Research
Black Cohosh
53 peer-reviewed studies curated from PubMed and Semantic Scholar.
Studies
Sorted by quality and recency
Efficacy and safety of Actaea racemosa for relieving climacteric complaints.
Systematic review assessing the quality of clinical trial reports on black cohosh for climacteric complaints, using CONSORT herbal extension and harms checklists. Adherence to reporting standards varied widely, indicating a need for further high-quality research.
Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis.
Updated meta-analysis of 22 articles including 2,310 menopausal women, assessing the efficacy of black cohosh extracts on menopausal symptoms. Black cohosh was associated with significant improvements in overall menopausal symptoms, hot flashes, and somatic symptoms compared to placebo, but did not significantly improve anxiety or depressive symptoms.
Phytochemistry and ethnopharmacological studies of genus Cimicifuga: A systematic and comprehensive review.
This systematic review compiles current knowledge on the pharmacological, phytochemical, and therapeutic properties of Cimicifuga sp., also known as black cohosh. It highlights the plant's potential anti-cancer, anti-viral, anti-microbial, anti-inflammatory, and estrogenic properties, among others. The review emphasizes the need for further studies on the plant's compounds before it can be fully utilized in clinical settings.
Weight gain in menopause: systematic review of adverse events in women treated with black cohosh.
Systematic review investigating whether black cohosh causes weight gain in perimenopausal and postmenopausal women. The review included 31 studies with 1839 women treated for up to 12 months. No significant differences in weight changes were observed between groups, and the study provides no scientific evidence that black cohosh causes weight gain.
Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms - an update on the evidence.
Meta-analysis of 35 clinical studies and one meta-analysis involving 43,759 women, with 13,096 treated with isopropanolic black cohosh extract (iCR). iCR was significantly superior to placebo for treating neurovegetative and psychological menopausal symptoms. The iCR+St. John's wort combination was more effective for psychological symptoms than iCR alone. iCR had a better benefit-risk profile compared to tibolone, with no evidence of hepatotoxicity or effects on hormone levels and estrogen-sensitive tissues.
[Efficacy of black cohosh extracts for improving low estrogen status induced by postoperative GnRHa treatment in patients with endometriosis: a systematic review].
Systematic review and meta-analysis of seven RCTs involving 745 patients evaluating black cohosh extracts for improving low estrogen status induced by GnRHa treatment in endometriosis patients. BCE improved perimenopausal symptoms but did not alter hormone levels.
Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause.
Systematic review and network meta-analysis of 47 RCTs evaluating treatments for vasomotor symptoms in postmenopausal women. Transdermal estradiol and progestogen were most effective, with isoflavones and black cohosh more effective than placebo but not significantly better than hormone therapy.
Black cohosh (Cimicifuga spp.) for menopausal symptoms.
Meta-analysis of 16 RCTs with 2027 perimenopausal or postmenopausal women evaluating black cohosh for menopausal symptoms. No significant difference was found between black cohosh and placebo in reducing hot flushes or menopausal symptom scores. Hormone therapy was more effective than black cohosh. Evidence on safety and other outcomes was inconclusive.
Suspected black cohosh hepatotoxicity: no evidence by meta-analysis of randomized controlled clinical trials for isopropanolic black cohosh extract.
Meta-analysis of five randomized, double-blind, and controlled clinical trials involving 1,117 women to evaluate the effect of isopropanolic black cohosh extract on liver function. The analysis showed no significant effects on liver function values, indicating no evidence of hepatotoxicity.
Black cohosh (Cimicifuga racemosa) for menopausal symptoms: a systematic review of its efficacy.
Systematic review evaluating the efficacy of black cohosh (Cimicifuga racemosa) in alleviating menopausal symptoms. Six RCTs with 1112 peri- and post-menopausal women were included. The evidence does not consistently demonstrate an effect, but a beneficial effect on peri-menopausal women cannot be excluded. Further rigorous trials are warranted.
