Anna Marchelak, Aleksandra Prokop, Anna Magiera

Black cohosh (Actaea racemosa L./Cimicifuga racemosa (L.) Nutt.) – role in modern phytotherapy for menopause ailments

2024-11-20

Object of review. Menopause is a natural consequence of the disappearance of ovarian follicles, the synthesis/secretion of hormones, or the effect of surgical or non-surgical medical procedures. The changing hormonal environment in the human organism creates a cascade of troublesome disorders and diseases related to, among others, the central nervous system, the musculoskeletal system, and the genitourinary system. Hormone replacement therapy (HRT), which includes estrogen and/or progesterone, is used to treat the symptoms of menopause by conventional medicine. However, there are many contraindications to the use of HRT, and HRT carries the risk of bothersome side effects. Therefore, women are increasingly turning to alternative therapies, e.g., preparations containing plant substances.  Only in the case of black cocosh the therapeutic efficacy in relieving menopausal symptoms has been confirmed by clinical evidence sufficient to grant the status of a drug with well-established medical use – in accordance with the opinion of the European Medicines Agency (EMA).

Goal of the review. Summary of the current state of knowledge about the rhizome and root of black cohosh (Actaea racemosa L.) as a plant substance used to treat peri- and postmenopausal ailments and introduction to the subject, terminology, causes, symptoms, and pharmacology of menopause.

Material and methods. The literature review was prepared based on the following databases: PubMed, Google Scholar, Web of Science, and Science Direct, using appropriate descriptors. In total, 31 scientific articles, two websites, two collections of monographs on plant substances, and three books were used.

Results and conclusions. The review characterized the species botanically, systematized data on the phytochemical profile, summarized reports from preclinical studies of biological activity, compiled data from clinical trials using plant substance extracts in the treatment of menopausal ailments, and presented information on the safety of use. Numerous clinical studies confirm the effectiveness of preparations containing specific extracts from the rhizome and root of A. racemosa in treating menopausal symptoms, such as hot flashes and profuse sweating. However, many issues regarding the root and rhizome of A. racemosa remain unexplained. The exact mechanism of action of the plant substance is unknown, although it is suggested that it is related to the serotonergic and dopaminergic systems. There is also a lack of complete data on the active compounds that condition the observed biological activity. To fully characterize the plant substance, it is necessary to explain the exact molecular mechanisms of activity and indicate activity markers. Due to the numerous adulterations of black cohosh preparations, developing appropriate quality control procedures is also very important.

Keywords: Actaea racemosa, Cimicifuga racemosa, black cohosh, phytotherapy, menopause.

© Farm Pol, 2024, 80(6): 401–414