Black cohosh is a wild perennial flowering plant that grows naturally in North America. A member of the family Ranunculaceae, or the buttercup family, its botanical names are Cimicifuga racemosa and Actaea racemosa. Black cohosh is both harvested in the wild and cultivated in herb gardens for the medicinal properties of its root. It has been used historically for many conditions, but shows the most promise for relieving unpleasant effects of menopause and perimenopause, as well as menstrual problems.
Availability
The black cohosh herb can be taken as a fresh or dried root, and it is available commercially as a liquid extract, tincture or in capsules and tablets. The dried root also can be found in health food stores. People who want to obtain fresh root can cultivate black cohosh at home. Although black cohosh can also be harvested from the wild, it is officially listed as endangered or threatened in several states.
Components
The main active component of black cohosh appears to be triterpene glycosides, which include actein and cimifugoside. Additionally, black cohosh root is a source of resins, caffeic acid, isoferulic acid, alkaloids, flavonoids and vitamin A and vitamin B5, or pantothenic acid.
Official Viewpoints
In Germany, the herb is approved as a prescription medication for alleviating premenstrual problems, menstruation cramps and menopausal effects, such as hot flashes. The country's regulatory agency for herbs, Commission E, has approved it as an alternative to hormone therapy. In the United States, people can buy black cohosh root in its various forms without a prescription. The American College of Obstetrics and Gynecology supports the use of black cohosh for treatment of menopausal symptoms for up to six months, particularly for alleviating sleep disorders, mood disturbances and hot flashes.
Expert Insight
The National Institutes of Health gives details of numerous studies on its website that have researched health benefits of black cohosh. The institute states that the research shows promise, but is still not sufficient for an official recommendation. Most studies have lasted six months or fewer, and show a lack of rigor in design, such as not having a placebo control group. Additionally, different sources and different amounts of black cohosh have been used in these studies. Some trials have indicated no difference between taking black cohosh root and taking a placebo. The most commonly-studied substance was a standardized commercial extract under the brand name Remifemin, produced by GlaxoSmithKline.
Specifics
Some encouraging studies have shown reduction in frequency and intensity of menopausal hot flashes and excessive sweating when taking black cohosh root. One study of 80 menopausal women showed that daily hot flashes decreased from 4.9 to 0.7 for those taking black cohosh, compared to 5.2 to 3.2 for those taking conjugated estrogen. Women in the placebo group had very similar results to the estrogen group. Another study of 60 women showed that black cohosh reduced symptoms similarly to estrogen treatment, but this study did not have a placebo group. Additional studies also have shown black cohosh efficacy similar to estrogen, but the research usually has structural issues such as the absence of control groups.
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