Systematic Review of Black Cohosh (Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility

source extracted confidence: high 2026-04-09
#pregnancy #female #humans #polycystic-ovary-syndrome #cimicifuga

Systematic Review of Black Cohosh (Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility

Fan et al., 2022 | J Pharm Pract | Systematic Review

Citation

Fan Chi Wai, Cieri-Hutcherson Nicole E, Hutcherson Timothy C. Systematic Review of Black Cohosh (Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility. J Pharm Pract. 2022-Dec;35(6):991-999. doi:10.1177/08971900211012244

Abstract

Polycystic ovary syndrome (PCOS) is a common cause of female infertility. To conduct a systematic review assessing the efficacy and safety of black cohosh for ovulation-induction through hormone regulation and increased endometrial thickness to improve pregnancy rates in women with PCOS-related infertility. Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used. A search of Medline, Embase, International Pharmaceutical Abstracts, Science Direct, and Cumulative Index of Nursing and Allied Health Literature spanning origin to December 19, 2020 was conducted using keywords and permutations of "black cohosh" and "PCOS." A search for "PCOS" in the National Clinical Trials database and International Clinical Trials Registry Platform was conducted in December 2020 to identify additional records. Eligibility criteria included reported efficacy or safety outcomes; studies in women with PCOS; English language; and primary literature. Eligible records were evaluated using applicable risk-of-bias tools. A total of 181 records were screened after deduplication from 207 results. Two randomized controlled trials (RCT) met inclusion criteria. Review of 1386 records from clinical trial registries and subsequent scoping searches resulted in identification of 4 additional records (3 published). Improvement in hormone regulation and endometrial thickness were found for black cohosh groups compared to clomiphene citrate (CC). Three RCTs reported improved pregnancy rates using black cohosh plus CC. There were no differences in adverse events. Studies demonstrated several risk-of-bias concerns. There is a lack of high-quality evidence supporting the effectiveness of black cohosh for improving pregnancy rates in PCOS-related infertility. Short-term use of black cohosh appears to be safe.

Key Findings

Short-term use of black cohosh appears to be safe.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Pregnancy
  • Female
  • Humans
  • Polycystic Ovary Syndrome
  • Cimicifuga
  • Fertility Agents, Female
  • Clomiphene
  • Infertility, Female
  • Pharmaceutical Preparations
  • Hormones

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article
  • Vertical: black-cohosh

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09