The effects of remifemin on subjective symptoms of menopause.
RCT of 2016 Hungarian women treated with an isopropanol extract of Cimicifuga racemosa (black cohosh) for menopausal symptoms. The study found significant improvements in the Kupperman index and symptoms such as hot flashes, sweating, insomnia, and anxiety after 12 weeks.
Assessing the combined effects of Black Cohosh, Soy Isoflavones, and SDG Lignans on menopausal symptoms: a randomized, double-blind, placebo-controlled clinical trial.
RCT of 96 postmenopausal women evaluating Black Cohosh, Soy Isoflavones, and SDG Lignans for menopausal symptoms over 90 days. Significant improvements were observed in somatic, psychological, urogenital, and total Menopause Rating Scale scores, with modest hormonal changes. The supplement combination was well-tolerated.
Effects of a combination of botanical actives on skin health and antioxidant status in post-menopausal women: A randomized, double-blind, placebo-controlled clinical trial.
RCT of 110 post-menopausal women evaluating a nutraceutical blend of Glycine max, Cimicifuga racemosa, Vitex agnus-castus, and Oenothera biennis extracts over 12 weeks. Significant improvements in skin elasticity, roughness, smoothness, scaliness, and wrinkles were observed in the treatment group. Antioxidant status improved with increased GSH and decreased MDA levels.
Efficacy and Safety of Nutraceutical on Menopausal Symptoms in Post-Menopausal Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
RCT of 101 post-menopausal women evaluating a nutraceutical containing soy isoflavone, black cohosh, chasteberry, and evening primrose oil. The treatment group showed significant reductions in menopausal symptoms, improved mood and sleep, and decreased C-reactive protein, LDL-C, and triglyceride levels compared to placebo.
Benefit–risk profile of black cohosh (isopropanolic Cimicifuga racemosa extract) with and without St John’s wort in breast cancer patients
Systematic review assessing the use of black cohosh (isopropanolic Cimicifuga racemosa extract) alone or with St John's wort in breast cancer survivors. The combination reduced climacteric symptoms and increased recurrence-free survival rates without estrogen-like effects or significant interactions with endocrine therapies.
Black cohosh and breast cancer: a systematic review.
Systematic review of black cohosh use in women with or at risk of breast cancer. Evidence on efficacy for hot flashes is divided, with some benefits seen compared to baseline but not placebo. No association found between black cohosh and increased risk of breast cancer, with some studies reporting reduced risk of primary breast cancer and recurrence.
Menopause: a standardized isopropanolic black cohosh extract (remifemin) is found to be safe and effective for menopausal symptoms.
This randomized, double-blind, placebo-controlled, multicenter clinical study investigated the efficacy and safety of a standardized isopropanolic extract of black cohosh (Remifemin) in 304 postmenopausal women. The study confirmed the efficacy and tolerability of the extract in addressing menopausal symptoms, particularly hot flashes.
Efficacy of Cimicifuga racemosa, Hypericum perforatum and Agnus castus in the treatment of climacteric complaints: a systematic review.
Systematic review examining the effects of Cimicifuga racemosa, Hypericum perforatum, and Agnus castus on climacteric complaints. CR monotherapy and HP and Agnus castus showed no better effect than placebo, but the combination of CR with HP demonstrated a positive effect on climacteric complaints.
Black cohosh for the management of menopausal symptoms : a systematic review of clinical trials.
Systematic review assessing the efficacy and safety of black cohosh for managing menopausal symptoms. The review included 16 studies with conflicting results and methodological flaws. The benefits of black cohosh in managing climacteric symptoms remain unproven, and potential adverse events need further exploration.
Black cohosh (Cimicifuga racemosa): a systematic review of adverse events.
Systematic review evaluating the safety of black cohosh, used for menopause symptoms. Thirteen clinical trials indicated relative safety, but serious safety concerns were noted in case reports, requiring further investigation.
The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin.
