Efficacy of Black Cohosh for Menopausal Symptoms Unclear

Does not reduce frequency of hot flashes versus placebo; insufficient evidence regarding safety

WEDNESDAY, Sept. 26 (HealthDay News) -- There is insufficient evidence to support the use of black cohosh for menopausal symptoms, according to the results of a systematic literature review published online Sept. 12 in The Cochrane Library.

Matthew J. Leach, Ph.D., of the University of South Australia, and Vivienne Moore, Ph.D., of the University of Adelaide in Australia, conducted a systemic review of 16 randomized controlled trials involving 2,027 perimenopausal or postmenopausal women to evaluate the safety and clinical effectiveness of black cohosh for treating menopausal symptoms.

The trials used oral monopreparations of black cohosh at a median dose of 40 mg/day for a mean duration of 23 weeks, and compared cohosh with placebo, hormone therapy, red clover, and fluoxetine. The researchers found that, compared with placebo, black cohosh did not reduce the frequency of hot flashes or improve menopausal symptoms. However, hormone replacement therapy did significantly reduce hot flash frequency and menopausal symptom scores compared with black cohosh. The safety of black cohosh could not be properly evaluated owing to poor reporting of adverse events. Data pertaining to health-related quality of life, sexuality, bone health, vulvovaginal atrophic symptoms, and night sweats were insufficient to pool.

"There is currently insufficient evidence to support the use of black cohosh for menopausal symptoms. However, there is adequate justification for conducting further studies in this area," the authors write. "The effect of black cohosh on other important outcomes, such as health-related quality of life, sexuality, bone health, night sweats, and cost-effectiveness also warrants further investigation."

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