Black cohosh (<i>Cimicifuga</i> spp.) for menopausal symptoms

Matthew J Leach; Vivienne Moore

doi:10.1002/14651858.CD007244.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Podcasts
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Figure 1

Study flow diagram.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Risk of bias graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 4

Forest plot of comparison: 1 Black cohosh versus placebo, outcome: 1.1 Vasomotor symptoms: daily hot flush frequency.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 5

Forest plot of comparison: 1 Black cohosh versus placebo, outcome: 1.5 Menopausal Symptom Score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 6

Forest plot of comparison: 2 Black cohosh versus hormone therapy, outcome: 2.5 Menopausal Symptom Score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Black cohosh versus placebo, Outcome 1 Vasomotor symptoms: daily hot flush frequency.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Black cohosh versus placebo, Outcome 2 Vasomotor symptoms: weekly hot flush frequency.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Black cohosh versus placebo, Outcome 3 Vasomotor symptoms: hot flush intensity.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Black cohosh versus placebo, Outcome 4 Vasomotor symptoms: night sweats.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Black cohosh versus placebo, Outcome 5 Menopausal Symptom Score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.6

Comparison 1 Black cohosh versus placebo, Outcome 6 Adverse events.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 Black cohosh versus hormone therapy, Outcome 1 Vasomotor symptoms: daily hot flush frequency.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Black cohosh versus hormone therapy, Outcome 2 Vasomotor symptoms: weekly hot flush frequency.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 Black cohosh versus hormone therapy, Outcome 3 Vasomotor symptoms: hot flush intensity.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 Black cohosh versus hormone therapy, Outcome 4 Vasomotor symptoms: night sweats.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.5

Comparison 2 Black cohosh versus hormone therapy, Outcome 5 Menopausal Symptom Score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.6

Comparison 2 Black cohosh versus hormone therapy, Outcome 6 Adverse events.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Black cohosh versus red clover, Outcome 1 Vasomotor symptoms: hot flush frequency.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 Black cohosh versus red clover, Outcome 2 Vasomotor symptoms: hot flush intensity.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.3

Comparison 3 Black cohosh versus red clover, Outcome 3 Menopausal score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4 Black cohosh versus fluoxetine, Outcome 1 Vasomotor symptoms: night sweats.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.2

Comparison 4 Black cohosh versus fluoxetine, Outcome 2 Menopausal score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Summary of findings for the main comparison. Black cohosh versus placebo for menopausal symptoms

Black cohosh versus placebo for menopausal symptoms
Patient or population: patients with menopausal symptoms Settings: Intervention: Black cohosh versus placebo
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of Participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Control	Black cohosh versus placebo
Vasomotor symptoms: daily hot flush frequency		The mean vasomotor symptoms: daily hot flush frequency in the intervention groups was 0.07 flushes per day higher (0.43 lower to 0.56 higher)		393 (3 studies)	⊕⊕⊕⊝ moderate¹
Vasomotor symptoms: hot flush intensity		The mean vasomotor symptoms: hot flush intensity in the intervention groups was 0.12 higher (0.06 lower to 0.3 higher)		214 (3 studies)	⊕⊕⊕⊝ moderate²
Vasomotor symptoms: night sweats		The mean vasomotor symptoms: night sweats in the intervention groups was 0.27 sweats per night higher (0.16 lower to 0.7 higher)		164 (1 study)	⊕⊕⊕⊝ moderate³
Menopausal Symptom Score		The mean menopausal symptom score in the intervention groups was 0.1 standard deviations lower (0.32 lower to 0.11 higher)		357 (4 studies)	⊕⊕⊕⊝ moderate⁴	SMD ‐0.1 (‐0.32 to 0.11)
Adverse events	427 per 1000	444 events per 1000 women (350 to 564)	RR 1.04 (0.82 to 1.32)	344 (2 studies)	⊕⊕⊝⊝ low^4,5
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio;
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
¹ Two of the three trials did not provide sufficient details for randomisation and allocation concealment and two trials did not provide details for reasons for losses to follow up in each group ² All three trials lacked some methodological detail ³ Evidence is based on a single trial ⁴ Most of the trials lacked methodological details to make a judgement or did not report the reasons for attrition for each group ⁵ Only two trials reported on adverse outcomes.

Summary of findings for the main comparison. Black cohosh versus placebo for menopausal symptoms