RCT of 310 peri or post-menopausal women examining the effects of black cohosh on lipids, fibrinogen, glucose, and insulin over 3 months. Black cohosh therapies showed no significant effects on these parameters compared to placebo.
Efficacy and tolerability of a medicinal product containing an isopropanolic black cohosh extract in Chinese women with menopausal symptoms: a randomized, double blind, parallel-controlled study versus tibolone.
RCT comparing isopropanolic black cohosh extract (iCR, Remifemin) to tibolone in 244 Chinese women with menopausal symptoms. Both treatments showed similar efficacy in reducing Kupperman Menopause Index scores, but iCR had a superior safety profile with fewer adverse events.
First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055.
A prospective, open-label, multinational, multicenter study involving 400 postmenopausal women assessed the endometrial safety and efficacy of the special black cohosh extract CR BNO 1055 over 52 weeks. No cases of endometrial hyperplasia were observed, and the number and intensity of hot flushes decreased significantly, indicating good tolerability and efficacy.
Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial.
A 1-year randomized, double-blind, placebo-controlled trial tested the efficacy of black cohosh, multibotanicals, soy, and hormone therapy for vasomotor symptoms in 351 women. Black cohosh, alone or in multibotanical regimens, showed no significant difference in symptom relief compared to placebo, except for worse symptom intensity with multibotanical plus soy at 12 months.
Black cohosh and St. John's wort for climacteric complaints: a randomized trial.
Double-blind randomized placebo-controlled trial of 301 women with climacteric complaints treated with black cohosh and St. John's wort extracts for 16 weeks. The treatment group showed significant improvements in Menopause Rating Scale and Hamilton Depression Rating Scale scores compared to placebo.
Efficacy and safety of isopropanolic black cohosh extract for climacteric symptoms.
This randomized, multicenter, double-blind clinical trial compared the efficacy and tolerability of isopropanolic black cohosh extract to placebo in treating climacteric complaints in 304 patients over 12 weeks. The extract was more effective than placebo, particularly in early climacteric women, with no significant differences in adverse events or tolerability.
A systematic review of the safety of black cohosh.
Systematic review of the safety of black cohosh, examining data from clinical studies and spontaneous reporting programs. Adverse events with black cohosh are rare, mild, and reversible, with gastrointestinal upsets and rashes being the most common. Serious adverse events are rare, and causality cannot be determined.
Effect of cimicifuga racemosa on menopausal syndrome caused by LHRH-a in breast cancer.
RCT investigating the effect of cimicifuga racemosa (Remifemin) on menopausal syndrome induced by LHRH-a in breast cancer patients. The Remifemin group showed significantly lower Kupperman menopause index scores compared to the control group, indicating effectiveness in managing menopausal symptoms. Hormone levels were similar between groups, but the incidence of cervical cysts was higher in the Remifemin group.
Stability of black cohosh triterpene glycosides and polyphenols: potential clinical relevance.
The study examined the long-term stability of black cohosh's major constituents, triterpene glycosides and polyphenols, over a 3-year period concurrent with a clinical trial for menopausal hot flashes. Results showed that these constituents remained stable, indicating that black cohosh products stored in controlled environments do not undergo significant changes.
Digitized assessment of mammographic breast density--effects of continuous combined hormone therapy, tibolone and black cohosh compared to placebo.
A prospective, double-blind, placebo-controlled study assessed the effects of continuous combined hormone therapy, tibolone, and black cohosh on mammographic breast density in postmenopausal women. Black cohosh did not influence mammographic breast density during six months of treatment, while E2/NETA and tibolone increased breast density.
Effect of exercise and Cimicifuga racemosa (CR BNO 1055) on bone mineral density, 10-year coronary heart disease risk, and menopausal complaints: the randomized controlled Training and Cimicifuga racemosa Erlangen (TRACE) study.
