Cimicifuga racemosa (black cohosh) rhizome and root extract have been used to treat menopausal symptoms. To date, there are still scarce information about its efficacy in Thai women with menopausal symptoms. The purpose of this study will assess the efficacy of black cohosh extract in management of menopausal symptoms in Thai women.

Inclusion Criteria:

• Thai women, aged ≥ 40 years
• Peri- or postmenopause
• Moderate to severe menopausal symptoms from Kupperman menopausal index score at least 20

Exclusion Criteria:

• Using any drugs or hormonal treatment within 1 month before enrollment
• BMI ≥ 30 kg/m2
• Allergic to drugs or any ingredient
• Liver disease or AST ≥ 37 U/L or ALT ≥ 40 U/L or total bilirubin ≥ 1 mg/dL or direct bilirubin ≥ 0.3 mg/dL
• Psychiatric disease
• Alcohol consumption or any elicit drug use
• Vegetarian (may consume more phytoestrogen)