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.

Design. 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.

Keywords:

• Black cohosh
• Cimicifuga racemosa
• climacteric complaints
• hot flushes
• breast cancer
• tamoxifen
• Menopause Rating Scale II

Acknowledgements

The financial support for this study (€6000) was provided by Schaper and Brümmer GmbH & Co.KG, Salzgitter, Germany. Ute Stammwitz is an employée of Schaper and Brümmer GmbH & Co.KG. She was responsible for statistics and monitoring.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.