RCT of 128 early postmenopausal women comparing exercise with and without Cimicifuga racemosa supplementation on bone mineral density and 10-year coronary heart disease risk. Exercise maintained lumbar spine BMD, but CR supplementation did not enhance effects. The 10-year CHD risk increased in the CR group.
Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial.
RCT evaluating the safety and efficacy of black cohosh and red clover compared to placebo for menopausal vasomotor symptoms. Neither black cohosh nor red clover significantly reduced vasomotor symptoms compared to placebo, but both were deemed safe over 12 months.
Influence of black cohosh (Cimicifuga racemosa) use by postmenopausal women on total hepatic perfusion and liver functions.
Prospective longitudinal clinical trial of 87 postmenopausal women taking 40 mg of Cimicifuga racemosa daily for 12 months to assess hepatic perfusion and liver functions. No significant changes in hepatic blood flow or liver functions were observed, suggesting no influence on the liver.
No effect of Cimicifuga racemosa extract on serum interleukin-6 levels and prostacyclin production by human endothelial cells.
RCT investigating the effect of Cimicifuga racemosa extract on serum interleukin-6 levels and prostacyclin production by human endothelial cells. The study found no effect.
Black cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational study.
Large-scale observational study of 6141 women evaluating Black cohosh alone or in combination with St. John's wort for menopausal symptoms. The combination therapy was superior in alleviating climacteric mood symptoms, with both therapies showing effectiveness and tolerability over 6 to 12 months.
Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized trial.
Prospective randomized trial comparing black cohosh and fluoxetine in 120 women with postmenopausal symptoms over 6 months. Black cohosh significantly reduced hot flushes and night sweats more than fluoxetine, while fluoxetine showed greater improvement on Beck's Depression Scale.
Black cohosh and St. John's wort (GYNO-Plus) for climacteric symptoms.
Double-blind randomized, placebo-controlled study of 89 peri- or postmenopausal women treated with black cohosh and St. John's wort (Gynoplus) for 12 weeks. The Gynoplus group showed significant improvement in climacteric symptoms and lipid metabolism compared to placebo.
Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study.
RCT of Phyto-Female Complex in 50 pre and postmenopausal women for 3 months. The treatment group reported a significant reduction in menopausal symptoms, including a 73% decrease in hot flushes and a 69% reduction in night sweats, with improved sleep quality. No significant changes in hormone levels or ultrasonography findings.
Black cohosh (Cimicifuga racemosa [L.] Nutt.): safety and efficacy for cancer patients.
Systematic review of clinical and preclinical studies on black cohosh for treating hot flashes and other symptoms in cancer patients. The efficacy for hot flashes in breast cancer patients is inconclusive, with some laboratory evidence of antiproliferative properties but no clinical confirmation for cancer prevention. Black cohosh appears to have a good safety profile, with inconclusive concerns about liver toxicity and no phytoestrogenic activity.
Safety of alternative treatments for menopausal symptoms after breast cancer: a qualitative systematic review.
Qualitative systematic review analyzing the safety of alternative treatments for menopausal symptoms in breast cancer patients, including black cohosh and phytoestrogens. The review found no valuable data indicating the absence of harmful effects, highlighting the need for randomized trials to assess safety.
Phase III double-blind, randomized, placebo-controlled crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1.
Phase III double-blind, randomized, placebo-controlled crossover trial studied the efficacy of black cohosh (Cimicifuga racemosa 20 mg BID) for treating hot flashes in postmenopausal women. The trial found no significant difference in hot flash reduction between black cohosh and placebo.
Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study.
Double-blind RCT of 62 postmenopausal women comparing black cohosh (CR BNO 1055), conjugated estrogens, and placebo over 12 weeks. Black cohosh showed beneficial effects on bone metabolism and weak estrogen-like activity on vaginal mucosa, with no significant effects on coagulation markers and liver enzymes.
The Herbal Alternatives for Menopause (HALT) Study: background and study design.
