Information about Black Cohosh.

What is Black Cohosh?
Black Cohosh (known as both Actaea racemosa and 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, rattleroot, rattletop, rattleweed, and macrotys. Preparations of black cohosh are made from its roots and rhizomes (underground stems).

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What are the uses of Black Cohosh?
Hot Flashes, Night Sweats, Mild Mood Changes. Black cohosh is an herb sold as a dietary supplement in the United States that is used for hot flashes, night sweats and mild mood disturbances seen during the menopause. The mechanism of action is not completely understood. However, it does not appear to act on target tissues such as the uterine lining, thereby no increase in bleeding should be seen with its use. The American College of Obstetricians and Gynecologists stated that black cohosh may be helpful in the short term (6 months or less) for women with vasomotor symptoms of menopause.

Black Cohosh was previously believed to bind to the estrogen receptor and lower certain hormone levels. However, in recent studies, it has shown no estrogen binding or estrogen-like activities. This is important for women concerned about estrogen or estrogen-like remedies and supplements.

What are the recommended Preparations/Dosages?
Manufacturer dosages vary according to standardization with total triterpene dose. Therefore, it is prudent to read the specific dosage instructions from each manufacturer.

One commercial standardized black cohosh preparation is Remifemin® , which contains black cohosh extract equivalent to 20 mg of root per tablet. Other preparations of black cohosh have been less well studied than Remifemin®. It has been used for decades in Germany to treat menopause symptoms. In fact, the German Commission E (equivalent to the US Food and Drug Administration) has done extensive testing under government supervision to determine the efficacy and safety of hundreds of herbal products. Black Cohosh has received an approval status by this Commission. This approval states that black cohosh is reasonably safe when used according to the dosage and helpful for premenstrual discomfort and menopause symptoms.

A recent well-done study by Liske, et al revealed that 40 milligrams per day of Remifemin® was well tolerated and decreased menopause symptoms in over 70%. This study also evaluated hormonal changes and did not find any estrogen-like effects. A recent study published in the Annals of Internal Medicine found that black cohosh has benefit in relieving hot flashes and other menopause symptoms. Lastly, a study published in the current issue of Breast Cancer Research and Treatment suggests that Remifemin® brand of black cohosh can be used safely to relieve menopausal symptoms in women with a history of breast cancer who cannot take estrogen. The study adds to the growing body of evidence showing that Remifemin® relieves symptoms without exerting an estrogenic effect. This is welcome news for the many women who cannot or who choose not to take hormone replacement therapy (HRT).

A common question to MenopauseRx is: "How do I convert from Hormone Replacement Therapy to Black Cohosh?"

Click here to read a common sense approach.

What about the Side Effects?
Side effects are very unusual and may include gastric discomfort. Fortunately, this usually does not persist. If discomfort, nausea or vomiting persist, discontinue use and see your health care practitioner.

What are the Contraindications?
This herbal product has not been adequately studied in pregnancy and is contraindicated in pregnancy and breastfeeding. Caution should be used in women who are being treated for high blood pressure.