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Cimicifuga + Hypericum (CIM/HIP) is a fixed-dose herbal combination therapy consisting of extracts from *Cimicifuga racemosa* (Black Cohosh) and *Hypericum perforatum* (St. John's Wort). Developed by Phytopharm Consulting Brazil, it is primarily indicated for the management of climacteric symptoms associated with perimenopause and menopause, such as hot flashes, irritability, and vasomotor complaints. The *Hypericum* component acts as a reuptake inhibitor of serotonin, norepinephrine, and dopamine, addressing psychological symptoms like mood swings and anxiety. The *Cimicifuga* component is thought to exert selective estrogen receptor modulating (SERM) effects or act via neurotransmitter pathways to alleviate vasomotor symptoms without the risks associated with traditional hormone replacement therapy. It has been evaluated in Phase 3 clinical trials (e.g., NCT01481025) comparing its efficacy to isolated Black Cohosh extracts.
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