Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study.
OBJECTIVE
In this study, the effects of the Cimicifuga racemosa (CR) preparation CR BNO 1055 on markers of bone metabolism, hormones, sex hormone-binding globulin (SHBG), lipometabolism, vaginal maturity, and routine laboratory parameters were compared with those of conjugated estrogens (CE) and placebo.


METHODS
Sixty-two postmenopausal women were included in this double-blind study. Treatment duration with CR (daily dose corresponds to 40 mg of herbal drug), CE (0.6 mg/day), or placebo was 12 weeks. Markers of bone turnover (bone-specific alkaline phosphatase, CrossLaps), estradiol, follicle-stimulating hormone, leuteinizing hormone, SHBG, triglycerides, total cholesterol, high-density cholesterol, low-density cholesterol, and routine clinical chemistry parameters were determined from blood samples. Vaginal "maturity index" was determined from vaginal smears.


RESULTS
The analyses of bone turnover markers indicated beneficial effects for CR and CE on bone metabolism. CR stimulated osteoblast activity, whereas CE inhibited osteoclast activity. Whereas CE showed strong estrogenic effects on vaginal mucosa, CR showed weak estrogen-like activity. No significant effects were seen on coagulation markers and liver enzymes in the blood. CR was well tolerated.


CONCLUSIONS
These results suggest that CR has beneficial bone remodeling and weak estrogen-like effects in the vaginal mucosa.
Wuttke
Wolfgang
W
Division of Clinical and Experimental Endocrinology, Department of Obstetrics and Gynaecology, University of Göttingen, Germany. ufkendo@med.uni-goettingen.de
Gorkow
Christoph
C
Seidlová-Wuttke
Dana
D
D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D016723:Bone Remodeling / Q000187:drug effects*; D031885:Cimicifuga; D004311:Double-Blind Method; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects; D008517:Phytotherapy / Q000379:methods*; D010936:Plant Extracts / Q000627:therapeutic use*; D017698:Postmenopause / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D016896:Treatment Outcome; D014621:Vagina / Q000166:cytology / Q000187:drug effects*; D014768:Virginia
D015415:Biomarkers; C475575:Cimicifuga extract BNO 1055; D004966:Estrogens, Conjugated (USP); D008055:Lipids; D010936:Plant Extracts; D012738:Sex Hormone-Binding Globulin