Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms - an update on the evidence

A systematic literature search revealed 35 clinical studies and one meta-analysis comprising 43,759 women, of which 13,096 were treated with isopropanolic Cimicifuga racemosa extract (iCR). Compared to placebo, iCR was significantly superior for treating neurovegetative and psychological menopausal symptoms, with a standardized mean difference of 0.694 in favor of iCR (p<0.0001). Effect sizes were larger when higher dosages of iCR as monotherapy or in combination with St. John's wort (Hypericum perforatum [HP]) were given ( 1.020 and 0.999, respectively), suggesting a dose-depend- ency. For psychological symptoms, the iCRþHP combination was superior to iCR monotherapy. Efficacy of iCR was c…