Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial

To compare the efficacy and safety of the black cohosh root extract Cr 99 with placebo in women with climacteric complaints. A multicenter, randomized, placebo-controlled, double-blind, parallel group study was conducted in 122 menopausal women (intention-to-treat population) with ≥3 hot flashes a day, treated over 12 weeks. Two main efficacy measures – weekly weighted score of hot flashes and Kupperman Index – and secondary efficacy variables, e.g. Menopause Rating Scale, were defined. Routine safety laboratory parameters and adverse events were documented. The primary efficacy analysis showed no superiority of the tested black cohosh extract compared to placebo. However, in the subgroup of patients with a Kupperman Index ≥ 20 a significant superiority regarding this index could be demonstrated ( P < 0.018). A decrease of 47% and 21% was observed in the black cohosh and placebo group, respectively. The weekly weighted scores of hot flashes ( P < 0.052) and the Menopause Rating Scale ( P < 0.009) showed similar results. Prevalence and intensity of the adverse events did not differ in the two treatment groups. The results indicate a superiority of the tested Cimicifuga racemosa extract compared to placebo in patients with menopausal disorders of at least moderate intensity according to a Kupperman Index ≥ 20, but not in the intention-to-treat population as a whole.