Schwabe Pharma MenoHerb
Schwabe Pharma positions MenoHerb as a traditional herbal remedy for hot flushes, night sweats, and temporary mood changes including nervous irritability and restlessness. While recent research suggests black cohosh may offer some benefit for overall menopausal symptoms and hot flushes, the evidence paints a more nuanced picture than the product's traditional use claims might imply.
The 2023 meta-analysis does show significant improvements in overall menopausal symptoms and hot flushes with black cohosh, but these effects are modest, and the ingredient does not appear to help with anxiety or depressive symptoms, which contrasts with claims about mood related relief.
The product contains an isopropanolic black cohosh extract, a specific form that shows the most promising evidence, though results remain mixed across the broader research landscape.
What's in it
MenoHerb is a traditional herbal medicine containing 6.5mg of black cohosh root and rhizome extract (equivalent to 29.25 to 55.25mg of the dried herb) per tablet. Black cohosh is a perennial plant native to North America that has been used for centuries in traditional medicine for female health concerns. The product is registered under the UK's Traditional Herbal Registration Scheme and manufactured to pharmaceutical standards.
What MenoHerb claims
Schwabe Pharma describes MenoHerb as:
"A traditional herbal medicinal product used for the relief of symptoms of the menopause such as hot flushes, night sweats and temporary changes in mood, based on traditional use only."
The brand emphasises that the product is:
"Traditionally used for hot flushes, night sweats and temporary mood changes"
More specifically, the product information states that MenoHerb is used for relief of:
"temporary changes in mood (such as nervous irritability and restlessness)"
Schwabe Pharma stresses that MenoHerb has been "assessed by the MHRA" and meets required standards of safety and quality. The brand positions black cohosh as having been "used for centuries by Native Americans for a wide range of female health concerns" and frames the product as providing "natural herbal remedy for the menopause."
What the evidence actually shows
Black cohosh for hot flushes and overall menopausal symptoms
The evidence for black cohosh has evolved considerably over the past decade. A 2012 Cochrane review of 16 RCTs involving 2027 women found no significant difference between black cohosh and placebo for hot flush frequency or menopausal symptom scores, concluding that there was insufficient evidence to support its use [1]. This earlier systematic review represents the most rigorous type of evidence synthesis and suggested black cohosh was no better than placebo.
However, an updated 2023 meta-analysis of 22 RCTs involving 2310 women demonstrated significant improvements in overall menopausal symptoms compared to placebo, with a moderate effect size [2]. This same analysis found significant, though more modest, improvements specifically for hot flashes and somatic symptoms (physical symptoms such as sweating, heart palpitations, and sleep disturbances) [2]. Women taking black cohosh were as likely to continue treatment as those on placebo, suggesting the herb is well tolerated [2].
A 2020 systematic review of the isopropanolic black cohosh extract (the specific form used in MenoHerb) in over 13,000 women showed significant superiority over placebo for neurovegetative symptoms (like hot flushes and night sweats) and psychological symptoms, with larger benefits seen at higher doses [3]. This is particularly relevant because MenoHerb contains this specific extract type.
The discrepancy between the 2012 and 2023 findings likely reflects the inclusion of newer, better quality studies and the analysis of specific extract types rather than pooling all black cohosh products together.
Black cohosh for mood symptoms
Schwabe's claim that MenoHerb addresses "temporary changes in mood (such as nervous irritability and restlessness)" is only partially supported by the evidence. The 2023 meta-analysis found that black cohosh did not significantly affect anxiety or depressive symptoms [2]. While the 2020 review of isopropanolic extract suggested benefits for "psychological symptoms," this was a broader category that included neurovegetative symptoms, not mood disorders specifically [3].
A combination product containing black cohosh alongside soy isoflavone, chasteberry, and evening primrose oil did significantly reduce depressed mood and irritability in a 12 week study of 101 postmenopausal women [5]. However, because this was a combination formula, it is impossible to determine whether black cohosh contributed to these mood benefits or whether other ingredients were responsible.
The evidence therefore suggests black cohosh may help with the physical symptoms of menopause but not the emotional ones, which limits the support for claims about mood changes, irritability, and restlessness.
Safety profile
Black cohosh appears generally safe for short term use. Adverse events are described as rare, mild, and reversible, with gastrointestinal upsets and rashes being the most common [6].
References
[1] Leach MJ, Moore V. Cochrane Database Syst Rev. 2012;2012:CD007244.PMID: 22972105 · https://pubmed.ncbi.nlm.nih.gov/22972105
[2] Sadahiro R, Matsuoka LN, Zeng BS, et al. Menopause. 2023;30:766-773.PMID: 37192826 · https://pubmed.ncbi.nlm.nih.gov/37192826
[3] Castelo-Branco C, Gambacciani M, Cano A, et al. Climacteric. 2020;24:109-119.PMID: 33021111 · https://pubmed.ncbi.nlm.nih.gov/33021111
[4] Hill DA, Crider M, Hill SR. Am Fam Physician. 2016;94:884-889.PMID: 27929271 · https://pubmed.ncbi.nlm.nih.gov/27929271
[5] Rattanatantikul T, Maiprasert M, Sugkraroek P, Bumrungpert A. J Diet Suppl. 2020;19:168-183.PMID: 33331798 · https://pubmed.ncbi.nlm.nih.gov/33331798
[6] Huntley A, Ernst E. Menopause. 2003;10:58-64.PMID: 12544678 · https://pubmed.ncbi.nlm.nih.gov/12544678
Black cohosh
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