The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Herbals vs hormones to treat cognition in menopause

    Dietary herbal supplements, such as black cohosh, have shown mixed and inconclusive results in placebo-controlled studies of menopausal symptoms.

    Researchers from Northwestern University, in Chicago, Illinois compared black cohosh and red clover to hormone therapy for their effects on cognition (reasoning).

    First, the details.

    • 66 midlife women with at least 35 weekly hot flashes were randomly assigned to a treatment group for 12 months.
      • Red clover (a phytoestrogen) 120 mg daily
      • Black cohosh 128 mg daily
      • 0.625 mg conjugated equine estrogens + 2.5 mg medroxyprogesterone acetate (a Prempro type combination hormone treatment)
      • Placebo
    • Neither the researchers nor patients knew the treatment given — double blind.
    • Verbal memory and other cognitive measures before and during the 12th treatment month were recorded.
    • 19 women carried ambulatory skin conductance monitors (example here).

    And, the results.

    • Neither herbal changed verbal memory and other cognitive measures.
    • Compared to placebo, combined hormone therapy led to a significantly greater decline in verbal learning after adjusting for the change in vasomotor symptoms (hot flashes).
    • Neither herbal showed changed verbal memory vs placebo.
    • Combined hormone therapy lead to a decrease in immediate digit recall (repeating a list of numbers after hearing them and an improvement in letter fluency (state as many words as possible beginning with a certain letter in 1 minute).
    • Only hormone therapy significantly reduced hot flashes.

    The bottom line?
    The researchers concluded, “Results indicate that a red clover (phytoestrogen) supplement or black cohosh has no effects on cognitive function. [Combined hormone therapy] reduces objective hot flashes but worsens some aspects of verbal memory.”

    The lack of effect of red clover reported is supported by an earlier study here.

    A PubMed search revealed no other studies of the effect of black cohosh on cognition during menopause.

    7/12/09 19:20 JR

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