Market Updates

Archives of Internal Medicine Article Finds One Black Cohosh Effective for Treating Menopausal Symptoms

By: Rebecca Wright

Editor/Associate Publisher

A July 24 review article published in the Archives of Internal Medicine (2006;166:1453-1465) concluded that alternative and complementary therapies are generally ineffective for treating menopause-related symptoms. Among the biologically based studies, only one on Remifemin out of the four black cohosh studies reviewed, was shown to be effective.

“A single large trial showed a benefit for vasomotor symptoms with the black cohosh Remifemin(R) (Enzymatic Therapy Inc., Green Bay Wisconsin) and is consistent with older German studies,” the reviewers wrote, indicating that the remaining three studies showed no benefits from black cohosh. Results from two “were confounded by concurrent use of tamoxifen, known to exacerbate hot flashes,” while another used a “more unusual (research) preparation, BN01055.”

“Buyer beware” was the general conclusion of the Archives review, which clearly applies to black cohosh since recent studies have proven that not all black cohosh is the same. Most products in the market lack the standardization and research that can ensure efficacy and safety. An article in the Journal of Agricultural & Food Chemistry (2006;54(9):3242-53), reported that three of 11 black cohosh supplements purchased and tested in the U.S. did not even contain black cohosh (Actaea racemosa syn. Cimicifuga racemosa). Instead, the three contained less expensive extracts of Chinese cimicifuga (specific other Actaea spp.) that do not have all the same chemical compounds or clinical uses as the native North American plant. A fourth product indicated a probable mixture of the two plants.

Remifemin comprises a proprietary, standardized extract (uniform dosage) of pure black cohosh root called RemiSure. It is the most OB/GYN-recommended non-prescription menopause brand. The German E Commission has approved the use of 40 mg/day of black cohosh (Remifemin(R) brand) for 6 months for relief of menopausal symptoms, as well as for premenstrual syndrome (PMS) and dysmenorrhea.

“Remifemin is clearly the world’s most clinically tested black cohosh product,” said Mark Blumenthal, Founder and Executive Director of the American Botanical Council. “Over 15 clinical trials demonstrate the safety and efficacy of the product, manufactured according to the latest GMPs by Shaper & Brummer GmbH, a highly respected German phytomedicine company with over 50 years of experience in manufacturing and testing Remifemin. Almost all of the scientific literature on black cohosh was conducted on Remifemin, including recent clinical trials showing no estrogenic activity of the product,” he explained.

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