What Exactly Is Black Cohosh And How Does It Work
Black cohosh is a plant. Its also called bugbane, and it belongs to the buttercup family. For years its roots and flowers have been used in Native American culture and in Eastern medicinebut its mainstream popularity really grew in the 1950s.
Black cohosh has earned quite the reputation over the years and might help with premenstrual syndrome , bone health, infertility, some hormone imbalances, PCOS, and yes: menopause symptoms. Exactly how black cohosh works is a little less clear. Its possible that black cohosh works because its a phytoestrogen. Phytoestrogens are plant compounds that have a similar function and composition to the natural estrogen you produce. These similarities let phytoestrogens act like weak estrogen in your body . In menopause, natural estrogen levels reach new lows. The estrogen-like properties of phytoestrogens can step in and offer some relief. You might start to notice your hot flashes, night sweats, insomnia, mood swings, anxiety, vaginal dryness, headaches, and other symptoms are bothering you less and less.
Dosage And How To Take
Black cohosh is available in capsule, liquid extract, or tea form.
Dosage recommendations vary widely between black cohosh brands. Typical doses are anywhere from 20120 mg of standardized black cohosh extract or powder daily .
For menopause symptoms, taking at least 20 mg of black cohosh daily which most brands will provide appears to be effective .
Some health professionals claim you should not take black cohosh for longer than 6 months to 1 year because of its slight potential to cause liver damage .
Because supplements are primarily subject to post-market regulation by the government, you should choose black cohosh supplements that have been third-party tested for quality. Some of these third-party testing organizations include United States Pharmacopeia and ConsumerLab.
Additionally, black cohosh is often sold in blends containing other herbal supplements, including:
- Red clover. Black cohosh and red clover can be taken together to help manage menopause symptoms, but theres no evidence that theyre more effective than a placebo (
What Are Black Cohosh Supplements Used For
In addition to menopause symptom treatment, scientists have conducted studies on a number of other potential uses for black cohosh. Some of the research shows theres potential for effectiveness, though in most cases theres not enough evidence to say for sure. Some of the conditions that have been studied and the potential for black cohosh efficacy include:
- : Mixed resultspotentially beneficial, potentially harmful
- : Mixed resultspotentially beneficial, potentially no effect
May Reduce Risk Of Osteoporosis
Theres more good news. A preliminary recent German study indicates that black cohosh may prevent bone loss in menopausal women. The study examined the effects of black cohosh extract on bone density in rats that had their ovaries removed. Typically, bone loss is accelerated after menopause, or in this case, after the removal of the rats ovaries, their main source of estrogen.
The rats were divided into three groups: one received a normal diet, the second group received a normal diet plus raloxifene and the third group was fed a normal diet with black cohosh extract.
The rats given black cohosh had significantly lower markers for bone loss in their urine. They also showed a reversal of the effects of ovariectomy on bone loss. These results were similar to the group given the prescription SERM, raloxifene, which is currently used to prevent osteoporosis. These exciting results led the researchers to conclude that a longer-term clinical trial of black cohosh for the treatment of osteoporosis is warranted.5
Controlling Menopausal Symptoms For Women In General
Remifemin is a common brand of black cohosh. Some early clinical trials showed that Remifemin helped to relieve menopausal symptoms. Others showed that it didn’t.
A Cochrane review in 2012 of 16 randomised controlled trials found there wasn’t enough evidence to support or oppose the use of black cohosh for menopausal symptoms.
They recommended higher quality research with larger groups of women. The researchers also made suggestions. They said that future research should be more precise about the type and quality of black cohosh they use. This is so that other researchers can use the same type.
Researchers also did a systematic review in 2016. They found no link between taking black cohosh and having less menopausal symptoms.
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Pros And Cons Of Black Cohosh
Research shows that black cohosh does appear to have positive impacts on specific menopausal symptoms, but they are very modest and depend on the individual.
