title: Black cohosh (Cimicifuga racemosa) in tamoxifen-treated breast cancer patients with climacteric complaints - a prospective observational study.
abstract: OBJECTIVE
  The antihormonal therapy of breast cancer patients with the antiestrogen tamoxifen often induces or aggravates menopausal complaints. As estrogen substitution is contraindicated, herbal alternatives, e.g. extracts of black cohosh are often used.
  
  
  METHODS
  A prospective observational study was carried out in 50 breast cancer patients with tamoxifen treatment. All patients had had surgery, most of them had undergone radiation therapy (87%) and approximately 50% had received chemotherapy. Every patient was treated with an isopropanolic extract of black cohosh (1-4 tablets, 2.5 mg) for 6 months. Patients recorded their complaints before therapy and after 1, 3, and 6 months of therapy using the menopause rating scale (MRS II).
  
  
  RESULTS
  The reduction of the total MRS II score under black cohosh treatment from 17.6 to 13.6 was statistically significant. Hot flashes, sweating, sleep problems, and anxiety improved, whereas urogenital and musculoskeletal complaints did not change. In all, 22 patients reported adverse events, none of which were linked with the study medication; 90% reported the tolerability of the black cohosh extract as very good or good.
  
  
  CONCLUSIONS
  Black cohosh extract seems to be a reasonable treatment approach in tamoxifen treated breast cancer patients with predominantly psychovegetative symptoms.
authors.affiliation: Institute of Complementary Medicine, University Hospital, Zurich, Switzerland. matthias.rostock@usz.ch
authors.forename: Matthias
authors.initials: M
authors.lastname: Rostock
authors.forename: Julia
authors.initials: J
authors.lastname: Fischer
authors.forename: Andreas
authors.initials: A
authors.lastname: Mumm
authors.forename: Ute
authors.initials: U
authors.lastname: Stammwitz
authors.forename: Reinhard
authors.initials: R
authors.lastname: Saller
authors.forename: Hans Helge
authors.initials: HH
authors.lastname: Bartsch
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001007:Anxiety / Q000139:chemically induced / Q000517:prevention & control; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D031885:Cimicifuga / Q000737:chemistry*; D004965:Estrogen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D008593:Menopause / Q000187:drug effects / Q000523:psychology; D008875:Middle Aged; D010352:Patient Dropouts; D008517:Phytotherapy / Q000009:adverse effects; D010936:Plant Extracts / Q000009:adverse effects / Q000627:therapeutic use*; D027343:Rhizome / Q000737:chemistry; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000139:chemically induced / Q000517:prevention & control; D013546:Sweating / Q000187:drug effects; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D004965:Estrogen Antagonists; D010936:Plant Extracts; D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen