Black/Blue CohoshChamomileDong QuaiEvening Primrose

Little evidence that herbals relieve menopause symptoms

Drugs and Therapeutics Bulletin, which is published by the British Medical Journal, has published their review of the evidence.

Black cohosh

  • 3 studies suggest beneficial effect.
  • 4 others do not.
  • The herb has been linked to liver toxicity.
    • However, 2 other recently published reviews disagree.

Red clover

  • A meta-analysis found no benefit.
    • Dr. Matthew Anderson from the Albert Einstein College of Medicine in New York agrees and says that 15 years of studies reveal “little evidence of benefit for these products [isoflavones] on menopausal symptoms.

Dong quai

  • No better than placebo in 1 study.
  • Better than placebo in another, where it was combined with chamomile.
  • Contraindicated in patients taking warfarin (Coumadin), as it may increase the risk for bleeding.
    • A review on The University of Maryland website agrees.

Evening primrose

  • Not superior to placebo in one study.
    • Reviewers at the Royal Worcestershire Hospital in the UK agree.
  • Evidence suggests it may increase the risk for seizures when used with other drugs that can cause seizures.

The bottom line?

I added the links because the abstract of this article lists no authors and no information on the strategy used to select the research reviewed.

Since posting this summary, A 2010 review tells us nothing has changed. “Herbal formulations such as dong quai, ginseng, kava, and dietary soy, among others, do not appear to benefit patients more than placebo.”

1/15/09 19:41 JR; updated 10/4/10 20:38 JR

Hi, I’m JR

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.