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Exercise Works to Protect Bones; Black Cohosh Doesn’t JUNE 2010 Postmenopausal women can protect their bones by exercising, but adding black cohosh—an herbal supplement thought to have estrogen-like effects—to exercise confers no extra protection. That’s the conclusion of a year-long clinical trial involving 128 women who recently went through menopause. Michael Bebenek of the University of Erlangen and colleagues randomly assigned 86 women to a vigorous exercise program that interspersed six weeks of high-impact aerobics and strength training with 10-week intervals of more moderate activity such as brisk walking and step aerobics. The rest of the women joined a “wellness” group that performed only less-strenuous activities including light walking and balancing and stretching exercise for one hour a week; this 10-week regimen alternated with 10 weeks of no exercise at all. Half of the exercise group also received daily 40-milligram doses of black cohosh (Cimicifuga racemosa), an herb touted as a “natural” form of hormone replacement therapy. Black cohosh has been promoted for relief of hot flashes and other meno - pause symptoms. Last year, an evidence review found mixed results in seven trials of black cohosh for menopause symptoms, but warned that women using it should be aware of the potential risk of liver toxicity. Bebenek and colleagues stated that they believe theirs is the first clinical trial to test black cohosh for benefits on bone density. After a year, women in the exercise group showed no significant decline in bone density at the spine and a slight increase in bone mass at the hip; those in the black cohosh subgroup saw no added benefit from the herb. Women in the wellness group, by comparison, saw declines in both measures of bone density. Researchers also measured changes in the women’s estimated risk of suffering a heart attack or dying of heart disease. “Our exercise program favorably affected bone, menopausal symptoms, lean body mass, and, to a smaller extent, 10-year coronary heart disease risk in early postmenopausal women,” Bebenek and colleagues concluded. Supplementation with black cohosh, they added, did not enhance these benefits. TO LEARN MORE: Menopause, online before print; abstract at dx.doi.org/10.1097/gme. 0b013e3181cc4a00.

Exercise Works to Protect Bones; Black Cohosh Doesn’t

JUNE 2010

Postmenopausal women can protect their bones by exercising, but adding black cohosh—an herbal supplement thought to have estrogen-like effects—to exercise confers no extra protection. That’s the conclusion of a year-long clinical trial involving 128 women who recently went through menopause.

Michael Bebenek of the University of Erlangen and colleagues randomly assigned 86 women to a vigorous exercise program that interspersed six weeks of high-impact aerobics and strength training with 10-week intervals of more moderate activity such as brisk walking and step aerobics. The rest of the women joined a “wellness” group that performed only less-strenuous activities including light walking and balancing and stretching exercise for one hour a week; this 10-week regimen alternated with 10 weeks of no exercise at all.

Half of the exercise group also received daily 40-milligram doses of black cohosh (Cimicifuga racemosa), an herb touted as a “natural” form of hormone replacement therapy. Black cohosh has been promoted for relief of hot flashes and other meno - pause symptoms. Last year, an evidence review found mixed results in seven trials of black cohosh for menopause symptoms, but warned that women using it should be aware of the potential risk of liver toxicity. Bebenek and colleagues stated that they believe theirs is the first clinical trial to test black cohosh for benefits on bone density.

After a year, women in the exercise group showed no significant decline in bone density at the spine and a slight increase in bone mass at the hip; those in the black cohosh subgroup saw no added benefit from the herb. Women in the wellness group, by comparison, saw declines in both measures of bone density.

Researchers also measured changes in the women’s estimated risk of suffering a heart attack or dying of heart disease.

“Our exercise program favorably affected bone, menopausal symptoms, lean body mass, and, to a smaller extent, 10-year coronary heart disease risk in early postmenopausal women,” Bebenek and colleagues concluded.

Supplementation with black cohosh, they added, did not enhance these benefits.

TO LEARN MORE: Menopause, online before print; abstract at dx.doi.org/10.1097/gme. 0b013e3181cc4a00.