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

    This blog ran from 2006 to 2016 and was 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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