Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2002; 7: 86
Cimicifuga racemosa has been advocated for a long time as a safe alternative therapy to hormone replacement therapy (HRT) to relieve menopausal symptoms. However, recent experimental studies and a clinical trial have raised some questions on its efficacy. The aim of this systematic review is to analyse all randomised controlled trials (RCTs) and experimental studies concerning C. racemosa to better explain both its effectiveness in the treatment of menopausal complaints and its mechanism of action.
Searches of the computerised literature databases Medline (PubMed), Embase, Amed, CISCOM and Cochrane Library were performed to identify all randomised controlled trials as well as animal and in vitro experiments on C. racemosa. In addition, bibliographies of the articles thus located were scanned for further relevant publications and manufacturers were asked to contribute published and unpublished material. No language restrictions were imposed.
There is no convincing evidence to demonstrate the efficacy of C. racemosa on menopausal symptoms. The most recent and methodologically best placebo-controlled RCT, which finds a large placebo effect and no significant difference between the placebo and the C. racemosa preparation, suggests that the beneficial effects previously observed are probably due to a placebo effect. Experimental studies imply that C. racemosa possesses a central activity instead of a hormonal effect.
Further rigorous RCTs and biochemical/chemical investigations are required both to define the efficacy of C. racemosa for menopausal symptoms and to identify the compounds responsible of its actions.