Ir a la tabla de la revisión

Table 1. The Cochrane Collaboration’s tool for assessing risk of bias

Domain	Support for judgement	Review authors’ judgement
Selection bias
Random sequence generation	Describe the method used to generate the allocation sequence in sufficient detail to allow an assessment of whether it should produce comparable groups	Selection bias (biased allocation to interventions) owing to inadequate generation of a randomised sequence
Allocation concealment	Describe the method used to conceal the allocation sequence in sufficient detail to determine whether intervention allocations could have been foreseen in advance of, or during, enrolment	Selection bias (biased allocation to interventions) owing to inadequate concealment of allocations prior to assignment
Performance bias
Blinding of participants and personnel Assessments should be made for each main outcome (or class of outcomes)	Describe all measures used, if any, to blind study participants and personnel from knowledge of which intervention a participant received. Provide any information relating to whether the intended blinding was effective	Performance bias owing to knowledge of the allocated interventions by participants and personnel during the study
Detection bias
Blinding of outcome assessmentAssessments should be made for each main outcome (or class of outcomes)	Describe all measures used, if any, to blind outcome assessors from knowledge of which intervention a participant received. Provide any information relating to whether the intended blinding was effective	Detection bias owing to knowledge of the allocated interventions by outcome assessors
Attrition bias
Incomplete outcome dataAssessments should be made for each main outcome (or class of outcomes)	Describe the completeness of outcome data for each main outcome, including attrition and exclusions from the analysis. State whether attrition and exclusions were reported, the numbers in each intervention group (compared with total randomised participants), reasons for attrition/exclusions where reported, and any re‐inclusions in analyses performed by the review authors	Attrition bias owing to amount, nature or handling of incomplete outcome data
Reporting bias
Selective reporting	State how the possibility of selective outcome reporting was examined by the review authors, and what was found	Reporting bias owing to selective outcome reporting
Other bias
Other sources of bias	State any important concerns about bias not addressed in the other domains in the tool. If particular questions/entries were pre‐specified in the review’s protocol, responses should be provided for each question/entry	Bias owing to problems not covered elsewhere in the table

Table 1. The Cochrane Collaboration’s tool for assessing risk of bias

Ir a la tabla de la revisión

Table 2. Baseline characteristics A

Study	Interventions	Age (years), mean (SD)	Ethnic groups (%)	Duration of amenorrhoea (years), mean (SD)	Body mass index (kg/m²), mean (SD)
Amsterdam 2009	I1: black cohosh	I1: 56.7 (6.5)	I1: White (71.4)	I1: NR	I1: NR
	C1: placebo	C1: 50.8 (3.2)	C1: White (61.5)	C1: NR	C1: NR
		Total: NR	Total: NR	Total: NR	Total: NR
Bai 2007	I1: black cohosh	I1: 51.8 (3.7)	I1: NR	I1: 2.68 (2.05)	I1: 23.2 (2.3)
	C1: tibolone	C1: 51.5 (3.5)	C1: NR	C1: 2.95 (2.11)	C1: 23.5 (2.4)
		Total: NR	Total: NR	Total: NR	Total: NR
Bebenek 2010	I1: exercise + black cohosh	I1: 51.8 (2.7)	I1: NR	I1: NR	I1: NR
	I2: exercise only	I2: 52.3 (2.3)	I2: NR	I2: NR	I2: NR
	C1: wellness control	C1: 52.4 (2.7)	C1: NR	C1: NR	C1: NR
		Total: NR	Total: NR	Total: NR	Total: NR