A 2010 review of nine studies found that black cohosh was able to provide a 26% reduction in hot flash symptoms and night sweats among menopausal women in seven of the studies. Yet, a 2012 review of sixteen studies found there was insufficient evidence to support the use of black cohosh for menopausal symptoms. A 2013 review found that black cohosh use resulted in a mild, but overall improvement in menopausal women when compared to a placebo. You can see from this sampling of research that the evidence is very mixed on whether black cohosh helps relieve menopause symptoms.
Its important to note that most of the research on black cohosh in menopause has been done with Remifemin, a specific brand of commercially sold black cohosh. In other words, the effectiveness of other black cohosh products in menopausal symptoms is largely unknown. In fact, other research indicates that many black cohosh products are about as effective as a placebo at reducing menopausal symptoms, making it impossible to know which one may or may not help you.
Some of the potential health consequences of using black cohosh include:
– Increased bleeding
– Mild vision impairments
Medications That Can Harm The Liver Interacts With Black Cohosh
There is concern that black cohosh might harm the liver. Taking black cohosh along with medication that might also harm the liver can increase the risk of liver damage. Do not take black cohosh if you are taking a medication that can harm the liver.Some medications that can harm the liver include acetaminophen , amiodarone , carbamazepine , isoniazid , methotrexate , methyldopa , fluconazole , itraconazole , erythromycin , phenytoin , lovastatin , pravastatin , simvastatin , and many others.
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Mood Changes Fatigue And Insomnia
Common mood changes that menopausal women experience include irritability, anxiety and depression. Mood changes often go hand-in-hand with poor sleep and fatigue, and night-time symptoms certainly contribute to this. Some herbal therapies have been found to benefit these symptoms.
Korean ginseng is traditionally used to help improve fatigue, physical exhaustion and loss of physical stamina. It may also increase vitality and improve your concentration. It is one of the most commonly self-prescribed herbs for menopausal symptoms because of its female hormonal properties and its ability to help you cope with stress.
Chamomile is a gentle sedative, and its relaxing action may be useful for aiding sleep and anxiety. Hops traditionally have been used to treat anxiety, stress and associated insomnia. Lemon balm, valerian and passionflower can aid sleep and reduce anxiety.
St John’s wort is used traditionally for mild to moderate anxiety, irritability and depressed mood associated with menopause.
Estrogen Antidepressants Black Cohosh
Menopause and the treatment of its symptoms are in the news again with the publication of new guidelines from the American College of Obstetricians and Gynecologists. And sadly, women seem just as confused as ever about how they should handle symptoms like hot flashes without risking their health.âI feel so baffled by the choices out there,â wrote one reader in the comments section of a New York Times story that examined the guidelines, published in the January 2014 issue of the journal Obstetrics & Gynecology. âI would like to take charge of my health, but all the information seems so contradictory.âThat confusion is understandable, said Dr. Katherine A. Guthrie, a statistician and menopause researcher in Fred Hutchinson Cancer Research Centerâs Public Health Sciences Division.âItâs a complex issue and itâs important to consider where you are as an individual,â she said.âEveryone and their brother seem to have a recommendation for women about what they should do about this,â Guthrie said. âWomen are suffering, their quality of life is suffering and theyâre being told to waste their time and money on solutions that we have good evidence donât work.â
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Clinical Use/possible Benefits Of Black Cohosh In Breast Cancer Patients
Endocrine therapy or Hormonal therapy such as Tamoxifen is one of the most common treatments used for breast cancer, especially in the estrogen receptor positive breast cancers. However, these treatments may result in severe climacteric or menopause symptoms in breast cancer survivors including adverse reactions like hot flushes, sleep problems, depressive symptoms, irritability, and mood swings. Several approaches have been tried out for handling such symptoms in breast cancer patients including the use of herbal medications.
In this blog, we will explore different studies carried out to evaluate the effect of using black cohosh for handling menopause symptoms in breast cancer patients. In many of these studies, a specific isopropanolic extract of black cohosh is used to study the impact. Remifemin, a herbal medicine used to relieve menopause complaints, is one of the most studied black cohosh supplements used in different clinical trials as well as open-label studies for monitoring its effects in physicians practices.
