Table 1.
Studies of Black Cohosh (Cimifuga racemosa)
| Menopausal symptoms | |||||
|---|---|---|---|---|---|
| Reference | Study Design | # of Participants | Dosage | Duration | Results |
| Wuttke et al, 2003 32 | RCT with 3 groups: Black Cohosh (BC), conjugated estrogen (CE), and placebo | 62 postmenopausal women | BC: 40 mg CE: 0.6 mg |
3 months | BC showed a significant reduction in symptoms compared to placebo, equivalent effect of CE. |
| Liske et al, 2002 33 | RCT with 2 groups: Standard (S) and High (H) dose of Remifemin | 152 peri and postmenopausal women | S: 39 mg H: 127.3 mg |
24 weeks | Found decrease of Kupperman-Menopause index (KPI) for both groups, no difference between standard and high dose. |
| Duker et al, 1991 34 | Placebo-controlled trial | 110 women with menopausal complaints | Remifemin: dosage not reported | 8 weeks | Significant reduction in LH levels compared to placebo, no significant change in FSH was observed |
| Lehmann- Willenbrock & Riedel, 1988 35 | Randomized comparison group study: Estriol (E), conjugated estrogen (CE), estrogen-gestagen (EG), Remifemin (R) | 60 women with hysterectomies and climacteric symptoms | E: 1 mg/day CE: 1.25 mg/day EG: 1 tablet/day Trisequens ® R: 48–140mg/day |
6 months | Remifemin produced a decline in KPI no significant differences were observed among treatment groups. |
| Petho, 1987 36 | Open trial | 70 women changing from hormone injections to black cohosh. | Remifemin 48–140 mg/day | 6 months | After 2 months, significant improvement in mean menopausal index, 82% reported black cohosh preparation good or very good for relief of menopausal complaints |
| Warnecke, 1985 36 | Open trial with 3 groups groups: Remifemin (R), Conjugated estrogens (CE), or Diazepam (D) | 60 women with menopausal complaints | R: 48–140mg/day CE: 0.6 mg/day D: 2 mg/day |
12 weeks | Remifemin and CE showed vaginal cytology changes, improvements in hot flashes and psychological symptoms in all three groups. |
| Geller, ongoing UIC | RCT with 4 groups: black cohosh (BC), red clover (RC), HRT, and placebo | 72 planned, 41 randomized | BC: 128 mg/day RC: 120 mg/day HRT: Prempro ® |
1 year | No data yet, ongoing clinical trial. |
| Kronenberg, ongoing Columbia | RCT with 2 groups: black cohosh v. placebo | unknown | BC: 80 mg/day | 1 year | No data yet, ongoing clinical trial. |
| Vasomotor symptoms in breast cancer survivors | |||||
| Reference | Study Design | # of Participants | Dosage | Duration | Results |
| Hernandez Munoz & Pluchino, 2003 37 | 2 arm randomized trial, open label: Group 1—Tamoxifen only, Group 2—Tamoxifen + black cohosh | 136 breast cancer survivors, perimenopausal | Tamoxifen: 20 mg/day BC: 40 mg/day |
6 months | Group taking combination therapy experienced significantly less severe hot flashes vs. group on tamoxifen only (24% vs. 74%) |
| Jacobson et al, 2001 38 | RCT: Placebo and black cohosh, stratified on tamoxifen use | 85 breast cancer survivors experiencing daily hot flashes | BC: 40 mg/day | 2 months | Black cohosh and placebo both reduced number and intensity of hot flashes during the study. There was no significant difference between BC and P. |
| Pockaj et al, 2004 39 | Open trial | 21 postmenopausal women, 13 w/history of breast cancer | Remifemin: dosage not reported | 4 weeks | Significant reduction from baseline in hot flashes and improvement in sleeping, fatigue levels, and abnormal sweating. |
RCT=Randomized-controlled trial (double-blind, placebo controlled)
Prempro=0.625 mg conjugated equine estrogen + 2.5 mg medroxyprogesterone acetate