title: Critical evaluation of the safety of Cimicifuga racemosa in menopause symptom relief.
abstract: OBJECTIVE
  This comprehensive review examines the safety of Cimicifuga racemosa for the treatment of menopause symptoms, particularly in populations in which conventional menopause treatment regimens, including estrogen replacement, are contraindicated.
  
  
  METHODS
  An extensive database of information on Cimicifuga, which included all published literature pertaining to preclinical and clinical safety of various forms of Cimicifuga, the FDA and World Health Organization adverse-event reporting systems, monographs, compendia, internal unpublished data from a major manufacturer, foreign literature, and historical anecdotal reports, was reviewed, and findings pertaining to the safety of Cimicifuga use for menopause treatment were reported.
  
  
  RESULTS
  Uncontrolled reports, postmarketing surveillance, and human clinical trials of more than 2,800 patients demonstrate a low incidence of adverse events (5.4%). Of the reported adverse events, 97% were minor and did not result in discontinuation of therapy, and the only severe events were not attributed to Cimicifuga treatment.
  
  
  CONCLUSIONS
  Although the effects of Cimicifuga may be dependent on the specific extract preparation, this review clearly supports the safety of specific Cimicifuga extracts, particularly isopropanolic preparations, for use in women experiencing menopausal symptoms and as a safe alternative for women in whom estrogen therapy is contraindicated.
authors.affiliation: 1Integrative Medicine Education Associates, Corrales, NM, and 2Innovative Science Solutions, LLC, Morristown, NJ 87048, USA. lowdogmd@aol.com
authors.forename: Tieraona
authors.initials: T
authors.lastname: Low Dog
authors.forename: Kara L
authors.initials: KL
authors.lastname: Powell
authors.forename: Steven M
authors.initials: SM
authors.lastname: Weisman
mesh_terms: D031885:Cimicifuga; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004353:Drug Evaluation, Preclinical; D005260:Female; D006801:Humans; D008593:Menopause / Q000187:drug effects*; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D011358:Product Surveillance, Postmarketing
chemical_list: D010936:Plant Extracts