Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis.

Che-Sheng Chu, Ping-Tao Tseng, Yutaka J Matsuoka, Chao-Ming Hung, Yu-Shian Cheng, Wei-Cheng Yang, Malcolm Hopwood, Mein-Woei Suen, Yen-Wen Chen, Tien-Yu Chen, Pao-Yen Lin, Yi-Cheng Wu, Brendon Stubbs, Hung-Yu Wang, Bing-Yan Zeng, Keng-Hsu Chen, Bing-Syuan Zeng, Lillian Nohara Matsuoka, Ryoichi Sadahiro, Yu-Kang Tu, Kuan-Pin Su, Yow-Ling Shiue, Cheuk-Kwan Sun

Journal: Menopause (New York, N.Y.) 2023;30(7):766-773

PMID: 37192826

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Abstract

OBJECTIVE

Menopausal symptoms are common in midlife women and have broad impacts on their daily functioning and quality of life. Black cohosh extracts have been widely used to relieve menopausal symptoms. However, the comparative benefits of different combined black cohosh regimens remain inconclusive. The aim of the current updated meta-analysis is to address the comparative efficacies of different black cohosh regimens in improving menopausal symptoms.

METHODS

Random-effect model pairwise meta-analysis of randomized controlled trials was conducted to investigate the treatment effect on menopausal symptoms by the black cohosh extract both alone or combined with other related active ingredients. The outcomes studied were changes in menopausal symptoms after treatment with black cohosh extracts in menopausal women.

RESULTS

Twenty-two articles including information on 2,310 menopausal women were included in the analyses. Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges' g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges' g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges' g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo. However, black cohosh did not significantly improve anxiety (Hedges' g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges' g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131). The dropout rate for black cohosh products was similar to that for placebo (odds ratio = 0.911, 95% CI = 0.660 to 1.256, P = 0.568).

CONCLUSIONS

This study provides updated evidence regarding the potentially beneficial effects of black cohosh extracts for relieving menopausal symptoms in menopausal women.

Address: From the Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center Japan, Tokyo, Japan.; School of Medicine, University of Tsukuba, Tsukuba, Japan.; Department of Medical Education, E-Da Hospital, I-Shou University, E-Da Healthcare Group, Kaohsiung, Taiwan.; Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.; Department of Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.; Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung City, Taiwan.; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan.; Center for Public Health Sciences, National Cancer Center Japan, Japan.

DOI: 10.1097/GME.0000000000002196

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MeSH Terms: Female, Humans, Cimicifuga, Phytotherapy, Quality of Life, Plant Extracts, Menopause, Hot Flashes