Abstract
Extracts from Cimicifuga racemosa (CR, synonym Actaea racemosa) have shown efficacy in trials in women with menopausal symptoms. Yet, dose dependency remains unclear. Therefore, 180 female outpatients with climacteric complaints were treated for 12 weeks in a randomized, double-blind, placebo-controlled, 3-armed trial (CR extract Ze 450 in 6.5 mg or 13.0 mg, or placebo). Primary outcome was the difference in menopausal symptoms (vasomotor, psychological, and somatic), assessed by the Kupperman Menopausal Index between baseline and week 12. Secondary efficacy variables were patients' self-assessments of general quality of life (QoL), responder rates, and safety. Compared to placebo, patients receiving Ze 450 showed a significant reduction in the severity of menopausal symptoms in a dose-dependent manner from baseline to endpoint (mean absolute differences 17.0 (95% CI 14.65–19.35) score points, P < 0.0001 for 13.0 mg; mean absolute differences 8.47 (95% CI 5.55–11.39) score points, P = 0.0003 for 6.5 mg). QoL and responder rates corresponded with the main endpoint. Changes in menopausal symptoms and QoL were inversely correlated. Reported adverse events and clinical laboratory testing did not raise safety concerns. The CR extract Ze 450 is an effective and well-tolerated nonhormonal alternative to hormone treatment for symptom relief in menopausal women.
Highlights
On the one hand, menopause is a normal biological process marking the transition of the lives of mature women from a reproductive into a postreproductive phase
There were no significant differences between the treatment groups in any of the demographic parameters or for baseline levels of T3, T4, thyroid-stimulating hormone (TSH), FSH, luteinizing hormone (LH), and E2
Our study demonstrated that the Cimicifuga racemosa (CR) extract administered for 12 weeks decreased significantly, and in a dose-dependent manner, the severity of climacteric symptoms in the total Kupperman Menopausal Index (KMI)
Summary
Menopause is a normal biological process marking the transition of the lives of mature women from a reproductive into a postreproductive phase. Menopausal changes can lead to vasomotor (e.g., hot flushes, sweating), psychological/vegetative (e.g., insomnia, nervousness/irritability, depressive event, and palpitation), somatic (e.g., joint pain), and urogenital/sexual (e.g., libido changes, dyspareunia, and vaginal dryness) symptoms. They vary in frequency and severity, are related to lifestyle, demographics and sociocultural circumstances, and have been well characterized [1,2,3]. The interrelationship of hot flushes and sweating with other neuropsychological symptoms seems to diminish QoL in symptomatic menopausal women [7, 8]
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