Black cohosh is a perennial plant native to the United States. It is avoided by insects, which gives it other names such as bugwort, rattleroot and rattleweed. Black cohosh is sold and used in the United States as a dietary supplement but is mainly used for menopausal symptoms. Although the use of black cohosh for menopausal symptoms is encouraging, there is no hard evidence to date supporting its effectiveness for symptoms associated with menopause.
Clinical Studies
According to the Mayo Clinic, black cohosh should not be confused with blue cohosh. They are two different plants; blue cohosh can damage your heart and raise blood pressure. Dr. Norman Farnsworth, Ph.D., University of Illinois at Chicago, "reviewed 11 different commercial products that have been used in clinical studies. Black cohosh products come in a variety of forms, including capsules, solution, drops, tincture, and tablets. Remifemin is the most widely studied product, at least of those sold in the United States. Overtime, the manufacturer has switched between isopropanolic and ethanolic preparation, and between fluid extracts and dried fluid extracts. While no clinical trials have been reported using powdered plant material, a range of different formulations has been used in clinical research. The changes in preparation method of Remifemin make comparisons of this one product complicated when comparing across different studies. And the variety of commercial preparations of black cohosh administered in clinical trials complicates comparisons across studies in terms of safety, toxicity and efficacy." In the future, The National Center for Complementary and Alternative Medicine (NCCAM) will be funding "a rigorous scientific study to determine whether treatment with black cohosh reduces the frequency and intensity of hot flashes, and other menopausal symptoms."
History
Black cohosh use goes back as far as the 19th century, when North American Indians used it for many medicinal purposes from malaria to kidney disorders and even gynecological disorders. It is still used for women suffering migraines due to menstruation and by midwives to induce labor.
Side Effects
Clinical trials comparing estrogen use and black cohosh have shown a low incidence of negative effects associated with black cohosh. Headaches, stomach problems, heaviness in the legs, and problems with weight control are the side effects reported most often. There have been reported cases that black cohosh used for inducing labor caused neurological complications with a baby after birth. Liver damage has also been reported but is low compared to the amount of patients taking black cohosh with no side effects.
Considerations
Women who are pregnant, have breast cancer or a history of liver problems should not take black cohosh unless directed by their physician. "Individuals who develop symptoms of liver trouble such as abdominal pain, dark urine or jaundice while taking the supplement should discontinue use and contact their doctor."
Drug Interactions
It has been reported that black cohosh acts as the estrogen hormone and could interfere with any hormone drugs or oral prescription contraceptives. Additionally, it is not clear how the herb actually works. Long term effects of black cohosh have not yet been determined.
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