Black Cohosh for Menopause Symptoms

Black Cohosh for Menopause Symptoms

Black cohosh (known as both Actaea racemosa and Cimicifuga racemosa) is a perennial plant that is native to North America and a member of the buttercup family. It is sold in the United States as a dietary supplement. Preparations of black cohosh are made from its roots and rhizomes (underground stems) with commercially available preparations usually containing 1 mg of total triterpene saponins (expressed as 26-deoxyactein) in each 20-mg dose of extract.

Historical Uses

Black cohosh was an important folk medicine for menstrual irregularities among the Native Americans and then the early settlers in North America. Adopted in medicinal practice in the early nineteenth century, it was well known as an anti-inflammatory for arthritis and rheumatism, for normalizing suppressed or painful menses, and for relieving pain after childbirth. It was also used for nervous disorders.

''A positive cure for all those painful complaints and weaknesses so common to our best female population'' is how the label read on Lydia E. Pinkham's Vegetable Compound, a famous patent medicine with black cohosh as its chief ingredient. The root was an official drug in the U.S. Pharmacopoeia from 1820 to 1926. By 1849, the newly formed American Medical Association was describing black cohosh as useful for ''the debility of females attendant upon uterine disorder.''

Used in Europe for over 40 years, with experience in over 1.5 million cases, black cohosh is approved for use in Germany for the treatment of premenstrual symptoms, painful or difficult menstruation, and for menopausal symptoms such as hot flashes. Black cohosh is again becoming known in its native land as a possible alternative for reducing unpleasant symptoms associated with menopause. Recent controlled clinical studies are helping to corroborate the long-term clinical experience of the herb's safety and efficacy.

Clinical Studies

It is not clear how black cohosh works. Some researchers think black cohosh contains plant estrogens and thus has hormonal effects, but the latest reports have found no estrogens or hormonal effects. A group of clinical studies have demonstrated positive results in the use of black cohosh in the treatment of menopause symptoms in studies that lasted as long as six months.

Menopause symptoms that have shown improvement with black cohosh include:

• Hot flashes
• Night sweats
• Irritability
• Mood swings
• Occasional sleeplessness

Clinical studies have not shown conclusive evidence that black cohosh has a positive effect on hormone levels or the structure of vaginal and uterine tissues, which changes in postmenopausal women due to declining estrogen.

As Always, Consult Your Physician

Herbs have been used over many centuries to help strengthen the body, however, care should always be taken to use herbs under the supervision of a knowledgeable practitioner. Herbs contain active substances that may trigger unwanted effects and interact with other herbs, supplements, or medications. Black cohosh has not been reported to interact with any drugs or to influence laboratory tests, however, this has not been rigorously studied.

The possible side effects of black cohosh that have been reported include stomach upset, headache, dizziness, heaviness of the legs and weight gain. Pregnant and breastfeeding women are advised to avoid black cohosh as the herb may stimulate contractions and lead to premature labor. Women with breast cancer may want to avoid black cohosh until its effects on breast tissue are understood.

Very rarely, liver disease has been reported in women taking black cohosh, however, it has not been clear if black cohosh contributed to the diseased condition. If jaundice or aches and pains develop, use should be stopped and a health care provider consulted. Women with a history of liver disease should be sure to consult their physicians before taking black cohosh.

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