Black cohosh
Two RCTs (with a low to moderate risk of bias) in women after breast cancer reported no difference in the frequency or severity of hot flushes between black cohosh cohosh (1 capsule, Cimicifuga racemosa 20 mg BID) and placebo.66, 67 Another RCT (with a high risk of bias) reported black cohosh (1 capsule, Cimicifuga racemosa, CR BNO 1055) plus tamoxifen (20mg/d) significantly reduced the frequency of hot flushes from baseline while tamoxifen alone did not, but between group differences were not reported.68 [ES13]
Three RCTs (with a moderate risk of bias) identified in a Systematic Review (with a low risk of bias) in peri- and postmenopausal women (including women with breast cancer) found that black cohosh (40 mg/d) did not reduce vasomotor symptom frequency or bother compared with placebo.69 [ES48]
Homeopathy
Two RCTs (with a low and high risk of bias) in women after breast cancer found no effect of homeopathy versus placebo on hot flush frequency or severity.70, 71 [ES14]
Phytoestrogens
Three RCTs (with a low to high risk of bias) in women after breast cancer found no effect of phytoestrogens (tablets, 114 mg of isoflavonids or soybean beverage or 235 mg of soy extract with 17.5 mg of Isoflavines 70mg/d) versus placebo on the Kupperman Index (which includes assessment of hot flushes) or the frequency or severity of hot flushes.72-74 [ES15]
Fifteen RCTs (with an unknown risk of bias) identified in a Systematic Review (with a moderate risk of bias) in peri- and early postmenopausal women (with hot flushes and at least one co-occurring symptom) found an inconsistent benefit of soy and other isoflavones on vasomotor symptoms compared with placebo and other nutritional comparators.75 [ES46]
Omega 3
One RCT (with a low risk of bias) in menopause transition and postmenopausal women found that 12 weeks of omega-3 supplement (1.8 grams daily: EPA; 425mg, DHA; 100mg, omega-3 90mg) did not significantly improve vasomotor symptoms frequency or bother compared to placebo.19, 76 [ES47]
Magnetic therapy
One RCT (with a moderate risk of bias) in women after breast cancer found that 3 days of magnetic therapy (6 magnets on acupuncture pressure sites per participant) had no effect on the severity of hot flushes compared with placebo, while placebo was reported to have had a greater effect than magnetic therapy on frequency of hot flushes.77 [ES16]