Black Cohosh: the Menopause Herb

Historically, Black Cohosh (cimicifugae racemosae rhizoma) Root has been used for a range of conditions. Native Americans and U.S. colonialists used it for amenorrhea, bronchitis, chorea, dropsy, fever, hysteria, itch, lumbago, nervous disorders, snakebite, yellow fever, and uterine disorders.

Interest in Black Cohosh and other dietary supplements from women seeking alternative treatments for symptoms associated with the menopausal transition, including hot flashes and night sweats, anxiety and depression, and vaginal dryness has increased recently in the wake of findings from the Women's Health Initiative (WHI), which pointed to a shift in current thinking on the risk/benefit balance of hormone therapy due to cardiovascular events, stroke, breast cancer, blood clots, and other conditions.

Black Cohosh Root is nowadays, in fact, used for a variety of complaints, but has become well known in the Western World for its beneficial effect on hormone functioning due to its phyto-estrogenic properties. Black Cohosh is also used by herbalists to prevent miscarriage. Many women miscarry very early in pregnancy and may not even realize that they have been pregnant.

Preparations of Black Cohosh consist of the fresh or dried rhizome with attached roots of Cimicifuga racemosa in effective dosage. It has as its main constituents triterpene glycosides, cinnamic acid derivatives, chromone, isoflavones, tannins and salicylic acid.

Recent clinical studies carried out in Germany have confirmed that Cimicifuga is strongly estrogenic and that it is effective in relieving menopausal symptoms. The daily dosage (as recommended by Germany’s Commission E Monographs) is, in extracts with alcohol 40 - 60 percent (v/v) corresponding, 40 mg of the drug.

Some authorities have suggested that medicinal quantities of Black Cohosh may increase the effects of synthetic hormones in susceptible women, e.g. women taking HRT or the contraceptive pill. Because of its oestrogen-like effects, it is thought that it may promote metastasis of breast cancer tissue, however, in an experiment done on mice, Black Cohosh increased metastasis of cancer to the lungs, but did not cause an increased incidence of breast cancer.

There are no known contraindications and few direct side effects to Black Cohosh Root extracts, except for occasional gastric discomfort, and rare hepatic (liver) dysfunction.

There are no known interactions with other drugs but it is considered prudent that preparations using Black Cohosh should not be used during pregnancy or lactation.

Black Cohosh (cimicifugae racemosae rhizoma) should not be confused with Blue Cohosh (caulophyllum thalictroides), which has different properties, treatment uses, and side effects than Black Cohosh. Black Cohosh is sometimes used with Blue Cohosh to stimulate labor, but this therapy has caused adverse effects in newborns, which appear to be due to Blue Cohosh.

While Black Cohosh shows great promise in the safe relief of menopausal symptoms, further research is being undertaken by The National Center for Complementary and Alternative Medicine, it is important to inform your health care providers about any herb or dietary supplement you are using, including Black Cohosh to ensure safe and coordinated care.

Ian Finlayson is webmaster of The Herb Spiral, a site committed to presenting balanced information on the benefits of medicinal herbs. Please visit the site for more information on Black Cohosh Root