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Black Cohosh

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What other names is Black Cohosh known by?

Actaea macrotys, Actaea racemosa, Actée à Grappes, Actée à Grappes Noires, Actée Noire, Aristolochiaceae Noire, Baie d'actée, Black Cohosh, Baneberry, Black Aristolochiaceae, Black Snakeroot, Bugbane, Bugwort, Cimicaire à Grappes, Cimicifuga, Cimicifuga Racemosa, Cimicifuge, Cohosh Negro, Cohosh Noir, Cytise, Herbe aux Punaises, Macrotys, Phytoestrogen, Phytoestrogène, Racine de Serpent, Racine de Squaw, Racine Noire de Serpents, Rattle Root, Rattle Top, Rattlesnake Root, Rattleweed, Rhizoma Cimicifugae, Sheng Ma, Snakeroot, Squaw Root.

What is Black Cohosh?

Black cohosh is an herb. The root of this herb is used for medicinal purposes. Black cohosh was first used for medicinal purposes by Native American Indians, who introduced it to European colonists. Black cohosh became a popular treatment for women's health issues in Europe in the mid-1950s.

Since that time, black cohosh has commonly been used to treat symptoms of menopause, premenstrual syndrome (PMS), painful menstruation, weakened bones (osteoporosis), and for starting labor in pregnant women. It is also used to promote sleep, for breast cancer, heart disease, to improve mental function, for infertility, arthritis, and indigestion.

Black cohosh has also been tried for a lot of additional uses, such as anxiety, fever, sore throat, and cough, but it is not often used for these purposes these days.

Some people also apply black cohosh directly on the skin. This is because there was some thought that black cohosh would improve the skin's appearance. Similarly, people used black cohosh for other skin conditions such as acne, wart removal, and even the removal of moles, but this is seldom done anymore.

Black cohosh also goes by the name "bugbane" because it was once used as an insect repellent. It is no longer used for this purpose. Frontiersmen had said that black cohosh was useful for rattlesnake bites, but no modern researchers have tested this.

Do not confuse black cohosh with blue cohosh or white cohosh. These are unrelated plants. The blue and white cohosh plants do not have the same effects as black cohosh, and may not be safe.

Is Black Cohosh effective?

There is some scientific evidence that black cohosh can help relieve some of the symptoms of menopause such as hot flashes after about a month of treatment. But black cohosh does not seem to help relieve hot flashes in women who have had breast cancer.

There isn't enough information to know if black cohosh is effective for the other conditions people use it for, including: premenstrual syndrome (PMS), painful menstruation, upset stomach, muscle pain, fever, sore throat, cough, and as an insect repellent.

Possibly Effective for...

  • Menopausal symptoms. Research shows that some black cohosh extracts can reduce some symptoms of menopause when taken by mouth. Most of this research is for a specific commercial black cohosh product, Remifemin. Research shows that the effects of Remifemin on menopausal symptoms are comparable to hormone therapy. The benefits may not occur with all products that contain black cohosh.

    Research using black cohosh products other than Remifemin has not always shown benefits for menopausal symptoms. Some studies show that other black cohosh products do not reduce hot flashes or menopausal symptoms any better than a sugar pill ("placebo").

    In some studies, products containing black cohosh and other ingredients have been investigated. Products containing black cohosh plus St. John's wort seem to reduce menopausal symptoms. Similar results have been observed for products containing black cohosh, Panax ginseng, soy, and green tea extract or black cohosh, kava, hops, and valerian extract. However, a homeopathic product containing black cohosh doesn't seem to be effective at reducing overall menopausal symptoms, although it may reduce hot flashes.

    Some women take black cohosh for hot flashes related to breast cancer treatment. Women with breast cancer should not use black cohosh without talking to their cancer specialist or other health provider. Some early research suggested that black cohosh might reduce hot flashes in breast cancer patients, but more recent and higher quality research shows that black cohosh does not reduce hot flashes in women with breast cancer. There is some question as to whether black cohosh is safe for women with breast cancer. It is important for a woman with breast cancer to discuss any use of black cohosh with her health provider before using it.

Insufficient Evidence to Rate Effectiveness for...

  • Breast cancer. One study suggests that taking black cohosh supplements is linked to a deceased risk of breast cancer. However, other research has found no link. Results from one study shows that taking black cohosh might increase survival in women already diagnosed with breast cancer.
  • Heart disease. Early research shows that taking 40 mg per day of a specific black cohosh extract (CR BNO 1055) does not reduce the risk of heart disease in postmenopausal women.
  • Mental function. Early research suggests that taking 128 mg of black cohosh daily for 12 months does not improve memory or attention in postmenopausal women.
  • Infertility. Early research suggests that taking 120 mg per day of black cohosh extract plus 150 mg of clomiphene citrate can increase pregnancy rates in infertile women compared to clomiphene citrate alone. Other research shows that taking 120 mg of black cohosh with 150 mg of clomiphene citrate results in pregnancy rates that are similar to those found when clomiphene citrate is taken with another fertility drug.
  • Induction of labor. Some people report that black cohosh can help start labor. As many as 45% of nurse-midwives use black cohosh to start labor in pregnant women at term. Despite its common use, there is no reliable scientific evidence that black cohosh works for this purpose.
  • Migraine headache. Early research shows that taking 25 mg of black cohosh extract plus 75 mg of soy extract and 50 mg of dong quai two times per day for 24 weeks reduces the occurrence of menstrual migraines.
  • Osteoarthritis. Early research suggests that taking a specific product containing black cohosh and other ingredients (Reumalex) daily for 2 months improves pain, but not joint function, in people with osteoarthritis.
  • Weak bones (Osteoporosis). Evidence regarding the benefit of black cohosh for treating or preventing osteoporosis is conflicting. One study shows that taking a product containing 40 mg of black cohosh (Remifemin, Schaper & Brümmer) for 3 months improves bone formation and reduces the breakdown of bone. Another study shows that taking a different product containing 40 mg of black cohosh extract (CR BNO 1055, Klimadynon/Menofem, Bionorica AG) for 3 months increases markers of bone formation in postmenopausal women. However, other research shows that taking this black cohosh product does not improve bone mineral density. It is not known if black cohosh reduces the risk of bone fractures.
  • Rheumatoid arthritis. Early research suggests that taking a specific product containing black cohosh (Reumalex, Gerard House Ltd.) twice daily for 2 months improves pain, but not joint function, in people with rheumatoid arthritis.
  • Acne.
  • Anxiety.
  • Bug bites.
  • Cough.
  • Fever.
  • Mole removal.
  • Painful menstruation.
  • Premenstrual syndrome (PMS).
  • Rheumatism.
  • Snake bite.
  • Sore throat.
  • Wart removal.
More evidence is needed to rate black cohosh for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).


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