Black cohosh (Cimicifuga racemosa), a member of the buttercup family, is a perennial plant that is native to North America. Other common names include black snakeroot, bugbane, bugwort, rattle root, rattle top, rattle weed, and macrotys. Insects avoid it, which accounts for some of these common names.
Black cohosh was used in North American Indian medicine for malaise, gynaecological disorders, kidney disorders, malaria, rheumatism, and sore throat. It was also used for colds, cough, constipation, hives, and backache and to induce lactation for breast feeding. In 19th-century America, black cohosh was a home remedy used for rheumatism and fever, as a diuretic, and to bring on menstruation. It was extremely popular among a group of alternative practitioners who called black cohosh “macrotys” and prescribed it for rheumatism, lung conditions, neurological conditions, and conditions that affected women’s reproductive organs (including menstrual problems, inflammation of the womb or ovaries, infertility, threatened miscarriage, and relief of labour pains)
Today black cohosh is known primarily as an herbal treatment for hot flushes and other menopausal symptoms, but does it work and is it safe?
The possibility that black cohosh exhibits hormone balancing estrogenic activity has been studied but the evidence is contradictory. Let’s examine the research on how well it works for menopausal symptoms. In a study of 704 women, 49% of the women who took the preparation experienced complete relief of menopausal symptoms (hot flushes, sweating, headache, vertigo, heart palpitation, and ringing in the ears.) An additional 37.8% reported significant improvement. According to the physicians who participated in the study, 72% of the women who took the black cohosh treatment experienced advantages over those given hormonal treatment.
In another controlled study, of 629 women with menopausal complaints who took a black cohosh twice a day, 76 to 93% had an overall improvement in hot flushes, headache, irritability, heart palpitations, mild depression and sleep disturbances. The reduction in headache, sleep disturbances and heart palpitations is understandable because black cohosh also contains a small amount of salicylic acid (used to make aspirin) that has anti-inflammatory and pain-relieving qualities.
You may have read some recent negative information on black cohosh. In 2006, The Medicines and Healthcare products Regulatory Agency’s (MHRA) cited 14 cases of women with liver problems that were “possibly” or “probably” linked to black cohosh. When the European Medicines Agency (EMEA), reviewed all the evidence worldwide, it concluded that, in fact, there were only two “possible” and two “probable” cases and that it is not clear whether black cohosh caused the problem. These four cases are such a small number when weighed up against an estimated 9 million treatment days of black cohosh used each year.Â
The National Institutes of Health in the US believes there’s no case to answer and their website states that black cohosh has few side effects and that ‘liver damage has been reported in a few individuals using black cohosh, but millions of people have taken the herb without apparent adverse health effects. There is no scientific evidence to show that the herb causes liver damage.’Â
Also worryingly, researchers have found that some black cohosh products on the market contain an Asian species of black cohosh which is cheaper than the North American black cohosh. Compared with the species cultivated in North America, the Asian variety has different chemical properties and may have different effects on the body. So I would still recommend that you use black cohosh as the herb of choice for the menopause symptoms but make sure that you buy from reputable companies so that you know you are getting the best quality herb and preferably buy organic. (for a good organic black cohosh formula – see Resources Page).
If you have hot flushes, night sweats, vaginal dryness or itching, depression, or bone loss due to natural or surgically-induced menopause, black cohosh is an herb that you may want to consider. We know that black cohosh is effective for the symptoms of the menopause and a recent study (April 2007) in the International Journal of Cancer has shown that black cohosh may halve the risk of breast cancer. So this herb can be doubly beneficial for women around the menopause.