Black Cohosh - Uses & Side Effects

Scientific Name(S): Cimicifuga racemosa (L.) Nutt. Family: Ranunculaceae. Plants associated with the name include other Cimicifuga species, Macrotys actaeoides and Actaea racemosa L.

Common Name(S): Black cohosh, baneberry, black snakeroot, bugbane, squawroot, rattle root

Black cohosh is popular as an alternative to hormonal therapy in the treatment of menopausal (climacteric) symptoms such as hot flashes, mood disturbances, diaphoresis, palpitations, and vaginal dryness. Several controlled trials and case series have reported black cohosh to improve menopausal symptoms for up to six months. Although these initial studies are suggestive, they have been few in number and have universally suffered from methodological weaknesses.

Botany: 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 that bloom from June to September. Its leaflets are shaped irregularly with toothed edges. 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.

History: 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 snakebites.

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 menopausal management since the mid-1950s.

Uses of Black Cohosh

• Black cohosh has a history of use for rheumatism (arthritis and muscle pain), but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause.
• Black cohosh has also been used for menstrual irregularities and premenstrual syndrome, and to induce labor.

Side Effects of Black Cohosh

• Overdose causes nausea, dizziness, nervous system and visual disturbances, reduced pulse rate and increased perspiration.
• Black cohosh has recently been linked to a few cases of hepatitis (inflammation of the liver), but it is not clear whether black cohosh caused the problem.
• It is not clear if black cohosh is safe for women who have had breast cancer or for pregnant women.

Toxicology: Overdose of black cohosh may cause ausea, vomiting, dizziness, nervous system and visual disturbances, reduced pulse rate and increased perspiration. The constituent acteina does not possess toxicity in animal studies.

Large doses of the plant may induce miscarriage. Black cohosh is contraindicated in pregnancy and may cause premature birth in large doses.

A case report describes a 45-year-old woman who experienced seizures, possibly related to consumption of an herbal preparation containing black cohosh.

Summary: Black cohosh has been used to control symptoms of menopause as an alternative to conventional HRT therapy. The plant seems to have no effect on estrogen-dependent cancers and may even exhibit inhibitory effects against the disease. Black cohosh may also be useful in other areas such as treatment for hypercholesteremia or peripheral arterial disease. Overdose of the plant reportedly causes nausea, dizziness and nervous system disturbances. It is contraindicated for use in pregnant women.