Saffron for Menopause: What Two Small Trials Measured

“Menopause symptoms” can mean hot flashes, disrupted sleep, anxiety, low mood or several concerns at once. Before using a supplement study to choose a product, check which symptom the researchers measured and which result came from a comparison with placebo.

The perimenopause trial had different answers across measures

The 2021 Australian trial¹ randomized 86 women aged 40 to 60 to 14 mg affron saffron extract twice daily or placebo for 12 weeks. Analyses included 82 participants; 76 completed all requirements. Psychiatric disorders other than mild-to-moderate anxiety were excluded.¹

Overall Greene Climacteric Scale scores fell 32% with saffron and 14% with placebo. The repeated-measures comparison across study visits was not statistically significant (P = 0.078), while the comparison of baseline-to-week-12 percentage changes was (P = 0.027).¹

The psychological subscale favored saffron, but the hot-flash and night-sweat subscale did not significantly outperform placebo. Separate anxiety and depression percentage-change analyses were post hoc.¹

Pharmactive supplied the extract and funded the study. The authors’ contract research organization received its funding. One saffron recipient withdrew with digestive complaints.¹

The mixed analyses matter when a headline presents one percentage as the study’s verdict. They also limit using this trial as evidence to treat a diagnosed depressive disorder that its eligibility rules excluded.

The postmenopause study measured interference

A 2018 trial² enrolled 60 women with postmenopausal hot flashes. They received 15 mg saffron twice daily or placebo for six weeks; 56 completed treatment. The published abstract reports significant advantages on the Hot Flash-Related Daily Interference Scale and Hamilton Depression Rating Scale, with no significant difference in adverse-event frequency.²

The interference scale concerns the impact of hot flashes on daily life. An improvement on that scale should not be presented as a measured reduction in the number of daily flashes. The abstract does not provide an absolute between-group score difference.²

These trials cannot establish whether perimenopausal or postmenopausal women benefit more. The doses, treatment durations and outcome measures differed. Nor can the study amounts specify a useful quantity of saffron in tea or food.

Put the trials beside treatment guidance

The Menopause Society’s 2023 nonhormone position statement did not recommend supplements or herbal remedies for vasomotor symptoms, meaning hot flashes and night sweats. It recommended several other approaches, including cognitive behavioral therapy, clinical hypnosis, certain antidepressants and gabapentin.³

That recommendation concerns treatment of the heat symptoms. If mood is the main concern, make it a separate part of the appointment rather than assuming that relief will follow from treating hot flashes.

NHS⁴ guidance includes antidepressants among options for low mood, depression or anxiety associated with menopause. It also warns that herbal remedies and complementary medicines can have serious interactions with other medicines.⁴

Bring the whole label, your prescribed and nonprescription medicines, and the symptom you want to improve. Ask what is known about the preparation, what treatment options fit your history and when to review whether the plan is helping. A short trial with few reported adverse effects cannot establish safety for years of use or for combinations the researchers did not study.

Give each symptom its own record

For hot flashes, record frequency and the activities they interrupt. For mood, note duration, effects on work or relationships, and whether symptoms persist even after a better night’s sleep. Include changes in periods, treatments and supplement use.

A useful summary is: “The heat episodes are less disruptive, but the low mood is still affecting work.” That gives the clinician two outcomes to assess instead of a single answer to whether you feel better overall.

My Body Changed. Now What?, Chapter 2’s “Answer Two: There’s a Supplement for That,” asks readers to check participant numbers, placebo comparisons and funding behind a supplement claim. Those questions are especially useful when one study reports several symptom scores.