Carlisle 2008	I1: black cohosh + calcium and vitamin D supplement	I1: 54.1 (5.0)	I1: NR	I1: NR	I1: 29.0 (5.4)
	C1: placebo + calcium and vitamin D supplement	C1: 52.8 (4.4)	C1: NR	C1: NR	C1: 29.8 (6.1)
		Total: 53.4 (4.7)	Total: NR	Total: NR	Total: 29.4 (5.7)
Frei‐Kleiner 2005	I1: black cohosh	I1: 52.5 (3.7)	I1: NR	I1: 3.23 (4.21)	I1: NR
	C1: placebo	C1: 52.2 (3.5)	C1: NR	C1: 3.11 (4.28)	C1: NR
		Total: NR	Total: NR	Total: NR	Total: NR
Geller 2009	I1: black cohosh	I1: 54.4 (3.9)	I1: White (61.9), African‐American (38.1), Hispanic (0)	I1: 3.4 (2.6)	I1: 28.3 (4.5)
	I2: red clover	I2: 52.4 (4.6)	I2: White (22.7), African‐American (59.1), Hispanic (13.6)	I2: 4.1 (2.8)	I2: 30.5 (4.3)
	I3: conjugated oestrogen + MDP	I3: 53.3 (4.0)	I3: White (69.9), African‐American (30.4), Hispanic (0)	I3: 3.6 (2.9)	I3: 26.0 (3.9)
	C1: placebo	C1: 52.0 (4.2)	C1: White (22.7), African‐American (72.7), Hispanic (4.6)	C1: 2.8 (2.9)	C1: 30.1 (4.9)
		Total: 53.0 (4.2)	Total: White (44.3), African‐American (50.0), Hispanic (4.5)	Total: 3.5 (2.8)	Total: 28.7 (4.7)
Jacobson 2001	I1: black cohosh	I1: NR	I1: European‐American (71.4), Hispanic (16.7), African‐American (9.5)	I1: NR	I1: NR
	C1: placebo	C1: NR		C1: NR	C1: NR
		Total: NR	Total: NR	Total: NR	Total: NR
Kronenberg 2009	I1: black cohosh	I1: 55.1 (4.1)	I1: White (86.5), African (10.8)	I1: NR	I1: 25.7 (3.9)
	C1: placebo	C1: 54.2 (3.6)	C1: White (86.5), African (5.4)		C1: 24.8 (4.0)
		Total: 54.7 (3.8)	Total: White (86.5), African (8.1)	Total: NR	Total: 25.2 (3.9)
Lehmann‐Willenbrock 1988	I1: black cohosh	I1: NR	I1: NR	I1: NR	I1: NR
	C1: oestriol	C1: NR	C1: NR	C1: NR	C1: NR
	C2: conjugated oestrogen	C2: NR	C2: NR	C2: NR	C2: NR
	C3: oestradiol/ norethisterone acetate	C3: NR	C3: NR	C3: NR	C3: NR
		Total: NR	Total: NR	Total: NR	Total: NR
Nappi 2005	I1: black cohosh	I1: 50.5 (2.1)	I1: NR	I1: NR	I1: 22.9 (2.2)
	C1: oestradiol + dihydrogesterone	C1: 50.9 (1.8)	C1: NR	C1: NR	C1: 22.0 (2.1)
		Total: NR	Total: NR	Total: NR	Total: NR
Newton 2006 / Reed 2008	I1: black cohosh	I1: 52.0 (2.2)	I1: White (91), African‐American (4)	I1: NR	I1: 27.3 (5.0)
	I2: multi‐botanical	I2: 52.2 (2.5)	I2: White (99), African‐American (1)	I2: NR	I2: 28.4 (6.3)
	I3: mult‐ibotanical + dietary soy	I3: 52.5 (2.5)	I3: White (95), African‐American (4)	I3: NR	I3: 28.4 (5.7)
	I4: conjugated oestrogen + MDP	I4: 52.3 (2.6)	I4: White (94), African‐American (0)	I4: NR	I4: 31.5 (7.9)
	C1: placebo	C1: 52.0 (2.5)	C1: White (88), African‐American (2)	C1: NR	C1: 29.2 (6.4)
		Total: 52.2 (2.4)	Total: White (93), African‐American (3)	Total: NR	Total: 28.6 (6.2)
Oktem 2007	I1: black cohosh	I1: 53.1 (5.6)	I1: NR	I1: NR	I1: 26.5 (3.8)
	C1: fluoxetine	C1: 52.7 (6.4)	C1: NR	C1: NR	C1: 27.8 (3.8)
		Total: NR	Total: NR	Total: NR	Total: NR
Osmers 2005	I1: black cohosh	I1: 54.6 (6.0)	I1: NR	I1: NR	I1: 25.5 (3.0)
	C1: placebo	C1: 55.0 (6.0)	C1: NR	C1: NR	C1: 24.9 (2.7)
		Total: NR	Total: NR	Total: NR	Total: NR
Pockaj 2006	I1: black cohosh	I1: 56.0 (8.3)	I1: NR	I1: NR	I1: NR
	C1: placebo	C1: 56.7 (8.9)	C1: NR	C1: NR	C1: NR
		Total: 56.4 (8.5)	Total: NR	Total: NR	Total: NR
Stoll 1987	I1: black cohosh	I1: 51.3 (3.1)	I1: NR	I1: NR	I1: NR
	C1: oestrogen	C1: 50.3 (2.8)	C1: NR	C1: NR	C1: NR
	C2: placebo	C2: 49.8 (3.1)	C2: NR	C2: NR	C2: NR
		Total: NR	Total: NR	Total: NR	Total: NR
Wuttke 2003/2006a/2006b	I1: black cohosh	I1: 52.3 (3.2)	I1: NR	I1: NR	I1: NR
	C1: conjugated oestrogens	C1: 52.3 (3.0)	C1: NR	C1: NR	C1: NR
	C2: placebo	C2: 54.1 (4.4)	C2: NR	C2: NR	C2: NR
		Total: NR	Total: NR	Total: NR	Total: NR
C: control; I: intervention; NR: not recorded.

