Black Cohosh
(Cimicifuga racemosa)

This section was compiled by Frank M. Painter, D.C.
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Black Cohosh Articles

What is Black Cohosh?
A nice review by students from the University of North Carolina School of Pharmacy

Recent Study on Black Cohosh Is Faulty, Claims
the American Botanical Council

American Botanical Council

The American Botanical Council responded to a study conducted by researchers at the Mayo Clinic in Scottsdale, Ariz. The four-week trial with 132 women was too short to measure any effect from the product tested. Most trials have run for three to six months. “Most of the clinical trials published to date on black cohosh have demonstrated positive results in helping to treat various symptoms of menopause.” A nice review by students from the University of North Carolina School of Pharmacy


Black Cohosh Abstracts

Efficacy of Black cohosh-containing Preparations
on Menopausal Symptoms: A Meta-analysis

Altern Ther Health Med. 2010 (Jan);   16 (1):   36–44

A systematic search of three databases (PubMed, Embase, and Cochrane library) was conducted to identify relevant literature. Two reviewers independently abstracted the data from the eligible studies. Of the 288 English language citations screened, nine randomized placebo-controlled trials were included. Among these trials, six demonstrated a significant improvement in the black cohosh group compared with the placebo group.

Hot Flashes: A Review of the Literature on Alternative and
Complementary Treatment Approaches

Alternative Medicine Review 2003 (Aug);   8 (3):   284–302 ~ FULL TEXT

Hot flashes are a common experience for menopausal women, with an 85-percent incidence in the West. With the increased knowledge of side effects attributable to conventional treatment options, more women are exploring natural alternatives. Although more definitive research is necessary, several natural therapies show promise in treating hot flashes without the risks associated with conventional therapies. Soy and other phytoestrogens, black cohosh, evening primrose oil, vitamin E, the bioflavonoid hesperidin with vitamin C, ferulic acid, acupuncture treatment, and regular aerobic exercise have been shown effective in treating hot flashes in menopausal women.

Cimicifuga racemosa Monograph
Alternative Medicine Review 2003 (May);   8 (2):   186–189 ~ FULL TEXT

Black Cohosh, known botanically as Cimicifuga racemosa, has been used by Native Americans and Europeans for gunecological conditions predating the settlement of the New World. Find out more here.

Black Cohosh: An Alternative Therapy for Menopause?
Nutr Clin Care 2002 (Nov);   5 (6):   283–289

Due to the long-term health risks now associated with hormone replacement therapy, many menopausal women are actively seeking alternative treatments. One such alternative is black cohosh (Actaea racemosa, syn. Cimicifuga racemosa), which has been used in the United States for the treatment of gynecologic complaints for more than 100 years. Review of the published clinical data suggests that black cohosh may be useful for the treatment of menopausal symptoms, such as hot flashes, profuse sweating, insomnia, and anxiety.

Therapeutic Efficacy and Safety of Cimicifuga racemosa
For Gynecologic Disorders

Advances in Therapy 1998;   15:   45–52

These studies show good therapeutic efficacy and tolerability profiles for C. racemosa. In addition, clinical and experimental investigations indicate that the rootstock of C. racemosa does not show hormone-like activity, as was originally postulated.

Efficacy and Safety of Phytomedicines for Gynecologic Disorders
with Particular Reference to Cimicifuga racemosa and Hypericum perforatum

Presented at First Asian European Congress on the Menopause
January 28–31, 1998;   Bangkok, Thailand

Extracts of Cimicifuga racemosa (black cohosh) and Hypericum perforatum (St. John's wort) have a historic reputation as herbal remedies. Clinical research with C. racemosa mono-preparations (i.e. Remifemin®) and with the herbal combination containing C. racemosa and H. perforatum (i.e. Remifemin® plus) in pre- and postmenopausal patients suffering from psychovegetative menopausal disorders shows a good therapeutic efficacy and safety profile finally resulting in a positive benefit-risk-ratio of these herbal preparations.

Phytocombination Alleviates Psychovegetative Disorders
TW Gynäkologie 1997;   10:   172–175

In a multicentric postmarketing surveillance the therapeutic efficacy and safety of the pharmaceutical combination of Black Cohosh (Cimicifuga racemosa) and St John's Wort (Hypericum perforatum) was investigated in psychovegetative disorders during menopause.

Cimicifuga racemosa L. – Black Cohosh
Quarterly Review of Natural Medicine, Spring 1996

Preparations of the drug have characteristics similar to those of hormones, where the estrogen-like active constituent is especially dominant. Formononetin is a competitive ligand in the estrogen receptor assay and binds ex vivo to the uterus of oophorectomized rats. Anti-inflammatory, hypoglycemic and hypotensive effects were measured using animal experiments.

Effects of Extracts from Cimicifuga racemosa (Black Cohosh) on
Gonadotropin Release in Menopausal Women and Ovariectomized Rats

Planta Med 1991 (Oct);   57 (5):   420–424

Remifemin (A German Black Cohosh preparation) is an ethanolic extract of the rhizome of Cimicifuga racemosa (C.r.) and is used to relieve climacteric hot flushes. In the present study the effects of this preparation on LH and FSH secretion of menopausal women were investigated. After an 8 weeks treatment, LH but not FSH levels were significantly reduced in patients receiving the Cimicifuga extract. To further characterize the endocrinologically active principles of this plant extract, a lipophilic extract of C.r. was prepared and subjected to Sephadex chromatography.

Clinical and Endocrinologic Studies of the Treatment of Ovarian Insufficiency
Manifestations following Hysterectomy with Intact Adnexa

Zentralbl Gynakol 1988;   110 (10):   611–618

60 hysterectomized patients under 40 years old, who all had at least one intact ovary and still complained of climacteric symptoms, were treated with estriol, conjugated estrogens, estrogen-gestagen sequential therapy or an extract from cimicifuga racemosa after randomized distribution into 4 equal groups.

Menopause Symptoms: Is it Possible to Switch from Hormone Treatment
to a Botanical Gynecologicum?

Arztliche Praxis 1987;   47:   1551–1553

In an open study in praxi 50 patients who had been in a hormone treatment because of menopausal complaints, got the herbal remedy Remifemin® (a Cimicifuga racemosa aka black cohosh preparation) for 6 months.

Phytotherapy Influences Atrophic Vaginal Epithelium
Therapeuticon 1987;   1:   23–31

After three months of therapy with the phytotherapeuticon, all three parameters had significantly improved. The applicated estrogen does proved to be too low, and yielded no effect compared to placebo. The usefulness of the phytopharmacon Remifemin® as an alternative to estrogen could be substantiated.

Menopause Symptoms: Success Without Hormones
Arztliche Praxis 1983;   35:   1946–1947

An account is given of an open study with 36 women who by reason of climacteric complaints had been treated with the phytotherapeutic preparation Remifemin® (a Cimicifuga racemosa aka black cohosh preparation). All women either showed contraindications to a hormone therapy or wished to be treated with a hormone-free preparation.

Essay on the Phytotherapy of Hormonal Disorders in Women
Med. Welt. 1960;   44:   2331–2333

The conclusion reached on the basis of 4 years of experience with 517 female patients is that the Cimicifuga product has a hormone-like and slightly euphoric effect. This beneficial effect is particularly evident in autonomic-psychic change-of-life phenomena in the various age groups. There is no risk of adverse side effects, particularly no unphysiological bleeding.

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