Black cohosh is obtained from the fresh or dried rhizome and roots of Cimicifuga racemosa. Triterpene glycosides including actein, cimigoside, and 27-deoxyactein may produce the therapeutic effects. Black cohosh also contains salicylic acid.

Black cohosh may affect hormones such as estradiol, luteinizing hormone, follicle stimulating hormone, and prolactin. However, the precise mechanism of action is presently unknown.

Black cohosh is available as capsules, liquid extract, powder, tablets, and tincture, in products such as Nuveg Black Cohosh Root, Remifemin, and Wild Countryside Black Cohosh.

Benefits And Uses of Black Cohosh

Black cohosh is effective for treating somatic and psychological symptoms of menopause, including hot flashes, diaphoresis, sleep disturbance, and anxiety. It doesn’t affect vaginal epithelium and may be ineffective for treating menopausal vaginal dryness. German Commission E has approved black cohosh for premenstrual discomfort, dysmenorrhea and menopausal symptoms of the autonomic nervous system. It may be safe for women with a history of breast cancer and other estrogen-sensitive cancers.

Administration

• Liquid extract 0:1 in 90% alcohol); 0.3 to 2.0 ml by mouth .
• Tincture 0:10 in 60% alcohol): 2 to 4 ml by mouth .
• Remifemin: 20 mg by mouth two times a day.

Side Effects of Black Cohosh

Black cohosh may be associated with GI discomfort. Tinctures contain alcohol and may cause a disulfiram or disulfiram-like reaction. Advise patient to avoid using with disulfiram and metronidazole.

Pregnant patients should avoid use because large doses may cause miscarriage or premature birth. Breast-feeding patients should avoid use because the effects aren’t known.

Patients who are salicylate sensitive-including those with asthma, gout, peripheral vascular disease, diabetes, hemophilia, and kidney and liver disease should use with caution.

Clinical considerations

• Effective doses are equivalent to 40 mg per day of crude drug.
• The adverse reactions of and precautions for salicylates may apply to black cohosh.
• Black cohosh has no known benefits for osteoporosis or cardiovascular disease.
• Tincture may contain up to 90% alcohol and so may be unsuitable for children, alcoholic patients, and those with liver disease.
• Black cohosh isn’t recommended for use for longer than 6 months.
• Signs and symptoms of overdose include nausea, vomiting, dizziness, nerus system and visual disturbance , reduced pulse rate, and increased perspiration.
• If patient is pregnant or breast-feeding or is planning pregnancy, advise her not to use this herb.
• Encourage patient to have a proper medical evaluation before treating symptoms of menopause.
• Advise patient to keep black cohosh away from children and pets.
• Tell patient to remind prescriber and pharmacist of any herbal or dietary supplement that she’s taking when obtaining a new prescription.
• Advise patient to consult her health care provider before using an herbal preparation because a treatment with proven efficacy may be available.

Research summary

The best evidence for black cohosh as a treatment for menopause comes from a double-blind study that followed 80 women for 12 weeks, comparing the benefits of black cohosh, conjugated estrogens (0.625 mg), and placebo. According to the reported results, black cohosh was actually more effective than estrogen, both in relieving symptoms and in normalizing the appearance of vaginal cells under microscopic evaluation.

Tagged under:black cohosh black cohosh benefits breast cancer diaphoresis gout Herbal Medicines menopause

Share This

Filed under: Herbal Medicines