Black Cohosh

Cimicafuga racemosa

Cohosh is a Native American word that means ‘knobby rough roots,’ and Black Cohosh is a native North American plant which grows from a gnarled black root, hence its name.

Black Cohosh has a history of usage for women's health problems, dating back to the Algonquian natives living in the Ohio Valley. 

Native Americans traditionally used Black Cohosh, otherwise known as squawroot, to treat uterine disorders such as menstrual and menopausal symptoms.

It was also used for other ailments, such as diarrhoea, sore throat, arthritis, and general weakness.
The Eclectic doctors of the 1800’s recommended Black Cohosh for ‘hysterical’ diseases, (their terminology for female reproductive disorders.)  They also used the herb for fevers, rashes, sleeplessness and malaria.

The beneficial effects of Black Cohosh are attributed to chemicals in the plant that resemble and mimic the effects of the female hormone, oestrogen.  However, the strength of the plant's oestrogenic effects has been disputed, and the exact physiological mechanism by which Black Cohosh works in the body is not well understood.

Today, Black Cohosh is still used for gynaecological problems from menstruation to menopause. The herb is often referred to as a ‘woman's remedy’ because of it’s ability to relieve premenstrual discomfort, menstrual cramps, and symptoms of menopause such as hot flushes.

Scientific studies have reported that Black Cohosh improved the condition of the vaginal epithelium, reduced menopausal symptoms and was well tolerated with few side-effects.

A 2002 study of menopausal women in the San Francisco Bay area found that women taking Black Cohosh and other herbal remedies for their symptoms reported higher satisfaction with their treatment than women receiving conventional allopathic therapy.

A 1982  study, in which over six hundred women took 80 mg of Black Cohosh for a period of six to eight weeks, found that more than 80% of the women experienced relief from several menopausal symptoms, including hot flushes, perspiration, headaches, heart palpitations, irritability, sleep disturbances and depression.

Another study looked at sixty women under forty years of age who had hysterectomies, with one ovary remaining.  The women were either given Black Cohosh or hormone replacement therapy (HRT). Although the HRT was more effective for symptom relief, the study concluded that Black Cohosh was a favourable natural alternative after hysterectomy.

A 1998 German clinical study showed that Black Cohosh had good therapeutic results in treating symptoms of menopause.

A 1999-2000 study at Cedars-Sinai Hospital in California, looked at the efficacy and safety of several traditional herbal medicines used to treat women's gynaecological conditions, such as PMS and menopause.  This study concluded that both Dong Quai and Black Cohosh were safe to use for the relief of menopausal symptoms.

A 1998 study at the University of Bridgeport in Connecticut reviewed eight previous studies of Black Cohosh in the treatment of menopausal symptoms.  The conclusion was that Black Cohosh was a safe alternative to oestrogen replacement therapy for women where oestrogen is contraindicated or declined.

There is concern that Black Cohosh might influence the effectiveness of cancer treatments and there is some disagreement in different studies of cancer cells grown in laboratory dishes.  Black Cohosh seems to have no impact on the effectiveness of radiation in cancer cells, but makes some chemotherapy drugs less effective and others more effective.

Some studies found Black Cohosh may reduce growth of breast cancer cells in laboratory dishes, but another study suggests that it can increase spread of breast cancer in mice.

Because of these conflicts and until more is known about this issue, many oncologists recommend a cautious approach and suggest delaying use of Black Cohosh in patient’s with cancer until treatment is complete.

Commission E (Germany's regulatory agency for herbs) supports the use of Black Cohosh for premenstrual discomfort, period pain and for the relief of menopausal symptoms.  The herb has been approved in Germany for more than fifty years and is commonly prescribed in other European countries.

The North American Menopause Society recommends considering Black Cohosh as one of the nonprescription remedies for mild menopausal symptoms but points out that the safety of this herb for women with breast cancer remains uncertain.

Cautions and Contraindications.
Hypertension, pregnancy and breast-feeding.
The German Commission E (the European regulatory body) recommends the herb not be taken for more than six months at a time.

There have been a few reports of serious liver disease among women who had recently started using Black Cohosh.  For this reason, some doctors suggest that people who already have liver problems should not use this supplement.