How Is Black Cohosh Used During Menopause
Black cohosh has gained popularity for the alleviation of menopausal symptoms. This is because black cohosh root appears to act similarly to estrogen, the hormone that decreases during menopause and causes the majority of symptoms women experience during midlife.
Some of the most commonly reported menopausal symptoms, for which women use black cohosh include:
– Night sweats or excessive sweating
– Vaginal dryness
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Treatments For Vaginal Dryness
The most effective treatment for vaginal dryness caused by decrease estrogen levels during menopause is estrogen therapy. Estrogen can increase the vagina’s natural moisture and strengthen vaginal walls to prevent vaginal atrophy. However, estrogen therapy does not work for all women, and it can have some serious side effects.
Lubricants and moisturizers can help women with vaginal dryness, along with talking to a therapist to work out any relationship issues. Herbal remedies for vaginal dryness usually do not work better than the placebo effect, and more research needs to be done to figure out how well these herbs work. However, if black cohosh is working for you, then you should feel free to continue taking it under your physician’s supervision. For more information on natural cures for vaginal dryness, click on the links below.
- National Institutes of Health. . Vaginal dryness alternative treatments. Retrieved September 30, 2015, from https://www.nlm.nih.gov/medlineplus/ency/article/002142.htm
- Office of Dietary Supplements. . Black Cohosh. Retrieved September 30, 2015, from https://ods.od.nih.gov/factsheets/BlackCohosh-HealthProfessional/
- University of Maryland Medical Center. . Black Cohosh. Retrieved September 30, 2015, from https://umm.edu/health/medical/altmed/herb/black-cohosh
St John’s Wort Hypericum Perforatum
St John’s wort traditionally has been used for menopausal symptoms of anxiety, irritability, insomnia and depression. It can be useful for hot flushes. It does not possess hormonal actions and its antidepressant action is believed to be due to a combination of active constituents in the herb. St John’s wort has been studied extensively for its effectiveness in mild to moderate anxiety and depression. It may be that St John’s wort is as effective as selective serotonin reuptake inhibitors for the treatment of depression, and it may have fewer side effects.
A recent review suggests St John’s wort, alone or combined with other herbs, may be significantly better than placebo in the treatment of menopausal symptoms. it is particularly effective when combined with black cohosh to decrease hot flushes and improve mood.
Precautions: St John’s wort influences your liver enzymes that can reduce or increase the effectiveness of certain medications. It is one of the few herbs that has been studied for interactions with medications. If you are on the following medications, you should be very cautious about using St John’s wort, and consult your own doctor:
- anticoagulants such as warfarin, heparin, aspirin, apixaban and rivaroxaban
- antidepressant drugs, especially SSRIs or serotonin and noradrenaline reuptake inhibitors
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When Should You Take Black Cohosh
Black cohosh has been used for medicinal purposes for centuries. Native Americans used it to treat pain, , and . They also used it to treat problems with womens reproductive health. Since about the 1950s, black cohosh supplements have been used to ease symptoms of menopause. It may also help with other health issues. Some women who take black cohosh for menopause may find relief from , , and . Black cohosh has both benefits and side effects, so be sure to weigh the risksand talk with your doctorbefore adding this supplement to your diet.
There’s No Proof Black Cohosh Works
Theres really no good evidence that black cohosh makes any difference to menopausal symptoms, says Carpenter, who was the lead author of a major menopause report published in Menopause, the journal of the North American Menopause Society in 2015. Theres plenty of anecdotal evidencewomen who say it helped them, Carpenter says, but overall, studies show that it’s no better than a placebo.In particular, Carpenter cites a 2012 Cochrane review that analyzed 16 randomized controlled trials of 2,027 perimenopausal and postmenopausal womenwomen who were either approaching menopause or who had already gone through it. After evaluating the studies, including their design, length, frequency of side effects, and other important factors, the reviewers concluded that when it comes to reducing the frequency of hot flashes, black cohosh worked no better than a placebo.Indeed, that placebo effect could explain why many women say black cohosh relieves their symptoms. We know that in studies women who are given placebos consistently experience a 30 percent reduction in hot flashes, Carpenter says. Women report fewer hot flashes during the day while taking a placebo, and they tell us theyre waking up fewer times in a sweat during the night, she says.
