Extrakte aus Cimicifuga racemosa – eine Behandlungsalternative bei Beschwerden in den Wechseljahren

Zusammenfassung

Der Einsatz von Pflanzenextrakten bei Wechseljahresbeschwerden hat zunehmend an Bedeutung gewonnen, wobei die Mehrzahl der Extrakte (Rotklee, Hopfen, Soja und daraus gewonnene Isoflavonpräparate) ihre Wirkungen, zumindest teilweise, über die Bindung an Östrogenrezeptoren erreichen. Die klinische Relevanz dieser Extrakte (»Phytoöstrogene«) ist nicht unumstritten. Wegen der Aktivierung von Östrogenrezeptoren kann mit ihrem Einsatz die Stimulation östrogensensitiver Geschwülste erfolgen. Abgegrenzt von der Gruppe der Phytoöstrogene ist der Extrakt aus Cimicifuga racemosa zu bewerten. Seine Wirkungen auf die psychischen und vegetativen Befindlichkeiten während der Wechseljahre sind klinisch belegt; sie werden überwiegend über das Zentralnervensystem vermittelt. Durch Östrogen stimuliertes Tumorwachstum wird sogar unterdrückt. Eine mit der klinischen Wirksamkeit verbundene Inhaltsstoffgruppe sind Triterpenglykoside. Es gibt Hinweise, dass mit einer Erhöhung des Gehalts an Triterpenglykosiden im Extrakt auch dessen klinische Wirksamkeit gesteigert wird.

Summary

Preparations from Cimicifuga racemosa for alternative treatment of menopausal complaints

The period of menopause is characterized by hormonal changes in the female body. The related complaints are temporary and in the most cases therapeutic intervention is not necessary. If the complaints are however heavy, a hormone replacement therapy might be an option. But such kind of therapy should be timely limited. Another option is the administration of psychoactive substances, especially anti-depressives. Herbs have gained increasing attention for treatment of menopausal complaints. Most of them (e.g. red clover, hops, soya, and their special preparations) activate, at least partially, oestrogen receptors. The clinical relevance of these herbs, which are summarized as phytoestrogens, is not unequivocal. Activation of the oestrogen receptors might induce growth of hormone sensitive tumours. Beside phytoestrogens, extracts prepared form Cimicifuga racemosa L. (black cohosh) are clinically effective. This effectiveness is mediated by central nervous processes and not by stimulation of the oestrogen receptors. In fact even oestrogen stimulated tumour growth becomes effectively inhibited by black cohosh extracts. The clinically proven efficacy to overcome psychological and vegetative complaints related to menopause is generally accepted. Triterpene glykosides are considered active principles within the extract and there are hints, that the clinical efficacy will be positively correlated with the content of the Triterpene glykosides.

Schlüsselwörter

Wechseljahre - alternative Behandlungen - Traubensilberkerze - Cimicifuga racemosa (L.) Nutt. - Ranunculaceae - Triterpenglykoside

Key words

Cimicifuga racemosa (L.) Nutt. - black cohosh - menopausal complaints - alternative treatment

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Online

http://dx.doi.org/10.1055/s-0030-1262408