Table 2. Baseline characteristics A

Ir a la tabla de la revisión

Table 3. Baseline characteristics B

	Frequency of hot flushes per week, mean (SD)	Frequency of hot flushes per day, mean (SD)	Intensity of hot flushes, mean (SD) (define index/scale)	Frequency of night sweats per week, mean (SD)	Intensity of night sweats, mean (SD) (define index/scale)	Frequency of urogenital symptoms per week, mean (SD) (define symptoms)	Intensity of urogenital symptoms, mean (SD) (define symptoms and index/scale)
Amsterdam 2009	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Bai 2007	I1: 30.0 (26.1)	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: 30.1 (20.1)	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Bebenek 2010	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR

	I2: NR	I2: NR	I2: NR	I2: NR	I2: NR	I2: NR	I2: NR

	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR

	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Carlisle 2008	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR

	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR

	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Frei‐Kleiner 2005	I1: NR	I1: 2.3 (1.9)	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: 3.5 (3.7)	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Geller 2009	I1: 44.8 (16.7)	I1: NR	I1: 2.4 (0.6) (3‐point severity scale)	I1: NR	I1: NR	I1: NR	I1: 0.8 (1.0)
	I2: 40.3 (15.4)	I2: NR	I2: 2.2 (0.7) (3‐point severity scale)	I2: NR	I2: NR	I2: NR	I2: 1.1 (1.0)
	I3: 52.1 (34.5)	I3: NR	I3: 2.0 (0.7) (3‐point severity scale)	I3: NR	I3: NR	I3: NR	I3: 0.7 (0.9)
	C1: 33.7 (14.1)	C1: NR	C1: 2.3 (0.7) (3‐point severity scale)	C1: NR	C1: NR	C1: NR	C1: 1.1 (0.9)
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
							(Vaginal dryness, 3‐point scale)
Jacobson 2001	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Kronenberg 2009	I1: 37.6 (18.7)	I1: NR	I1: 2.5 (1.04)	I1: NR	I1: NR	I1: NR	I1: NR
	C1: 40.1 (16.6)	C1: NR	C1: 2.4 (0.85)	C1: NR	C1: NR	C1: NR	C1: NR
	Total: 38.9 (17.5)	Total: NR	Total: 2.5 (0.94)	Total: NR	Total: NR	Total: NR	Total: NR
			(scale not defined)
Lehmann‐Willenbrock 1988	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	C2: NR	C2: NR	C2: NR	C2: NR	C2: NR	C2: NR	C2: NR
	C3: NR	C3: NR	C3: NR	C3: NR	C3: NR	C3: NR	C3: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Nappi 2005	I1: 10.5 (1.5)	I1: 11.0 (2.7)	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: 11.5 (1.0)	C1: 10.4 (2.3)	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Newton 2006 / Reed 2008	I1: 32.9 (17.5)	I1: 4.7 (3.0)	I1: NR	I1: 14.0 (8.4)	I1: NR	I1: NR	I1: NR
	I2: 30.8 (21.0)	I2: 4.4 (3.0)	I2: NR	I2: 12.6 (7.7)	I2: NR	I2: NR	I2: NR
	I3: 32.2 (22.4)	I3: 4.6 (3.0)	I3: NR	I3: 13.3 (8.4)	I3: NR	I3: NR	I3: NR
	I4: 35.0 (30.8)	I4: 5.2 (4.6)	I4: NR	I4: 12.6 (7.0)	I4: NR	I4: NR	I4: NR
	C1: 30.1 (21.0)	C1: 4.3 (3.0)	C1: NR	C1: 13.3 (8.4)	C1: NR	C1: NR	C1: NR
	Total: 32.2 (21.7)	Total: NR	Total: NR	Total: 13.3 (8.4)	Total: NR	Total: NR	Total: NR
Oktem 2007	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Osmers 2005	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
	(median reported but no ranges)
Pockaj 2006	I1: NR	I1: 6.7 (3.7)	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: 6.2 (3.6)	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Stoll 1987	I1: 4.9 (‐)	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: 5.2 (‐)	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	C2: 5.1 (‐)	C2: NR	C2: NR	C2: NR	C2: NR	C2: NR	C2: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Wuttke 2003/2006a/2006b	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
C: control; I: intervention; NR: not recorded.

Table 3. Baseline characteristics B

Ir a la tabla de la revisión

Table 4. Baseline characteristics C