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Does Black Cohosh Have Side Effects
Black cohosh is generally considered to be a safe supplement however, theres the potential for some drug interactionsincluding breast treatmentsso discuss with your doctor any medications youre taking.
Recent studies have not linked black cohoshs benefits to an estrogen-like effect, which reduces scientists worries about how the supplement might affect uterine and breast tissue. However, women with any hormone-sensitive health conditions should use caution before taking black cohosh supplements. A doctor may recommend avoiding the herb altogether.
Other potential side effects of black cohosh, particularly in high doses, include:
- Cramps and abdominal pain
Cimicifuga Racemosa Actaea Racemosa
Black cohosh is a perennial herb native to North America. A member of the buttercup family, it grows in woodland areas and can reach heights of two to four feet. A popular garden ornamental, its dried seedheads remain attractive for weeks after it flowers. It has a distinctive, variable odor that has been described as sweet, cloying or putrid.
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Use Of Isopropanolic Extract Of Black Cohosh Alone Or In Combination With St Johns Wort In Breast Cancer Patients With Menopausal Symptoms Receiving Endocrine Therapy
Through a systematic literature search done by the researchers from the Capital Medical University in Beijing, China, University Hospitals of Tuebingen, Blankenstein Hospital and Schaper & Brümmer GmbH & Co. KG in Germany, they evaluated whether menopausal symptoms in Breast cancer patients who received Endocrine therapy can be treated with an isopropanolic extract of Black Cohosh alone or in combination with St Johns wort. The intent of the study was to offer orientation for health care providers by giving an overview of the experimental and clinical data on the efficacy and safety of using Isopropanolic extract of Black Cohosh with or without St Johns wort, its use in breast cancer patients, and putative interactions with the endocrine treatment.
For this, data was obtained through search in MEDLINE, EMBASE, EMBASE Alert, BIOSIS, and PubMed databases for clinical studies with Isopropanolic extract of Black Cohosh alone or in combination with St Johns wort and the specific St Johns wort component in the herbal combinations.
Key Findings of the study:
The researchers didnt find any adverse events or serious side-effects due to herb-drug interactions in these patients treated with Black cohosh. Hence, they concluded that the isopropanolic extract of Black Cohosh alone or in combination with St Johns wort may offer a safe non-hormonal therapeutic option for breast cancer survivors receiving endocrine therapy such as Tamoxifen.
What Are The Risks Of Taking Black Cohosh
- Side effects from black cohosh include headaches and upset stomach, but there are many others. Side effects may be more likely to occur at high doses. There have been some people who may have developed liver problems after using black cohosh, the specifics of which are still being investigated. Nonetheless, people with pre-existing liver problems, or those taking any other medication/substance that affects the liver, should either avoid black cohosh or check in with their health care provider prior to use.
- Risks. Black cohosh may not be safe for:
- Women who are pregnant
- Women who have — or have had — breast cancer or uterine cancer
- Women who have endometriosis
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What Is Black Cohosh
Black cohosh is a flowering perennial plant with fragrant white blooms on a stem, forming a spike-like structure of up to 5 feet tall. A member of the buttercup family, it grows in the woodlands of the eastern United States and Canada.
Black cohosh goes by other names, too.
- Black bugbane.
- Rheumatism weed.
What To Look For
Look for supplements that contain black cohosh root, the medicinal part of the plant.
The Food and Drug Administration does not regulate supplements. As a result, the quality and amount of active ingredients in the product can vary from brand to brand.
Look for products certified by an independent third-party tester such as Consumer Labs, U.S. Pharmacopeia, or NSF International.
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