Effect of cimicifuga racemosa on menopausal syndrome caused by LHRH-a in breast cancer

J Ethnopharmacol. 2019 Jun 28;238:111840. doi: 10.1016/j.jep.2019.111840. Epub 2019 Mar 29.


Ethnopharmacological relevance: Cimicifuga racemose is previously proved effective on nature menopausal syndrome (MPS). However, its clinical value in treating with MPS induced by luteinizing-hormone releasing hormone analogue (LHRH-a) therapy of pre-/peri-menopausal breast cancer patients is still unknown.

Aim of study: This perspective randomised-design study is to investigate the effect and safety of cimicifuga racemosa on MPS induced by LHRH-a in breast cancer (clinical trial registered: NCT03339882).

Materials and methods: Breast cancer patients planning for LHRH-a treatment were randomly divided into 2 groups. The control group which was being treated with the standard treatment of LHRH-a. The other group was being treated with Remifemin, the commercialized product of cimicifuga racemose extract, combined with LHRH-a, called Remifemin group. Our main endpoint was Kupperman menopause index (KMI). Hormone levels in peripheral blood and gynecological complications were also evaluated.

Results: Totally, 85 patients (42 in Remifemin group and 43 in control group) were enrolled in Zhejiang Cancer Hospital. At the 4th, 8th and 12th week after using LHRH-a, the KMI were all significantly lower in Remifemin group than in control group (P < 0.01), while the hormone levels, including estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were similar in the two groups. In addition, the incidence of cervical cyst in Remifemin group was higher than that in control group (P = 0.02), and there was no significant difference in the other gynecological complications, including endometrial thickening, ovarian cyst or uterine fibroid (P > 0.05).

Conclusions: Cimicifuga racemose is effective, oncological safe and reliable for treatment of MPS caused by LHRH-a in breast cancer.

Keywords: Breast cancer; Cimicifuga racemosa; Luteinizing-hormone releasing hormone analogue; Menopause syndrome.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Breast Neoplasms / drug therapy*
  • Cimicifuga
  • Female
  • Gonadotropin-Releasing Hormone / adverse effects*
  • Humans
  • Menopause, Premature / drug effects*
  • Phytotherapy
  • Plant Extracts / therapeutic use*
  • Syndrome


  • Plant Extracts
  • Remifemin
  • Gonadotropin-Releasing Hormone

Associated data

  • ClinicalTrials.gov/NCT03339882