Study	Intensity of urogenital symptoms, mean (SD) (define symptoms and index/scale)	Menopausal symptom score, mean (SD) (define index/scale)	Quality of life, mean (SD) (define index/scale)	Sexuality, mean (SD) (define outcome measure)	Bone health, mean (SD) (define outcome measure)
Amsterdam 2009	I1: NR	I1: NR	I1: 112.4 (19.5) (PGWBI)	I1: NR	I1: NR
	C1: NR	C1: NR	C1: 115.2 (24.1) (PGWBI)	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Bai 2007	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: 24.7 (6.1) (KI)	Total: NR	Total: NR	Total: NR
Bebenek 2010	I1: NR	I1: 11.86 (4.71) (MRS)	I1: NR	I1: NR	I1: 0.97 (0.13) (BMD, lumbar)
					I1: 0.77 (0.10) (BMD, fem. head)
	I2: NR	I2: 10.84 (5.35) (MRS)	I2: NR	I2: NR	I2: 0.96 (0.12) (BMD, lumbar)
					I2: 0.76 (0.10) (BMD, fem. head)
	C1: NR	C1: 9.88 (3.48) (MRS)	C1: NR	C1: NR	C1: 0.99 (0.13) (BMD, lumbar)
					C1: 0.75 (0.11) (BMD, fem. head)
	Total: NR	Total: NR	Total: NR	Total: NR	Totals: NR
Carlisle 2008	I1: NR	I1: NR	I1: NR	I1: NR	I1: 10.65 (2.78) (serum osteocalcin, ng/mL)
					I1: 0.48 (0.25) (C‐terminal telopeptide, ng/mL)
	C1: NR	C1: NR	C1: NR	C1: NR	C1: 11.19 (4.16) (serum osteocalcin, ng/mL)
					C1: 0.56 (0.32) (C‐terminal telopeptide, ng/mL)
	Total: NR	Total: NR	Total: NR	Total: NR	Totals: NR
Frei‐Kleiner 2005	I1: NR	I1: 19.5 (7.9) (KI)	I1: NR	I1: NR	I1: NR
	C1: NR	C1: 19.0 (7.2) (KI)	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Geller 2009	I1: 0.8 (1.0)	I1: 18.2 (5.4)	I1: NR	I1: NR	I1: NR
	I2: 1.1 (1.0)	I2: 22.5 (8.1)	I2: NR	I2: NR	I2: NR
	I3: 0.7 (0.9)	I3: 19.2 (7.8)	I3: NR	I3: NR	I3: NR
	C1: 1.1 (0.9)	C1: 20.7 (6.6)	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
	(Vaginal dryness, 3‐point scale)
Jacobson 2001	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Kronenberg 2009	I1: NR	I1: 18.5 (8.8) (GCS)	I1: NR	I1: NR	I1: NR
	C1: NR	C1: 19.1 (9.6) (GCS)	C1: NR	C1: NR	C1: NR
	Total: NR	Total: 18.8 (9.2) (GCS)	Total: NR	Total: NR	Total: NR
Lehmann‐Willenbrock 1988	I1: NR	I1: 48.73 (8.72) (KI)	I1: NR	I1: NR	I1: NR
	C1: NR	C1: 49.12 (7.76) (KI)	C1: NR	C1: NR	C1: NR
	C2: NR	C2: 46.44 (8.18) (KI)	C2: NR	C2: NR	C2: NR
	C3: NR	C3: 47.84 (8.52) (KI)	C3: NR	C3: NR	C3: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Nappi 2005	I1: NR	I1: 7.5 (0.6) (GCS)	I1: NR	I1: NR	I1: NR
	C1: NR	C1: 8.0 (0.9) (GCS)	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Newton 2006 / Reed 2008	I1: NR	I1: 2.2 (1.2)	I1: NR	I1: NR	I1: NR
	I2: NR	I2: 2.2 (1.1)	I2: NR	I2: NR	I2: NR
	I3: NR	I3: 2.2 (1.2)	I3: NR	I3: NR	I3: NR
	I4: NR	I4: 2.1 (1.0)	I4: NR	I4: NR	I4: NR
	C1: NR	C1: 2.5 (1.2)	C1: NR	C1: NR	C1: NR
	Total: NR	Total: 2.3 (1.2)	Total: NR	Total: NR	Total: NR
Oktem 2007	I1: NR	I1: 25.1 (6.7) (mKI)	I1: NR	I1: NR	I1: NR
	C1: NR	C1: 25.2 (6.8) (mKI)	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Osmers 2005	I1: NR	I1: 0.35 (0.12) (MRS)	I1: NR	I1: NR	I1: NR
	C1: NR	C1: 0.35 (0.12) (MRS)	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Pockaj 2006	I1: NR	I1: NR	I1: NR	I1: NR	I1: NR
	C1: NR	C1: NR	C1: NR	C1: NR	C1: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Stoll 1987	I1: NR	I1: 34.4 (‐) (KI)	I1: NR	I1: 1.9 (‐) (NSC)	I1: NR
	C1: NR	C1: 34.0 (‐) (KI)	C1: NR	C1: 1.5 (‐) (NSC)	C1: NR
	C2: NR	C2: 31.0 (‐) (KI)	C2: NR	C2: 1.6 (‐) (NSC)	C2: NR
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
Wuttke 2003/2006a/2006b	I1: NR	I1: 2.73 (0.52) (MRS)	I1: NR	I1: NR	I1: 0.25 (0.2) (CrossLaps, ng/mL)
	C1: NR	C1: 2.83 (0.51) (MRS)	C1: NR	C1: NR	C1: 0.24 (0.12) (CrossLaps, ng/mL)
	C2: NR	C2: 3.23 (1.0) (MRS)	C2: NR	C2: NR	C2: 0.25 (1.6) (CrossLaps, ng/mL)
	Total: NR	Total: NR	Total: NR	Total: NR	Total: NR
BMD: bone mineral density; C: control; GCS: Greene Climacteric Scale; I: intervention; KI: Kupperman Index; MDP: medroxyprogesterone; mKI: Modified Kupperman index; MRS: Menopause Rating Scale; NR: not recorded; NSC: number of sexual complaints; PGWBI: Psychological General Wellbeing Index; WMSS: = Wiklund Menopause Symptom Score.

