Black Cohosh: Insights into its Mechanism(s) of Action

Ruhlen, Rachel L.; Sun, Grace Y.; Sauter, Edward R.

doi:10.4137/117863370800300002

Cited by 27 publications

(14 citation statements)

References 71 publications

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“…In addition, serotonin-binding properties in the brain may contribute to its mechanism of action [21, 22]. If indeed CR lacks estrogenic effects, it would have a beneficial influence on climacteric vasomotor and psychiatric symptoms without adversely affecting the development of breast or uterine tissue tumors or increasing the cardiovascular risk.…”

Section: Introductionmentioning

confidence: 99%

Dose-Dependent Effects of theCimicifuga racemosaExtract Ze 450 in the Treatment of Climacteric Complaints: A Randomized, Placebo-Controlled Study

Schellenberg¹,

Saller

Hess³

et al. 2012

Evidence-Based Complementary and Alternative Medicine

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Extracts from Cimicifuga racemosa (CR, synonym Actaea racemosa) have shown efficacy in trials in women with menopausal symptoms. Yet, dose dependency remains unclear. Therefore, 180 female outpatients with climacteric complaints were treated for 12 weeks in a randomized, double-blind, placebo-controlled, 3-armed trial (CR extract Ze 450 in 6.5 mg or 13.0 mg, or placebo). Primary outcome was the difference in menopausal symptoms (vasomotor, psychological, and somatic), assessed by the Kupperman Menopausal Index between baseline and week 12. Secondary efficacy variables were patients' self-assessments of general quality of life (QoL), responder rates, and safety. Compared to placebo, patients receiving Ze 450 showed a significant reduction in the severity of menopausal symptoms in a dose-dependent manner from baseline to endpoint (mean absolute differences 17.0 (95% CI 14.65–19.35) score points, P < 0.0001 for 13.0 mg; mean absolute differences 8.47 (95% CI 5.55–11.39) score points, P = 0.0003 for 6.5 mg). QoL and responder rates corresponded with the main endpoint. Changes in menopausal symptoms and QoL were inversely correlated. Reported adverse events and clinical laboratory testing did not raise safety concerns. The CR extract Ze 450 is an effective and well-tolerated nonhormonal alternative to hormone treatment for symptom relief in menopausal women.

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Section: Introductionmentioning

confidence: 99%

Dose-Dependent Effects of theCimicifuga racemosaExtract Ze 450 in the Treatment of Climacteric Complaints: A Randomized, Placebo-Controlled Study

Schellenberg¹,

Saller

Hess³

et al. 2012

Evidence-Based Complementary and Alternative Medicine

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“…Since the 5-HT 1A and 7 receptor subtypes are present in the hypothalamus, it has been proposed that serotonergic activity in the hypothalamic thermoregulatory centers may be responsible for the reduction in hot flashes. 50,59 Safety: Hepatotoxicity…”

Section: Mechanism Of Actionmentioning

confidence: 99%

Black Cohosh and Breast Cancer

et al. 2013

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Background. Many women use black cohosh as a natural treatment for menopausal symptoms. However, controversy exists around safety in breast cancer, because of its purported estrogenic activity. We conducted a systematic review of black cohosh use in women with or at risk of breast cancer.Methods. We searched MEDLINE, Embase, the Cochrane Library, and AMED from inception to July 2012 and October 2012 for human interventional or observational data pertaining to the safety and efficacy of black cohosh in patients with or at risk of breast cancer, including an assessment of the effect of black cohosh on estrogen responsive tissues. Results. Of 450 records, we included 26 articles: 14 randomized controlled trials, 7 uncontrolled trials, and 5 observational studies.The evidence on efficacy for ho t flashes is divided, with some benefits seen when compared with baseline, but not when compared with placebo. Two observational studies found no association between black cohosh and risk of breast cancer, whereas 2 studies reported significant reductions in risk of primary breast cancer among postmenopausal women (adjusted odds ratio = 0.47, 95% confidence interval = 0.27-0.82), and risk of recurrence (adjusted hazard ratio = 0.75, 95% confidence interval = 0.63-0.89). Seventeen trials showed no significant impact on circulating hormone levels or proliferation in estrogen responsive tissues. Conclusions. Current evidence does not support an association between black cohosh and increased risk of breast cancer. There is a lack of evidence supporting the efficacy of black cohosh for reduction of hot flashes in breast cancer patients. Given conflicting but promising results, and apparent safety, further research is warranted.

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“…This is a potentially significant finding, given that this is such a common compound. However, these results have not been confirmed by others, and black cohosh is not estrogenic as determined in numerous in vitro and in vivo studies [11, 125–128]. …”

Section: 8 Cholines and Betainsmentioning

confidence: 66%

Nitrogen-Containing Constituents of Black Cohosh: Chemistry, Structure Elucidation, and Biological Activities

Nikolić

Lankin

Cisowska

et al. 2015

The Formation, Structure and Activity of Phytochemicals

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The roots/rhizomes of black cohosh (Actaea racemosa L. syn. Cimicifuga racemosa [L]. Nutt., Ranunculaceae) have been used traditionally by Native Americans to treat colds, rheumatism, and a variety of conditions related to women’s health. In recent years black cohosh preparations have become popular dietary supplements among women seeking alternative treatments for menopausal complaints. The popularity of the plant has led to extensive phytochemical and biological investigations, including several clinical trials. Most of the phytochemical and biological research has focused on two abundant classes of compounds: the triterpene glycosides and phenolic acids. A third group of phytoconstituents that has received far less attention consists of the alkaloids and related compounds that contain nitrogen. This chapter summarizes the current state of knowledge of the chemistry and biological activities associated with this group of constituents and provides some perspective on their significance for future research on this interesting plant.

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Black Cohosh: Insights into its Mechanism(s) of Action

Cited by 27 publications

References 71 publications

Dose-Dependent Effects of theCimicifuga racemosaExtract Ze 450 in the Treatment of Climacteric Complaints: A Randomized, Placebo-Controlled Study

Dose-Dependent Effects of theCimicifuga racemosaExtract Ze 450 in the Treatment of Climacteric Complaints: A Randomized, Placebo-Controlled Study

Black Cohosh and Breast Cancer

Nitrogen-Containing Constituents of Black Cohosh: Chemistry, Structure Elucidation, and Biological Activities

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