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Home > Understanding Breast Cancer > Breast Cancer Research > Table 63: Black cohosh for menopausal symptoms

  


Table 63: Black cohosh for menopausal symptoms

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.

Introduction: Although menopausal hormone therapy (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 menopausal symptoms.  

Taking black cohosh (an herb) has been suggested as a way to relieve menopausal symptoms. However, most randomized controlled trials do not show a benefit for breast cancer survivors or cancer-free women. Although studies did not show any harmful side effects of black cohosh for breast cancer survivors, there are no long-term safety data.  

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 and meta-analyses.

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 

Black Cohosh Reduced Menopausal Symptoms More Than Placebo?  

Randomized controlled trials 

Herbal Alternatives for Menopause Study [2,3]

351
cancer-free
women

1 year

Hot flashes

No

 

 

 

Vaginal dryness

No

Osmers et al. [4]

304
cancer-free
women

12 weeks

Hot flashes and
sleep problems

Yes

 

 

 

Vaginal dryness

Yes

Uebelhack et al. [5]*

294
cancer-free
women 

16 weeks

Hot flashes

Yes

Pockaj et al. [6]

132
breast cancer survivors
and
women at high risk

9 weeks

Hot flashes

No

Frei-Kleiner et al. [7]

122
cancer-free
women

12 weeks

Hot flashes

No

van der Sluijs et al. [8] †

 93
cancer-free
women

20 weeks

Hot flashes

No

Jacobson et al. [9]

85
breast cancer survivors

57-60 days

Hot flashes

No

Meta-analyses 

Cochrane Collaboration [10]

16 studies

Various

Hot flashes

No

* Supplement contained black cohosh and St. John's wort.

† Supplement contained black cohosh and Chinese herbs.

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. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 9:CD007244, 2012.

Updated 05/16/14