Table 4. Baseline characteristics C

Ir a la tabla de la revisión

Table 5. Adverse effects A

Study	Interventions	Participants who died (n)	Adverse events (n, %)	Serious adverse events (n, %)
Amsterdam 2009	I1: black cohosh	I1: NR	I1: 14 (93%)	I1: 1 (7%)
	C1: placebo	C1: NR	C1: 8 (62%)	C1: 0 (0%)
		Total: NR	Total: 22 (78%)	Total: 1 (4%)
Bai 2007	I1: black cohosh	I1: 0	I1: 139 (‐)	I1: 0 (0%)
	C1: tibolone	C1: 0	C1: 253 (‐)	C1: 1 (0.8%)
		Total: 0	Total: 392 (‐)	Total: 1 (0.4%)
Bebenek 2010	I1: exercise + black cohosh	I1: NR	I1: 0 (0%)	I1: NR
	I2: exercise only	I2: NR	I2: 0 (0%)	I2: NR
	C1: wellness control	C1: NR	C1: 0 (0%)	C1: NR
		Total: NR	Total: 1 (1%)	Total: NR
Carlisle 2008	I1: black cohosh + calcium and vitamin D supplement	I1: NR	I1: NR	I1: NR
	C1: placebo + calcium and vitamin D supplement	C1: NR	C1: NR	C1: NR
Frei‐Kleiner 2005	I1: black cohosh	I1: NR	I1: 17 (20%)	I1: NR
	C1: placebo	C1: NR	C1: 10 (23%)	C1: NR
		Total: NR	Total: 27 (21%)	Total: NR
Geller 2009	I1: black cohosh	I1: NR	I1: NR	I1: NR
	I2: red clover	I2: NR	I2: NR	I2: NR
	I3: conjugated oestrogen + MDP	I3: NR	I3: NR	I3: NR
	C1: placebo	C1: NR	C1: NR	C1: NR
		Total: NR	Total: NR	Total: NR
Jacobson 2001	I1: black cohosh	I1: NR	I1: 10 (24%)	I1: 2 (5%)
	C1: placebo	C1: NR	C1: 3 (7%)	C1: 1 (2%)
		Total: NR	Total: 13 (15%)	Total: 3 (4%)
Kronenberg 2009	I1: black cohosh	I1: NR	I1: 19 (31%)	I1: 0 (0%)
	C1: placebo	C1: NR	C1: 34 (50%)	C1: 0 (0%)
		Total: NR	Total: 53 (41%)	Total: 0 (0%)
Lehmann‐Willenbrock 1988	I1: black cohosh	I1: NR	I1: NR	I1: NR
	C1: oestriol	C1: NR	C1: NR	C1: NR
	C2: conjugated oestrogen	C2: NR	C2: NR	C2: NR
	C3: oestradiol/ norethisterone acetate	C3: NR	C3: NR	C3: NR
		Total: NR	Total: NR	Total: NR
Nappi 2005	I1: black cohosh	I1: NR	I1: 0 (0%)	I1: NR
	C1: oestradiol + dihydrogesterone	C1: NR	C1: 2 (6%)	C1: NR
		Total: NR	Total: 2 (3%)	Total: NR
Newton 2006 / Reed 2008	I1: black cohosh	I1: NR	I1: 57 (NR)	I1: 0 (0%)
	I2: multi‐botanical	I2: NR	I2: 44 (NR)	I2: 1 (1%)
	I3: mult‐ibotanical + dietary soy	I3: NR	I3: 57 (NR)	I3: 1 (1%)
	I4: conjugated oestrogen + MDP	I4: NR	I4: 41 (NR)	I4: 0 (0%)
	C1: placebo	C1: NR	C1: 67 (NR)	C1: 0 (0%)
		Total: NR	Total: 266 (NR)	Total: 2 (0.6%)
Oktem 2007	I1: black cohosh	I1: NR	I1: 7 (18%)	I1: NR
	C1: fluoxetine	C1: NR	C1: 13 (33%)	C1: NR
		Total: NR	Total: 20 (25%)	Total: NR
Osmers 2005	I1: black cohosh	I1: NR	I1: 71 (33%)	I1: 0 (0%)
	C1: placebo	C1: NR	C1: 67 (31%)	C1: 0 (0%)
		Total: NR	Total: 138 (45%)	Total: 0 (0%)
Pockaj 2006	I1: black cohosh	I1: NR	I1: NR	I1: NR
	C1: placebo	C1: NR	C1: NR	C1: NR
		Total: NR	Total: NR	Total: NR
Stoll 1987	I1: black cohosh	I1: NR	I1: NR	I1: NR
	C1: oestrogen	C1: NR	C1: NR	C1: NR
	C2: placebo	C2: NR	C2: NR	C2: NR
		Total: NR	Total: NR	Total: NR
Wuttke 2003/2006a/2006b	I1: black cohosh	I1: NR	I1: 6 (15%)	I1: 0 (0%)
	C1: conjugated oestrogens	C1: NR	C1: 8 (18%)	C1: 0 (0%)
	C2: placebo	C2: NR	C2: 6 (15%)	C2: 0 (0%)
		Total: NR	Total: 20 (32%)	Total: 0 (0%)
C: control; I: intervention; NR: not recorded.

