section name header

Evidence summaries

Black Cohosh (Cimicifuga Spp.) for Menopausal Symptoms

Black cohosh is probably not effective for menopausal symptoms compared with placebo or hormone therapy. Level of evidence: "C"

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and selective reporting).

Summary

A Cochrane review [Abstract] 1 included 16 studies with a total of 2027 subjects. All studies used oral monopreparations of black cohosh at a median daily dose of 40 mg, for a mean duration of 23 weeks. There was no significant difference between black cohosh and placebo in the frequency of hot flushes (mean difference (MD) 0.07 flushes per day; 95% CI -0.43 to 0.56 flushes per day; 3 trials, n=393) or in menopausal symptom scores (SMD -0.10; 95% CI -0.32 to 0.11; 4 trials, n=35). Compared to black cohosh, hormone therapy significantly reduced daily hot flush frequency (3 trials; data not pooled) and menopausal symptom scores (SMD 0.32; 95% CI 0.13 to 0.51; 5 trials, n=468).

A meta-analysis 2 assessed plant-based therapies on menopausal symptoms. 4 RCTs on black cohosh showed that overall black cohosh was not associated with changes in the rate of hot flushes, night sweats frequency, or menopausal symptom score.

Date of latest search:2019-11-22

    References

    • Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev 2012;(9):CD007244. [PubMed]
    • Franco OH, Chowdhury R, Troup J et al. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA 2016;315(23):2554-63. [PubMed]

Primary/Secondary Keywords