Data from the HALT study, Herbal Alternatives for Menopause, found that black cohosh, in three formulations, was no better than placebo in reducing symptoms of hot flashes and night sweats during menopause.
The randomized, controlled trial assigned women to one of five groups taking: a black cohosh pill, a multibotanical pill with black cohosh and nine other ingredients, the multibotanical pill plus counseling to encourage intake of soy products, hormone therapy (estrogen with or without progestin), or a placebo pill.
Hormone therapy worked as expected in substantially reducing the number and severity of symptoms. None of the black cohosh formulations worked any better than placebo. Black cohosh products are widely used as treatments for menopausal symptoms.
An accompanying editorial says that the study is a “well-designed, adequately powered RCT that makes an important contribution, albeit one that will disappoint women who have been hoping for an effective, safe alternative to estrogen”.
The good news, says the writer, is that women in the placebo group experienced about a 30 percent reduction in severity and frequency of symptoms during the 12-month follow-up period. This means that many women will probably have fewer symptoms within six to 12 months without any treatment at all.