Table 5. Adverse effects A

Ir a la tabla de la revisión

Table 6. Adverse effects B

Study	Interventions	Left study because of adverse events (n, %)	Hospitalised (n, %)	Symptoms reported (n, %)	Notes
Amsterdam 2009	I1: black cohosh	I1: 1 (7%)	I1: NR	I1: light headedness (2, 15%), difficulty falling asleep (2, 15%), dry mouth (1, 8%), diaphoresis (1, 8%), pain (1, 8%), oedema, GI bloating (1, 8%), diarrhoea (1, 8%), abdominal cramping (1, 8%), vaginal bleeding (1, 8%), mid‐night wakening (1, 8%), anxiety (1, 8%).
	C1: placebo	C1: 0 (0%)	C1: NR	C1: menstrual flow (2, 15.4%), irritability (1, 8%), listlessness (1, 8%), flu symptoms (1, 8%), breast tenderness (1, 8%), constipation (1, 8%), vaginal spotting (1, 8%).
		Total: 1 (4%)	Total: NR
Bai 2007	I1: black cohosh	I1: 5 (6%)	I1: NR	I1: breast pain/enlargement (32, 21%), abdominal pain (12, 10%), vaginal bleeding (6, 5%), vaginal spotting (11, 7%), oedema (7, 5%), leucorrhoea (7, 6%)
	C1: tibolone	C1: 9 (7%)	C1: NR	C1: breast pain/enlargement (48, 35%), vaginal bleeding (40, 23%), abdominal pain (30, 24%), leucorrhoea (27, 18%), vaginal spotting (21, 13%), oedema (17, 12%)
		Total: 14 (6%)	Total: NR
Bebenek 2010	I1: exercise + black cohosh	I1: NR	I1: NR	I1: NR
	I2: exercise only	I2: NR	I2: NR	I2: NR
	C1: wellness control	C1: NR	C1: NR	C1: NR
		Total: NR	Total: NR
Carlisle 2008	I1: black cohosh + calcium and vitamin D supplement	I1: NR	I1: NR	I1: NR
	C1: placebo + calcium and vitamin D supplement	C1: NR	C1: NR	C1: NR
Frei‐Kleiner 2005	I1: black cohosh	I1: NR	I1: NR	I1: NR
	C1: placebo	C1: NR	C1: NR	C1: NR
		Total: NR	Total: NR
Geller 2009	I1: black cohosh	I1: 0 (0%)	I1: NR	I1: NR
	I2: red clover	I2: 0 (0%)	I2: NR	I2: NR
	I3: conjugated oestrogen + MDP	I3: 1 (4%)	I3: NR	I3: NR
	C1: placebo	C1: 0 (0%)	C1: NR	C1: NR
		Total:	Total: NR
Jacobson 2001	I1: black cohosh	I1: 3 (7%)	I1: NR	I1: hysterectomy (1, 2%), breast cancer recurrence (1, 2%), constipation (1, 2%), arrhythmia (1, 2%), weight gain (1, 2%), endometrial hyperplasia (1, 2%), dilatation and curettage (1, 2%), cramping (1, 2%), indigestion (1, 2%), vaginal bleeding (1, 2%)	The majority of participants were also taking tamoxifen
	C1: placebo	C1: 1 (2%)	C1: NR	C1: appendectomy (1, 2%), swollen finger (1, 2%), abdominal rash (1, 2%)
		Total: 4 (5%)	Total: NR
Kronenberg 2009	I1: black cohosh	I1: NR	I1: NR	I1: upper respiratory infection (5, 8%), skin complaints (4, 7%), vaginal bleeding (4, 7%), vaginitis (1, 2%), abnormal ECG (2, 3%), increased endometrial thickness (3, 5%)
	C1: placebo	C1: NR	C1: NR	C1: upper respiratory infection (12, 18%), skin complaints (11, 16%), vaginitis (4, 6%), abnormal ECG (3, 4%), elevated liver enzymes (2, 3%), vaginal bleeding (1, 2%), increased endometrial thickness (1, 2%)
		Total: NR	Total: NR
Lehmann‐Willenbrock 1988	I1: black cohosh		I1: NR	I1: NR
	C1: oestriol	C1: NR	C1: NR	C1: NR
	C2: conjugated oestrogen	C2: NR	C2: NR	C2: NR
	C3: oestradiol/ norethisterone acetate	C3: NR	C3: NR	C3: NR
		Total: NR	Total: NR
Nappi 2005	I1: black cohosh	I1: NR	I1: NR	I1: NA
	C1: oestradiol + dihydrogesterone	C1: NR	C1: NR	C1: vaginal spotting (2, 6%)
		Total: NR	Total: NR
Newton 2006 / Reed 2008	I1: black cohosh	I1: NR	I1: NR	I1: menstrual disorders (10, NR), GI upset (12, NR), headache (12, NR), fatigue (12, NR), myalgia / arthralgia (11, NR)
	I2: multi‐botanical	I2: NR	I2: NR	I2: menstrual disorders (8, NR), breast discomfort (1, NR), GI upset (11, NR), headache (8, NR), fatigue (7, NR), myalgia / arthralgia (9, NR)
	I3: mult‐ibotanical + dietary soy	I3: NR	I3: NR	I3: menstrual disorders (14, NR), breast discomfort (2, NR), GI upset (8, NR), headache (12, NRI4: menstrual disorders (19, NR), breast discomfort (5, NR), GI upset (4, NR), headache (6, NR), fatigue (6, NR), myalgia / arthralgia (1, NR)), fatigue (12, NR), myalgia / arthralgia (9, NR)
	I4: conjugated oestrogen + MDP	I4: NR	I4: NR	I4: menstrual disorders (19, NR), breast discomfort (5, NR), GI upset (4, NR), headache (6, NR), fatigue (6, NR), myalgia / arthralgia (1, NR)
	C1: placebo	C1: NR	C1: NR	C1: menstrual disorders (17, NR), headache (16, NR), GI upset (13, NR), myalgia / arthralgia (10, NR), fatigue (8, NR), breast discomfort (3, NR)
		Total: NR	Total: NR
Oktem 2007	I1: black cohosh	I1: NR	I1: NR	I1: dyspepsia (2, 5%), constipation (2, 5%), tiredness (1, 3%), skin allergy (1, 3%), irritability (1, 3%)
	C1: fluoxetine	C1: NR	C1: NR	C1: dyspepsia (1, 3%), constipation (1, 3%), sleep disturbance (3, 8%), dry mouth (2, 5%), tiredness (2, 5%), skin allergy (2, 5%), irritability (1, 3%), headache (1, 3%)
		Total: NR	Total: NR
Osmers 2005	I1: black cohosh	I1: 7 (5%)	I1: NR	I1: musculoskeletal disorder (15, 10%) infection (13, 9%), GI disorder (8, 5%), nervous system disorder (4, 3%), reproductive / breast disorder (4, 3%), skin disorder (3, 2%), psychiatric disorder (2, 1%), tachycardia (2, 1%), metabolic / nutrition disorder (2, 1%), blood disorder (1, 1%), renal/urinary disorder (1, 1%), vascular disorder (1, 1%)
	C1: placebo	C1: 5 (3%)	C1: NR	C1: infection (19, 13%), musculoskeletal disorder (10, 7%) GI disorder (7, 5%), nervous system disorder (5, 3%), psychiatric disorder (5, 3%), reproductive / breast disorder (4, 3%), skin disorder (3, 2%), blood disorder (1, 1%), ear/labyrinth disorder (1, 1%), vascular disorder (1, 1%), respiratory disorder (1, 1%)
		Total: 12 (4%)	Total: NR
Pockaj 2006	I1: black cohosh	I1: NR	I1: NR	I1: NR
	C1: placebo	C1: NR	C1: NR	C1: NR
		Total: NR	Total: NR
Stoll 1987	I1: black cohosh	I1: 1 (3%)	I1: NR	I1: NR
	C1: oestrogen	C1: 2 (7%)	C1: NR	C1: NR
	C2: placebo	C2: 2 (10%)	C2: NR	C2: NR
		Total: 5 (6%)	Total: NR
Wuttke 2003/2006a/2006b	I1: black cohosh	I1: 0 (0%)	I1: NR	I1: vaginal spotting (3, 15%), vertigo (1, 5%), hypertension (1, 5%), headache (1, 5%), bronchitis (1, 5%), rhinitis (1, 5%), viral infection (1, 5%)
	C1: conjugated oestrogens	C1: 0 (0%)	C1: NR	C1: bronchitis (2, 9%), toothache (2, 9%), vaginal spotting (1, 5%), diarrhoea (1, 5%), dermatitis (1, 5%), viral infection (1, 5%), elevated ALT (1, 5%)
	C2: placebo	C2: 0 (0%)	C2: NR	C2: vaginal spotting (2, 10%), hyperglycaemia (1, 5%), arthritis (1, 5%), local skin reaction (1, 5%), rhinitis (1, 5%), back pain (1, 5%), breast pain (1, 5%)
		Total: 0 (0%)	Total: NR
C: control; GI: gastrointestinal; I: intervention; MDP: medroxyprogesterone; NR: not recorded.

