Effectiveness and Safety of Cimicifuga Racemosa and Blackberry Compared to Soy Isoflavone for the Treatment of Climacteric Symptoms: An Overview of Systematic Reviews

The female reproductive phase ends with climacteric syndrome, marked by hormonal variations (progesterone/estrogen). Cimicifuga racemosa (CR), Morus nigra (MN), and soy isoflavones (SI) have emerged as complementary treatments, potentially reducing symptoms. However, evidence gaps persist regarding the effectiveness and safety of CR and MN, necessitating a systematic review. Objectives: To compare the effectiveness and safety of CR or MN with SI in managing climacteric syndrome. Study design: A review of systematic reviews was conducted, structured using the PICO acronym. Searches were performed in March 2024 across Medline via PubMed, Web of Science, Cochrane, Embase, Lilacs, and grey literature. The study was registered in PROSPERO, adhering to PRISMA 2020 guidelines. Titles and abstracts were screened, followed by full-text reviews by two independent reviewers. Methodological quality was assessed with AMSTAR-2. Results: Of 1,291 records, 27 studies underwent full-text review, but none were included. Variability in dosages, SI formulations, and the frequent use of placebo comparators precluded synthesis of safety and effectiveness for CR or MN versus SI. Conclusion: Despite substantial scientific interest in herbal treatments for climacteric syndrome, comparative evidence on CR, MN, and SI remains unavailable. This gap limits evidence-based decision-making for managing climacteric symptoms.