| PDF[?] (Download) | Black cohosh (Cimicifuga racemosa)Menopause | | Date: September 15, 1999 | HC# 042292-163 |
Re:Black Cohosh: A Review of the Therapeutic Effects in Gynecology
Liske, E. Therapeutic Efficacy and Safety of Cimicifuga racemosa for Gynecologic Disorders Advances In Natural Therapy. Vol. 15 (1) 1998:pp. 45-53.
Black cohosh (Cimicifuga racemosa) root is recognized by the German Commission E for use in the treatment of premenstrual, dysmenorrheal, and menopausal neurovegetative complaints. Neurovegetative complaints consist of hot flashes, profuse sweating, headache, vertigo, and heart palpitations. A number of clinical trials and scientific investigations validate the therapeutic uses of this North American perennial. This article examines some of the scientific studies of black cohosh.
The author scoured a number of databases for case reports, drug-monitoring studies, and clinical studies of black cohosh preparations. A multicenter drug-monitoring study of 704 menopausal women with associated complaints found significant improvement in both neurovegetative and psychological symptoms (nervousness, irritability, insomnia, and depression) in 80 percent of participants after four weeks of treatment. Only 7 percent of the subjects experienced transitory, mainly gastrointestinal, side effects.
Many studies of black cohosh involved perimenopausal women with similar complaints, facilitating comparison across studies. Most trials also used an internationally recognized quantitative scale for rating symptoms, such as the Kupperman Index and the Clinical Global Impression Scale (CGI). Two such studies (86 total subjects) from the early 1980s established significant therapeutic success after 12 weeks of treatment. This article provided no percentages. An open, controlled, randomized study of 60 subjects found significant and equivalent success in treatment with black cohosh or conjugated estrogens. An 80-subject, double-blind, randomized, placebo-controlled comparison of black cohosh with conjugated estrogens found treatment with black cohosh superior to hormone therapy after 12 weeks.
Fifty-six percent of patients receiving hormone replacement therapy (HRT) were switched to black cohosh with no untoward effects, according to one open, non-controlled study of 50 women. Black cohosh treatment also helped women younger than 40 with menopausal symptoms related to ovariandeficiencies after surgery. Black cohosh was compared with estriol, conjugated estrogens, or a hormone combination for six months. No statistically significant difference existed between the treatment groups.
Despite reports in the popular literature, black cohosh does not appear to be estrogenic, in vitro studies established that black cohosh does not act like estrogen in estrogen-receptor-positive breast cancer cell lines that produce estrogen dependent breast cancers. In fact, black cohosh may block estrogen receptors. In vitro studies show that the combination of tamoxifen and black cohosh inhibited breast cancer cells more effectively than either treatment alone. According to the author, Remifemin(, a monodrug preparation of black cohosh, is suitable for use by menopausal women with a history of breast cancer. (The author is employed by the manufacturer of Remifemin(, Schaper & Brümmer in Germany.)
Toxicity studies do not show a toxic potential with black cohosh. Other tests do not demonstrate mutagenic or teratogenic potentials with this phytotherapy. (It does not appear to cause cancer or birth defects in lab animals.)[Teratogenic studies have been performed using a Chinese herbal formula containg black cohosh root, but not studies have investigated black cohosh alone.] No known contraindications or interactions with other substances have been observed for black cohosh extracts.
According to the published literature and clinical experience, black cohosh rhizome extract is an effective treatment for perimenopausal neurovegetative and psychological symptoms, while it has also shown anti-inflammatory, analgesic, and antipyretic effects. - Leela Devi, MSN, RN
Enclosure: Copyright( 1998, Advances In Therapy. Bin #163 |