Risks and Benefits of Black Cohosh - A Natural Treatment For Menopause

Black cohosh is an herb known by the Botanical name Cimicifuga racemosa. It is native to North America and classified as part of the buttercup family. Black cohosh is a popular herbal supplement used to relieve symptoms of menopause and perimenopause.

This herb was first used by Native Americans to relieve discomfort related to menstruation and other women's health issues. European settlers learned of black cohosh shortly after arriving in North America. Common names for black cohosh vary by region and reflect its traditional uses. Some common names include squaw root, rattleweed, black snake root, and bugwort. Black cohosh was not used exclusively by women. It was also used as an insect repellent or a remedy for snake bites, fatigue, and arthritis. 

Menopause and Natural Hormone Replacement Therapy

Symptoms of menopause include hot flashes, mood swings, breast soreness, insomnia, and vaginal dryness. Many women experience a drop in sex drive and may feel discomfort or pain during sex. Perimenopause refers to the period before menopause when symptoms first appear. Indicators of perimenopause are severe premenstrual syndrome, irregular menstruation, and symptoms associated with menopause. The duration of perimenopause is different for each woman, although it lasts an average of two to four years.

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Black cohosh is often thought of as natural hormone replacement therapy.

It is very important to remember that 'natural' or 'herbal' supplements are not always safe. Many herbs, plants and other natural substances can be dangerous. Even medications derived from plants must be used with care. There is no official agency responsible for regulating herbal supplements. Other types of cohosh, such as blue or white cohosh, have been found in supplements labeled as black cohosh. White and blue cohosh are separate herbs, and they have different effects and risks than those associated with black cohosh.

How It works

Black cohosh contains substances called phytoestrogens.

Phytoestrogens have a molecular structure that is very similar to estrogen. It was once believed that phytoestrogens were responsible for the effects of black cohosh on menopausal symptoms. Recent research suggests that phytoestrogens may not act like estrogen at all, and phytoestrogens might actually block the effects of estrogen.

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Studies have been done to evaluate the effectiveness and safety of black cohosh, although the research is sparse. FDA-approved medications go through rigorous testing and a long process of research and trials before they are declared safe. Black cohosh is not approved by the FDA because it is an herbal supplement.

Some early studies observed minor relief of menopausal symptoms in women taking black coshosh, but most studies have found it is no more effective than a placebo. Most evidence that black cohosh is effective comes from individual testimonials and anecdotal claims. Interactions between black cohosh and other medications have also been observed, especially medications used to treat hormone-sensitive breast cancer.

Side Effects

A wide range of side effects have been reported in conjunction with black cohosh. These side effects include headache, nausea, vomiting, dizziness, and vaginal bleeding. Side effects such as muscle pain and weakness, an allergic reaction, or difficulty breathing may require emergency medical care.

Scattered cases of liver damage were observed during controlled studies of black cohosh. Signs of liver damage include dark urine, abdominal pain, pale or clay colored stool, poor appetite, nausea, abdominal pain, and jaundice. Jaundice is the medical term for yellow-tinged skin or eyes.

Black cohosh should not be taken during pregnancy or while breastfeeding.  Do not start taking black cohosh or any other herbal supplement while receiving treatment for cancer without a doctor's approval and supervision. A doctor can help develop a comprehensive treatment plan for relief of problematic symptoms.

Women taking black cohosh should consult their doctors for a thorough discussion of how the herb may be affecting their health. A doctor or pharmacist can provide assistance to assess possible interactions between black cohosh and other medications. It is vital for women to fully understand any medication or herbal supplement they choose to take. Weigh benefits and risks carefully, and do not hesitate to contact medical professionals if any negative side effects occur.

By Annie Knapp