H. H., and Farnsworth, N. R. Discussion of a well-designed clinical trial which did not demonstrate effectiveness: UIC center for botanical dietary supplements research study of black cohosh and red clover. Fitoterapia 2011;82(1):88-91. View abstract.

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Suh, K. S., Koh, G., Park, C. Y., Woo, J. T., Kim, S. W., Kim, J. W., Park, I. K., and Kim, Y. S. Soybean isoflavones inhibit tumor necrosis factor-alpha-induced apoptosis and the production of interleukin-6 and prostaglandin E2 in osteoblastic cells. Phytochemistry 2003;63(2):209-215. View abstract.

Tice J, Cummings SR Ettinger B et al. Few adverse effects of two red clover extracts rich in phytoestrogens: a multicenter, placebo-controlled trial. Alt Ther 2001;7:S33.

Tomar, R. S. and Shiao, R. Early life and adult exposure to isoflavones and breast cancer risk. J.Environ.Sci.Health C.Environ.Carcinog.Ecotoxicol.Rev. 2008;26(2):113-173. View abstract.

Umland, E. M. Treatment strategies for reducing the burden of menopause-associated vasomotor symptoms. J.Manag.Care Pharm. 2008;14(3 Suppl):14-19. View abstract.

Vrieling, A., Rookus, M. A., Kampman, E., Bonfrer, J. M., Bosma, A., Cats, A., van, Doorn J., Korse, C. M., Witteman, B. J., van Leeuwen, F. E., van't Veer, L. J., and Voskuil, D. W. No effect of red clover-derived isoflavone intervention on the insulin-like growth factor system in women at increased risk of colorectal cancer. Cancer Epidemiol.Biomarkers Prev. 2008;17(10):2585-2593. View abstract.

Vrieling, A., Rookus, M. A., Kampman, E., Bonfrer, J. M., Korse, C. M., van Doorn, J., Lampe, J. W., Cats, A., Witteman, B. J., van Leeuwen, F. E., van't Veer, L. J., and Voskuil, D. W. Isolated isoflavones do not affect the circulating insulin-like growth factor system in men at increased colorectal cancer risk. J Nutr 2007;137(2):379-383. View abstract.

Wang, Y., Man, Gho W., Chan, F. L., Chen, S., and Leung, L. K. The red clover (Trifolium pratense) isoflavone biochanin A inhibits aromatase activity and expression. Br.J Nutr 2008;99(2):303-310. View abstract.

Anderson JW, Johnstone BM, Cook-Newell ME. Meta-analysis of the effects of soy protein intake on serum lipids. N Engl J Med 1995;333:276-82. View abstract.

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Anthony MS. Soy and cardiovascular disease: Cholesterol lowering and beyond. J Nutr 2000;130:662S-3S. View abstract.

Atkinson C, Compston JE, Day NE, et al. The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 2004;79:326-33. View abstract.

Atkinson C, Oosthuizen W, Scollen S, et al. Modest protective effects of isoflavones from a red clover-derived dietary supplement on cardiovascular disease risk factors in perimenopausal women, and evidence of an interaction with ApoE genotype in 49-65 year-old women. J Nutr 2004;134:1759-64. View abstract.

Atkinson C, Warren RM, Sala E, et al. Red clover-derived isoflavones and mammographic breast density: a double-blind, randomized, placebo-controlled trial [ISRCTN42940165]. Breast Cancer Res 2004;6:R170-R179. View abstract.

Baber R, Clifton Bligh P, Fulcher G, et al. The effect of an isoflavone extract (PO81) on serum lipids, forearm bone density and endometrial thickness in postmenopausal women [Abstract]. Proceedings of the North American Menopause Society (New York, 1999).

Baber RJ, Templeman C, Morton T, et al. Randomized placebo-controlled trial of an isoflavone supplement and menopausal symptoms in women. Climacteric 1999;2:85-92.. View abstract.

Baird DD, Umbach DM, Lansdell L, et al. Dietary intervention study to assess estrogenicity of dietary soy among postmenopausal women. J Clin Endocrinol Metab 1995;80:1685-90. View abstract.

Barnes S, Kim H, Darley-Usmar V, et al. Beyond ERalpha and ERbeta: Estrogen receptor binding is only part of the isoflavone story. J Nutr 2000;130:656S-7S. View abstract.

Blakesmith SJ, Lyons-Wall PM, George C, et al. Effects of supplementation with purified red clover (Trifolium pratense) isoflavones on plasma lipids and insulin resistance in healthy premenopausal women. Br J Nutr 2003;89(4):467-474. View abstract.

Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected review commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. View abstract.

Campbell MJ, Woodside JV, Honour JW, et al. Effect of red clover-derived isoflavone supplementation on insulin-like growth factor, lipid and antioxidant status in healthy female volunteers: a pilot study. Eur J Clin Nutr 2004;58(1):173-179. View abstract.

Cassady JM, Zennie TM, Chae YH, et al. Use of a mammalian cell culture benzo(a)pyrene metabolism assay for the detection of potential anticarcinogens from natural products: inhibition of metabolism by biochanin A, an isoflavone from Trifolium pratense L. Cancer Res 1988;48:6257-61. View abstract.

Chedraui P, San Miguel G, Hidalgo L, et al. Effect of Trifolium pratense-derived isoflavones on the lipid profile of postmenopausal women with increased body mass index. Gynecol Endocrinol 2008;24(11):620-624. View abstract.

Cheong JL, Bucknall R. Retinal vein thrombosis associated with a herbal phytoestrogen preparation in a susceptible patient. Postgrad Med J 2005;81:266-7.. View abstract.

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Coon JT, Pittler MH, Ernst E. Trifolium pratense isoflavones in the treatment of menopausal hot flushes: a systematic review and meta-analysis. Phytomedicine 2007;14(2-3):153-159. View abstract.

del Giorno C, Fonseca AM, Bagnoli VR, et al. Effects of Trifolium pratense on the climacteric and sexual symptoms in postmenopause women. Rev Assoc Med Bras 2010;56(5):558-562. View abstract.

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Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: 786bafc6f6343634fbf79fcdca7061e1&rgn=div5&view= text&node=21:

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Geller J, Sionit L, Partido C, et al. Genistein inhibits the growth of human-patient BPH and prostate cancer in histoculture. Prostate 1998;34:75-9. View abstract.

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