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