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International Journal of Phytomedicine and Phytotherapy

Table 2 Short description of clinical studies with Cimiciduga racemosa preparations preparations

From: Black cohosh (Cimicifuga racemosa) is a non-estrogenic alternative to hormone replacement therapy

Ref. (placebo or comparator controlled) Design Patient characteristics and age Treatment, dose, and duration Outcome measures Finding and comments Effects in short
No = Ø
Signif. pos = +
Signif. neg = −
Newton et al. 2006 [44] Randomized, double-blind, comparator and placebo-controlled 351 early postmenopausal women with 2 or more hot flushes daily 160 mg of a CR extract daily (probably equivalent to 1600 mg dried rhizome powder) vs a multibotanical preparation vs placebo vs 0.625 mg conjugated estrogens with or without 2 mg medroxyprogesterone- acetate, duration 1 year Frequency and intensity of vasomotor symptoms (Wiklund Vasomotor Symptom Subscale) Significant reduction under hormone treatment. No significant differences between CR and placebo, worsening of symptoms in multibotanical group. -
Note: the CR dose was approximately 40 fold higher than in the studies which yielded positive effects
Bai et al. 2007 [45] Randomized, double-blind, comparator controlled 244 early post-menopausal women with Kupperman Index > or = 15 Isopropanolic CR extract (40 mg dried rhizome powder daily (equivalent to 5 mg dried extract)) vs 2.5 mg tibolone, duration 3 months. Kupperman Menopause Index CR preparation was as effective as tibolone in reducing KMI score +
Oktem et al. 2007 [46] Randomized, comparator controlled trial 120 women with climacteric symptoms Aquous-ethanolic CR extract BNO 1055 (40 mg dried rhizome powder daily (equivalent to approximately 6.5 mg dried extract)) vs serotonin reuptake inhibitor fluoxetine, duration 6 months Kupperman Menopause Index, Beck’s Depression Scale Hot flush score improved by 85 % vs 62 under fluoxetine, whereas fluoxetine was more effective than CR to reduce depressive symptoms +
Geller et al. 2009 [47] Randomized, double-blind, comparator and placebo-controlled 89 postmenopausal women with 35 or more hot flushes per week 128 mg of an ethanolic CR extract, vs 398 mg of a red clover extract (containing 120 mg isoflavones) vs 0.625 mg conjugated estrogens in combination with 2.5 mg medroxyprogesterone -acetate vs placebo, duration 12 months Number of vasomotor symptoms and night sweats No significant effects by both plant preparation Significant superiority of the hormone preparation.
Note: the CR dose was approximately 25 fold higher than in the studies which yielded positive effects
Van der Sluijs et al. 2009 [52] Randomized, double-blind placebo controlled trial 93 women women with 6 or more vasomotor symptoms per day 3150 mg dried rhizome powder (equivalent to approximately 300 mg CR extract) per day, duration 16 weeks Greene Climacte5ric Sclae No significantly more improvement in comparison to placebo
Note: The CR dose was approximately 50 fold higher than in the studies which positive results
  1. CE conjugated oestrogens, CR Cimicifuga racemosa, DB double blind, GCS greene climacteric scale, KMI Kupperman menopause index, MRS menopause rating scale, PM postmenopausal, RCT randomised controlled trial