Table 6. Adverse effects B

Ir a la tabla de la revisión

Comparison 1. Black cohosh versus placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Vasomotor symptoms: daily hot flush frequency Show forest plot	3	393	Mean Difference (IV, Fixed, 95% CI)	0.07 [‐0.43, 0.56]

2 Vasomotor symptoms: weekly hot flush frequency Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Vasomotor symptoms: hot flush intensity Show forest plot	3	214	Mean Difference (IV, Fixed, 95% CI)	0.12 [‐0.06, 0.30]

4 Vasomotor symptoms: night sweats Show forest plot	1	164	Mean Difference (IV, Fixed, 95% CI)	0.27 [‐0.16, 0.70]

4.1 Night sweat frequency per day	1	164	Mean Difference (IV, Fixed, 95% CI)	0.27 [‐0.16, 0.70]
5 Menopausal Symptom Score Show forest plot	4	357	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐0.32, 0.11]

5.1 Kupperman Index	2	165	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.02 [‐0.34, 0.30]
5.2 Greene Climacteric Scale	1	28	Std. Mean Difference (IV, Fixed, 95% CI)	0.43 [‐0.32, 1.18]
5.3 Wiklund Menopause Symptom Score	1	164	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.27 [‐0.58, 0.04]
6 Adverse events Show forest plot	2	344	Risk Ratio (M‐H, Fixed, 95% CI)	1.04 [0.82, 1.32]

Comparison 1. Black cohosh versus placebo

Ir a la tabla de la revisión

Comparison 2. Black cohosh versus hormone therapy

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Vasomotor symptoms: daily hot flush frequency Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Vasomotor symptoms: weekly hot flush frequency Show forest plot	1	44	Mean Difference (IV, Fixed, 95% CI)	26.42 [18.59, 34.25]

3 Vasomotor symptoms: hot flush intensity Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4 Vasomotor symptoms: night sweats Show forest plot	1	112	Mean Difference (IV, Fixed, 95% CI)	0.93 [0.47, 1.39]

4.1 Night sweat frequency per day	1	112	Mean Difference (IV, Fixed, 95% CI)	0.93 [0.47, 1.39]
5 Menopausal Symptom Score Show forest plot	5	468	Std. Mean Difference (IV, Fixed, 95% CI)	0.32 [0.13, 0.51]

5.1 Kupperman Index	3	312	Std. Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.02, 0.43]
5.2 Greene Climacteric Scale	1	44	Std. Mean Difference (IV, Fixed, 95% CI)	0.25 [‐0.37, 0.87]
5.3 Wiklund Menopause Symptom Score	1	112	Std. Mean Difference (IV, Fixed, 95% CI)	0.77 [0.35, 1.19]
6 Adverse events Show forest plot	1	42	Risk Ratio (M‐H, Fixed, 95% CI)	0.83 [0.21, 3.24]

Comparison 2. Black cohosh versus hormone therapy

Ir a la tabla de la revisión

Comparison 3. Black cohosh versus red clover

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Vasomotor symptoms: hot flush frequency Show forest plot	1	49	Mean Difference (IV, Fixed, 95% CI)	9.38 [‐1.04, 19.80]

2 Vasomotor symptoms: hot flush intensity Show forest plot	1	50	Mean Difference (IV, Fixed, 95% CI)	0.42 [‐0.08, 0.92]

3 Menopausal score Show forest plot	1	51	Mean Difference (IV, Fixed, 95% CI)	‐1.28 [‐5.48, 2.92]

Comparison 3. Black cohosh versus red clover

Ir a la tabla de la revisión

Comparison 4. Black cohosh versus fluoxetine

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Vasomotor symptoms: night sweats Show forest plot	1	80	Mean Difference (IV, Fixed, 95% CI)	‐85.0 [‐132.50, ‐37.50]

1.1 Night sweat score per month	1	80	Mean Difference (IV, Fixed, 95% CI)	‐85.0 [‐132.50, ‐37.50]
2 Menopausal score Show forest plot	1	80	Mean Difference (IV, Fixed, 95% CI)	‐5.5 [‐8.86, ‐2.14]

2.1 Kupperman Index	1	80	Mean Difference (IV, Fixed, 95% CI)	‐5.5 [‐8.86, ‐2.14]

Comparison 4. Black cohosh versus fluoxetine

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet