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Cimicifuga foetida for symptoms of menopause.

Cimicifuga foetida for symptoms of menopause

Gao L, Zheng T, Xue W, Wang Y, Deng Y, Zuo H, Sun A. Efficacy and safety evaluation of Cimicifuga foetida extract in menopausal women. Climacteric 2018;21(1):69-74.

Menopausal symptoms such as hot flushes, sweating, and sleep disorders are estimated to affect more than 80% of women. Hormone replacement therapy (HRT) was first introduced in the 1940s for treatment of symptoms associated with menopause; however, concerns about side effects remain.

Cimifuga racemosa (black cohosh) has been used as an alternative to HRT; however, studies assessing safety and effectiveness over a longer time frame are limited. The present study aimed to evaluate the long-term effectiveness and safety of C. foetida, a species of genus Cimifuga, in the treatment of menopausal symptoms of women in China.

The study was a prospective, randomised, controlled trial, conducted within a Peking hospital. Participants were menopausal (defined as experiencing amenorrhoea for longer than 6 months and less than 5 years), 40-60 years old, serum estradiol <30 pg/ml, and follicle stimulating hormone >40 IU/l, with climacteric symptoms. Exclusion criteria included taking HRT during the 3 months prior to first examination, contraindication for HRT, or taking other medication that may influence results. Women were randomly allocated to one of three groups: Group A (E2+MPA) (1 mg/day estradiol continuous plus 4 mg/ day medroxyprogesterone acetate for the last 12 days of each 30-day cycle), Group B (E2 + MP) (1 mg/ day estradiol continuous plus 100 mg/day micronised progesterone for the last 12 days of each 30-day cycle) or Group C (C. foetida extract) (100 mg daily continuous C. foetida extract) (Ximingting tablets, Shan Dong LvYe Pharmaceutical Co Ltd). Symptoms of menopause were assessed through a modified Kupperman Menopausal Index (mKMI). The Menopausal-Specific Quality of Life (MENQOL) questionnaire was used to assess quality of life. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate anxiety and depression in participants. The trial was undertaken for 24 months with follow-up every three months.

Of the 96 women recruited for the study, a total of 81 patients completed the treatment and follow-up visits. Baseline characteristics were comparable in terms of age, menopause age, duration of menopause, systolic and diastolic blood pressure, and height. Prior to intervention, there was no significant difference in mKMI scores between groups.

The mKMI decreased significantly in all groups after three months compared with baseline; however, a between-group difference was noted with less score reduction in C. foetida group. At six months and beyond, the significant reductions from baseline scores remained for all groups, with no significant difference between groups. The E2+MPA group after nine months and the E2 + MP after three months had lower anxiety scores compared with baseline measurements. The C. foetida group demonstrated no changes in the depression scale scores. No significant changes were observed to liver and renal function and components of the metabolic syndrome in C. foetida group. Endometrial thickness was assessed at the end of treatment. There was no significant difference in post-treatment endometrial thickness in groups A and C, with patients in group B having a significant increase in endometrial thickness compared to baseline.

Strengths of the study include its use of active comparator groups and the long-term duration of the interventions to allow for assessing efficacy and safety over time. The results of the study are promising and suggest a potential treatment in C. foetida that is effective and seemingly safe over a longer time frame for treatment of symptoms associated with menopause.
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Author:Tester, Jodie
Publication:Australian Journal of Herbal and Naturopathic Medicine
Date:Jun 1, 2018
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