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Black cohosh helpful for menopausal symptoms

17 May 2021

It is believed that up to 80% of women suffering from hot flushes use complementary and alternative medicine, often without informing their health-care providers. There has been a need for some time for evidence-based information on the efficacy and safety of these treatments.

A popular herbal remedy is Cimicifuga racemosa (CR) syn. Actaea racemosa (black cohosh). Reports on effectiveness and safety of CR have provided conflicting conclusions over the years.

Adding to the complexity is that unlike synthetic drugs, the active ingredient of phytopharmaceuticals is not a single substance but the whole plant extract. Herbal extracts contain many different constituents and their composition varies depending on many factors (e.g. cultivation, harvesting conditions, extraction process, extractant, and standardization). Therefore, results of studies from a certain extract may not apply to other extracts of even the same herb.

To improve understanding, a review which studied all placebo-controlled clinical data and additional data from clinical studies with isopropanolic black cohosh extract iCR from 1997 until January 2020, has been published in Climacteric.

In summary, the review authors concluded that iCR plus low-dose St. John's wort (Hypericum perforatum) (iCR+HP) is an effective and safe, evidence-based treatment option for natural menopausal symptoms, with benefits clearly outweighing risks. It was also felt that with its good safety profile in general and at estrogen-sensitive organs, iCR can also be used in patients with hormone-dependent tumors suffering from treatment induced menopausal symptoms. However, this should only take place under medical supervision. The review suggested that breast cancer patients taking iCR may possibly benefit from prolonged recurrence-free survival, but this should be confirmed by further clinical trials.

Reference Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms - an update on the evidence

C. Castelo-Branco - iD , M. Gambacciani, A. Cano et al Climacteric Volume 24, 2021 - Issue 2

See more about Alternative therapies at Menopause Remedies: Menopause Matters and Complementary/alternative therapies for menopausal women | Women's Health Concern

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