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TriStar Centennial Medical Center

Natural and Alternative Treatment Study Report: Menopausal Symptoms: The Benefits of St. John's Wort Combined With Black Cohosh

Image for menopause article In 2002, evidence from the Women’s Health Initiative study showed that hormone replacement therapy does not protect against heart disease (as previously thought) and, furthermore, can have serious adverse consequences. Use of hormone replacement therapy has drastically declined since that time, and women have been eager to find alternative therapies for their menopausal symptoms.

The herb black cohosh is one of the prime candidates. Although study results have not been consistent, there is considerable promising evidence that extracts of black cohosh can improve hot flashes and perhaps other symptoms of menopause.

Another herb is a logical candidate: St. John’s wort. Psychological disturbances are common in menopause, and standard antidepressant drugs have been found helpful. Because a very large body of evidence shows that St. John’s wort is as effective as standard antidepressants for the treatment of all but the most severe forms of depression, it is reasonable to assume that St. John’s wort might be useful for depression caused by menopause as well. For this reason, researchers have tested formulations containing proprietary formulations that combine extracts of both black cohosh and St. John’s wort.

In 2006, German researchers published the results of a double-blind study that enrolled 301 women experiencing depression as part of their overall menopausal symptoms. The results showed that use of a proprietary black cohosh / St. John’s wort combination treatment was significantly more effective than placebo for both problems.

A subsequent double-blind, placebo-controlled study, published in April of 2007, tested a similar formulation of black cohosh and St. John’s wort in 89 women with general menopausal symptoms. The results, as reported by these Korean researchers, indicated improvements in hot flashes as well as overall menopause symptom scores. In addition, the combination therapy appeared to raise levels of HDL (“good”) cholesterol, an unexpected benefit.

For more information, including dosage and safety issues, see the full black cohosh , St. John’s wort , and menopause articles.

  • Chung DJ, Kim HY, Park KH, et al. Black cohosh and St. John's Wort (GYNO-Plus(R)) for climacteric symptoms. Yonsei Med J . 2007;48:289-94.

  • Uebelhack R, Blohmer JU, Graubaum HJ, et al. Black cohosh and St. John's Wort for climacteric complaints: a randomized trial. Obstet Gynecol . 2006;107:247-55.

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