Black Cohosh | Benefits, Uses & Treatments for Estrogen

Black Cohosh

Black cohosh is an herb derived from the buttercup family of perennial plant. It is native to North America and is commonly known as snakeroot, bugbane, bugwort, rattleroot, rattletop, rattleweed, and macrotys.

Traditionally, the juice of the black cohosh plant was used as an insect repellent and was made into a salve that could be applied to treat snake bites. The Native Americans used black cohosh as a traditional folk remedy for female health conditions that included menstrual cramps and hot flashes. The herb was also used for arthritis, muscle pain, sore throat, cough and indigestion. In more recent years, black cohosh has been used as a nutritional supplement to help treat hot flashes, mood swings, night sweats, vaginal dryness and other symptoms that can occur during menopause. It is also used to relieve menstrual cramps and bloating.

The fresh or dried roots and underground stems, called rhyzomes, are the portion of the plant used medicinally. This part of the black cohosh plant is available in several forms including tea, capsule, tablet or liquid extract forms. The active compound in black cohosh is thought to be 26-deoxyactein.

Menopausal Symptoms and Black Cohosh

Black cohosh is primarily used today for helping to treat and relieve symptoms associated with menopause. It has been found to be effective in reducing the occurrence and severity of hot flashes and night sweats. Black cohosh also works to decrease the incidence of migraines and prevent heart palpitations as well as diminish mood disturbances and vaginal dryness. The American College of Obstetricians and Gynecologists stated in 2001 that black cohosh may be helpful in treating menopausal symptoms such as hot flashes in the short-term. Most research conducted on the use of black cohosh has found it to be successful in relieving menopause and menstrual symptoms for periods of up to six months. There has not been enough research on black cohosh to determine its efficacy and safety for long periods of time or for chronic use for more than six months.

How Does It Work?

It is still unknown exactly how black cohosh works. Its mechanism of action is unclear. Specifically, it was originally though that black cohosh had an estrogenic effect in the human body. However, with continued research, the effects of black cohosh on estrogen receptors or hormonal levels (if any) are not definitively known. Recent publications and research contradict the claim that black cohosh has an impact on estrogen receptors. This remains an area of active controversy. Therefore, it is strongly recommended that women who may be contraindicated for use of hormone related drugs and herbs use black cohosh only under the direct supervision of a physician. This is particularly important for women who have a history breast, uterine, or ovarian cancer.

Side Effects

Black cohosh has not been studied or evaluated closely for a time period of longer than 6 months. One study that observed the use of black cohosh in women over 5 years showed a slight increase in the risk of disease. The safety of black cohosh for pregnant or breastfeeding women has not yet been determined. Black cohosh is sometimes used by nurse/midwives for the purpose of inducing labor. Therefore, it should never be used by a pregnant woman without the supervision of their healthcare provider because it could promote uterine contractions, induce labor, or result in miscarriage.

Black cohosh should be avoided by people with hormone sensitive conditions such as cancer of the breast, prostate, ovaries or uterus, endometriosis or uterine fibroids. Other potential negative side effects of black cohosh are indigestion, headache, nausea, perspiration, vomiting, heaviness in the legs, weight gain, and low blood pressure. Excessive use of black cohosh has been associated with seizures, visual disturbances and slow or irregular heartbeat. In addition, black cohosh has also been associated with liver damage. In most cases of diagnosed liver damage where black cohosh was suspect, there were also other conditions present or medications being taken that could have been responsible for the liver damage. Nonetheless, it is important to note that liver damage is one of the most concerning side effects potentially linked to black cohosh.

Because black cohosh contains small amounts of salicylic acid, people with allergies to aspirin or salicylates should avoid black cohosh.

People with a history of blood clots or stroke, seizures, liver disease and those who are taking medications for high blood pressure should not use black cohosh.

People who have allergies to the buttercup (Ranunculaceae) family of plants should also avoid black cohosh.

Drug Interactions

Black cohosh could interfere with oral contraceptives or hormone replacement therapy. Black cohosh could also interfere with the chemotherapy drug, crisplatin.

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