This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.
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Introduction: Although postmenopausal hormones containing estrogen and progestin may ease menopausal symptoms, long-term use increases the risk of breast cancer (see Table 8) [1]. For this reason, many women seek other ways to reduce hot flashes and other symptoms.
Black cohosh (an herb) has been suggested as a way to relieve menopausal symptoms. However, most randomized controlled trials do not support its use among breast cancer survivors or cancer-free women.
Learn more about black cohosh.
Learn about the strengths and weaknesses of different types of studies.
Study selection criteria: Randomized controlled trials with at least 80 participants.
Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.
Study
|
Study Population
(number of participants)
|
Treatment Duration
|
Menopausal Symptoms Studied
|
Menopausal Symptoms Reduced?
|
Randomized controlled trials
|
Black cohosh versus placebo
|
Herbal Alternatives for Menopause Study [2,3]
|
351
cancer-free
women
|
1 year
|
Hot flashes and
night sweats
|
No
|
|
|
|
Vaginal dryness
|
No
|
Osmers et al. [4]
|
304
cancer-free
women
|
12 weeks
|
Hot flashes and
sleep disorders
|
Yes
|
|
|
|
Vaginal dryness,
sexual disorders and
urinary problems
|
Yes
|
Pockaj et al. [5]
|
132
breast cancer survivors
and
women at high risk
|
9 weeks
|
Hot flashes
|
No
|
Frei-Kleiner et al. [6]
|
122
cancer-free
women
|
12 weeks
|
Hot flashes
|
No
|
Jacobson et al. [7]
|
85
breast cancer survivors
|
57-60 days
|
Hot flashes
|
No
|
Supplement containing black cohosh and St. John's wort versus placebo
|
Uebelhack et al. [8]
|
294
cancer-free
women
|
16 weeks
|
Hot flashes
|
Yes
|
Supplement containing black cohosh and Chinese herbs versus placebo
|
van der Sluijs et al. [9]
|
93
cancer-free
women
|
20 weeks
|
Hot flashes
|
No
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References
1. Rossouw JE, Anderson GL, Prentice RL, et al. for the Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 288(3):321-33, 2002.
2. Newton KM, Reed SD, LaCroix AZ, Grothaus LC, Ehrlich K, Guiltinan J. Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med. 145(12):869-79, 2006.
3. Reed SD, Newton KM, LaCroix AZ, Grothaus LC, Grieco VS, Ehrlich K. Vaginal, endometrial, and reproductive hormone findings: randomized, placebo-controlled trial of black cohosh, multibotanical herbs, and dietary soy for vasomotor symptoms: the Herbal Alternatives for Menopause (HALT) Study. Menopause. 15(1):51-8, 2008.
4. Osmers R, Friede M, Liske E, Schnitker J, Freudenstein J, Henneicke-von Zepelin HH. Efficacy and safety of isopropanolic black cohosh extract for climacteric symptoms. Obstet Gynecol. 105(5 Pt 1):1074-83, 2005.
5. Pockaj BA, Gallagher JG, Loprinzi CL, et al. Phase III double-blind, randomized, placebo-controlled crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1. J Clin Oncol. 24(18):2836-41, 2006.
6. Frei-Kleiner S, Schaffner W, Rahlfs VW, Bodmer Ch, Birhuäser M. Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial. Maturitas. 51(4):397-404, 2005.
7. Jacobson JS, Troxel AB, Evans J, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol. 19(10):2739-45, 2001.
8. Uebelhack R, Blohmer JU, Graubaum HJ, Busch R, Gruenwalk J, Wernecke KD. Black cohosh and St. John's wort for climacteric complaints: a randomized trial. Obstet Gynecol. 107(2 Pt 1):247-55, 2006.
9. van der Sluijs CP, Bensoussan A, Chang S, Baber R. A randomized placebo-controlled trial on the effectiveness of an herbal formula to alleviate menopausal vasomotor symptoms. Menopause. 16(2):336-44, 2009.
Updated 09/28/12
