Each year, millions of women around the globe struggle with the frustrating and unpredictable symptoms of menopause. Black cohosh was used in American Indian folk medicine to treat menopausal symptoms, and it is also heavily promoted in Europe as a natural supplement for women nearing this change of life. Remifemin is the brand name of a product containing black cohosh that has been widely used by menopausal women in Germany since the mid-1950s.
Identification
Black cohosh is a perennial plant with tall spikes of brilliant white flowers that is a member of the buttercup family and native to forests in North America from Canada down through Missouri. The root is the part of the plant used in herbal formulations. Each Remifemin tablet contains proprietary standardized extract of 20 mg of black cohosh to be taken twice a day. The manufacturer claims the product has been well-studied for 50 years and that it is 70-percent effective in improving hot flashes, night sweats, irritability, moods swings, insomnia and anxiety.
Benefits for Menopause
The active compounds in black cohosh are believed to be 26-deoxyactein and other alkaloid chemicals, although the actions of the compounds in the plant aren't completely understood. It was once believed to act like an estrogen, but it's more likely that black cohosh boosts your body's own ability to balance estrogen. The chemicals in black cohosh may also work like human opiate receptors, the receptors in your brain that react to morphine and antidepressants.
The Kupperman Index
In 1959, H.S. Kupperman created a scoring system, called the Kupperman Index, used to cover 11 menopausal symptoms graded from zero, indicating an absence of symptoms, up to 35, representing peak distress. A Chinese study in 2009 at Peking University First Hospital's Department of Obstetrics and Gynecology compared the effects of Remifemin to tibolone, a prescription of a synthetic steroid used to treat menopause symptoms. After 12 weeks, researchers used the Kupperman Index to assess the 180 menopausal women in the study. The results showed that the over-the-counter Remifemin was as effective as the prescription tibolone, but without the higher risk for vaginal bleeding and breast swelling found in the tibolone group.
Hot Flashes
A randomized, double-blind, placebo-controlled trial in German from 1985 reported by the National Institutes of Health Office of Dietary Supplements treated 80 menopausal women with 8 mg per day of Remifemin or with estrogens or a placebo. After 12 weeks, the women were assessed with the Kupperman Index, wherein researchers found that hot flashes decreased to almost zero in the group taking Remifemin but didn't decrease much in the groups on estrogen or the placebo. A separate German study in 1991, published in "Planta Medica," used Remifemin for eight weeks on laboratory rats. The researchers found three endocrinologically active compounds in Remifemin that suppressed luteinizing hormone, or LH, a natural hormone that in higher levels may cause hot flashes.
References
- Remifemin.com: Remifemin
- Office of Dietary Supplements: Black Cohosh
- "Zhonghua Fu Chan Ke Za Zhi"; Efficacy and Safety of Remifemin Compared to Tibolone for Controlling of Perimenopausal Symptoms; W.P. Bai, et al.; August 2009
- "Therapeutikon"; Phytotherapy Influences Atrophic Vaginal Epithelium: Double-blind Study of Cimicifuga vs. Estrogenic substances; W. Stoll, et al.; 1987
- Drugs.com; Black Cohosh; 2009
- "Planta Medica"; Effects of Extracts from Cimicifuga Racemosa on Gonadotropin Release in Menopausal Women and Ovariectomized Rats; E.M. Düker, et al.; October 1991
