There have been some mixed reviews about Black Cohosh (Cimicifuga racemosa) and its use in preventing menopausal symptoms. Clinically, women that I see have improved greatly when using this herb for symptoms such as night sweats, hot flushes, fatigue and mood. Now, a study at the First Hospital of Peking University in Beijing, published the first major trial looking at the effect of Black Cohosh vs a pharmaceutical drug for menopausal women.
The study randomized 244 Chinese women aged 40-60 to either daily treatment with 40 mg of a standardized Black Cohosh known as Remifemin or 2.5 mg of Tibolone which is a synthetic steroid whose hormonal effects are said to be “tissue-specific” primarily with estrogen. It is used in Europe and Asia as an alternative to hormone replacement for menopausal symptoms and is said to have fewer side effects than traditional hormone treatments. Tibolone effects estrogen, progesterone and testosterone activity.
After 12 weeks, both treatment groups had significant improvement in symptoms including hot flushes, insomnia, depression, weakness and fatigue, joint pain, headaches and palpitations. WOW!!
In terms of safety and side effect profiles, Remifemin was the clear winner. None of the women in this group had vaginal bleeding, while 17 in the Tibolone group had abnormal bleeding. This is a common reason why women stop their hormone replacement therapy. The Tibolone group also had breast and abdominal pain while the Black Cohosh group had none of these symptoms.
This is one of the few studies comparing an herb head-to-head with a pharmaceutical drug for women in menopause (it’s about time!). I recommend Remifemin frequently for my patients with mild to moderate symptoms and see very few side effects.
Reference: Hudson, T. Holistic Primary Care. “Black Cohosh Compares Favorably With Drug Therapy for Menopausal Symptoms”. Fall 2008, p. 14.