ObjectiveTo evaluate the efficacy and safety of black cohosh (cimicifuga racemaosa, Remifemin) for treatment of menopausal symptoms in patients with early endometrial cancer after operation. MethodsSixty patients with early endometrial cancer, who suffered menopausal symptoms after operation, were evenly divided into experimental group and control group. Patients in the experimental group took Remifemin tablet (20 mg) twice a day for 24 weeks. Patients in the control group took no drugs. All the patients were followed up for 12 months. The Kupperman menopause index (KMI), bone mineral density (BMD), cancer recurrence rate, death rate, and hepatic and renal functions were compared between the two groups. ResultsThe KMI score of the experimental group was significantly decreased 24 weeks after treatment with Remifemin (9±4 vs 26±7, P<0.05), and that in the control group was not significantly changed (21±5 vs 25±8, P>0.05). The BMD in the experimental group was significantly increased 24 h after treatment with Remifemin (\[0.891±0.21\] g/cm2 vs \[0.790±0.17\] g/cm2, P＜0.05); and there was no significant difference in the control group (\[0.816±0.15\] g/cm2 vs \[0.808±0.19\] g/cm2, P＞0.05). No adverse effects were observed in the experimental group. During 1-year follow-up, one patient died in the experimental group; one had recurrence and one died in the control group. ConclusionBlack cohosh can improve the menopausal symptoms in patients with early endometrial cancer after operation, without increasing the risk of tumor recurrence.