Black Cohosh

Common names: Black cohosh also is known as baneberry, black snakeroot, bugbane, squawroot, cimifuga, rattletop, rattleweed, and rattle root.

Efficacy-safety rating:

ÒÒ...Ethno or other evidence of efficacy.

Safety rating:

What is Black Cohosh?

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Black cohosh grows in open woods at the edges of dense forests from Ontario to Tennessee and west to Missouri. This perennial grows to 8 feet and is topped by a long plume of white flowers. The term “black” refers to the dark color of the rhizome. The name “cohosh” comes from an Algonquian word meaning “rough,” referring to the feel of the rhizome. Plants associated with the name include other Cimicifuga species, Macrotys actaeoides and Actaea racemosa.

What is Black Cohosh used for?

The roots and rhizomes of this herb are used medicinally. Traditional uses include the treatment of dysmenorrhea, dyspepsia, and rheumatisms. A tea from the root has been recommended for sore throat. The Latin name cimicifuga means “bug-repellent” and the plant has been used for this purpose. American Indians used the plant to treat general malaise, kidney ailments, malaria, rheumatism, sore throat, gynecological disorders (eg, menstrual cramps, ease of labor), and snakebites. North American colonists used the herb for treating amenorrhea, bronchitis, chorea, dropsy, fever, hysteria, itch, lumbago, nervous disorders, snakebite, yellow fever, and uttering disorders. In traditional Chinese medicine, the herb was valued for its anti-inflammatory, analgesic, and fever reducing properties.

The plant has been used in Europe since the 17th century to treat joint pain, neuralgia, and pain in pregnancy and labor.

Old-time remedy “Lydia Pinkham's Vegetable Compound” (early 1900s) contained many natural ingredients, one of which was black cohosh.

Remifemin, the brand-name of the standardized extract of the plant, has been used in Germany for management of menopausal symptoms. This product is used for the management of menopausal hot flashes. This product shows no effect on endometrium, so there is no need to “oppose” therapy with progesterone as with conventional HRT. Data from studies using this product suggest that black cohosh has a measurable effect on certain reproductive hormones. The plant extract's action proves to be more like estriol than estradiol, which is associated with higher risk for breast, ovarian, and endometrial cancers. The plant seems to have no stimulatory effect on estrogen-dependent cancers and may even exhibit inhibitory effects against the disease.

Black cohosh has been used to help manage some symptoms of menopause and as an alternative to HRT therapy. The purported estrogenic effects of the plant could not be reproduced in extensive tests in mice. More clinical studies are needed to confirm the benefits of black cohosh for symptoms of menopause.

Black cohosh also may be useful for the treatment of osteoporosis and bone health, and for hypercholesteremia and peripheral arterial disease. More studies are needed, however, to address these possible effects with use of the product.

What is the dosage of Black Cohosh?

On the basis of clinical studies, the currently recommended daily dose of black cohosh is a 40% to 60% methanol or isopropranolol extract of 40 to 80 mg herbal drug that is standardized to contain 1 mg of triterpene 27-deoxyactein per 20 mg tablet. Therapeutic effects generally begin after 2 weeks, with maximum effects usually seen within 8 weeks.

Is Black Cohosh safe?

Black cohosh is contraindicated in pregnancy and may cause premature birth in large doses. Avoid black cohosh during lactation. It is also contraindicated in patients with aspirin sensitivity because it contains salicylates.

See Contraindications.

None well documented.

There is a low incidence of side effects.

Overdose causes nausea, dizziness, nervous system and visual disturbances, reduced pulse rate, and increased perspiration. Case reports primarily document hepatic toxicity; however, cardiovascular and circulatory disorders and 1 case of convulsions have been reported.

References

Copyright © 2006 Wolters Kluwer Health

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