Black Cohosh Controls Menopausal Symptoms

Laurie Barclay, MD

June 21, 2002

June 24, 2002 -- Black cohosh was effective in controlling menopausal symptoms, according to a presentation on June 21 at Endo 2002, the 84th annual meeting of The Endocrine Society. In a double-blind study comparing the phytoestrogen to placebo and to conjugated equine estrogen, it had favorable estrogenic effects on bone and lipids but no effect on the uterus.

"Extracts of the rhizome of black cohosh (Cimicifuga racemosa) are traditionally used to treat climacteric complaints," write Wolfgang Wuttke and colleagues from the University of Goettingen in Germany. "Little is known whether [black cohosh] preparations have effects on other than climacteric complaints such as osteoporosis and lipid metabolism."

In the study of 97 postmenopausal women, duration of amenorrhea was more than six months and climacteric complaints included having more than three hot flashes per day. In double-blind fashion, the women received daily treatment for three months with commercially available black cohosh (Klimadynona or Menofema, 40 mg), conjugated estrogens (0.6 mg), or placebo.

Both black cohosh and estrogen reduced major climacteric complaints significantly more than did placebo (P<.05). Black cohosh improved blood lipid and bone-specific alkaline phosphatase levels. Although estrogen increased endometrial thickness, black cohosh did not.

"These data, together with animal experimental results suggest that the [black cohosh] preparation contains one or more phytoestrogens with selective estrogen receptor modulator activity with no effect in the uterus but favorable estrogenic activity in the bone and on serum lipids," the authors write.

Animal studies presented by the same group suggested that black cohosh contained phytoestrogens with a mild estrogenic (E2-like) effect on bone, and a stronger effect on fat tissue but not on cholesterol metabolism. In the same animal model, soy extract containing genistein and daidzein was completely ineffective in preventing osteoporosis or improving lipid metabolism.

Endo 2002: Abstracts P3-333, P3-317. June 21, 2002.

Reviewed by Gary D. Vogin, MD

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