The HALT study is a randomized double-blind trial examining the effects of black cohosh and a multibotanical supplement on menopause symptoms. Women were assigned to various interventions including black cohosh, a multibotanical supplement, and dietary soy counseling. The study aims to provide information on the side effects and efficacy of these alternative therapies.
Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial.
A multicenter, randomized, placebo-controlled, double-blind study in 122 menopausal women compared the efficacy of black cohosh extract to placebo over 12 weeks. The extract showed no overall superiority, but was significantly more effective in patients with a Kupperman Index ≥20. Adverse events were similar between groups.
Physiological investigation of a unique extract of black cohosh (Cimicifugae racemosae rhizoma): a 6-month clinical study demonstrates no systemic estrogenic effect.
Controlled, randomized, double-blinded study of perimenopausal and postmenopausal women treated with two doses of C. racemosa extract over 24 weeks. The study found improvement in menopause symptoms without evidence of estrogenlike effects, suggesting the standard dose is preferable.
Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer.
RCT of black cohosh versus placebo in 85 breast cancer survivors experiencing hot flashes. Both groups reported declines in hot flashes and menopausal symptoms, but differences were not statistically significant. Black cohosh was not significantly more efficacious than placebo.
Black cohosh improves objective sleep in postmenopausal women with sleep disturbance.
RCT of black cohosh in 42 postmenopausal women with sleep disturbance. Black cohosh treatment led to significant improvements in sleep efficiency and reduced wake after sleep onset duration compared to placebo. No adverse events were attributed to black cohosh.
Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (black cohosh) in women with anxiety disorder due to menopause.
RCT of black cohosh extract in 28 women with anxiety disorder due to menopause. No significant anxiolytic effect of black cohosh compared to placebo was found, though small sample size and other factors may have influenced results.
Pharmacokinetics of 23-epi-26-deoxyactein in women after oral administration of a standardized extract of black cohosh.
This study investigates the pharmacokinetics of 23-epi-26-deoxyactein, a triterpene glycoside in black cohosh, in 15 healthy menopausal women. Single doses of black cohosh extract were administered, and pharmacokinetic analyses showed that the maximum concentration and area under the curve increased proportionately with dosage, with a half-life of ~2 hours. No acute toxicity or estrogenic hormone effects were observed.
Pilot evaluation of black cohosh for the treatment of hot flashes in women.
Pilot study evaluating black cohosh for reducing hot flashes in postmenopausal women, including those with breast cancer. Over 4 weeks, black cohosh reduced mean daily hot flash frequency by 50% and weekly hot flash scores by 56%. Patients reported less trouble with sleeping, fatigue, and abnormal sweating, with no adverse effects leading to discontinuation.
In vitro formation of quinoid metabolites of the dietary supplement Cimicifuga racemosa (black cohosh).
The study aimed to identify phase I metabolites of black cohosh in vitro and determine their presence in the urine of perimenopausal women taking black cohosh supplements. Eight electrophilic metabolites were detected in vitro, but mercapturate conjugates were not found in urine samples from women who consumed up to 256 mg of black cohosh extract, indicating no safety concerns for moderate doses.
Black cohosh (Cimicifuga racemosa) in tamoxifen-treated breast cancer patients with climacteric complaints - a prospective observational study.
Prospective observational study of 50 breast cancer patients on tamoxifen treated with black cohosh extract for 6 months. Significant reduction in menopause rating scale scores, with improvements in hot flashes, sweating, sleep problems, and anxiety. Tolerability was reported as very good or good by 90% of participants.
Black cohosh has central opioid activity in postmenopausal women: evidence from naloxone blockade and positron emission tomography neuroimaging.
Mechanistic study in postmenopausal women testing black cohosh's action on the central endogenous opioid system. Black cohosh treatment for 12 weeks showed no effect on luteinizing hormone pulsatility or estrogen concentrations, but naloxone blockade revealed suppression of luteinizing hormone pulse frequency and increased mu-opioid receptor binding potential in several brain regions.