Black Cohosh Root

Black Cohosh Uses and Side Effects

Black Cohosh has long been used for treating various gynecological disorders and menopausal symptoms such as hot flashes and menstrual dysfunction. There are many studies that have been done on Black Cohosh and its uses and effects on management of hot flashes. There are a limited number of studies suggesting no benefits of using Black Cohosh [2, 3], while many other studies citing conclusive evidence of such benefits. One study conducted at the Mayo Clinic and Mayo Foundation in the US had results which suggests that there lacks any evidence that black cohosh reduced hot flashes more than placebo.

This double-blind, randomized, cross-over clinical trial studied the effects of Black Cohosh on hot flashes. 1 capsule containing 20mg of Cimicifuga racemosa (black cohosh) was given to 132 female participants for 4 weeks. During the trial period, scores were assigned by the women to assess the severity of their hot flashes. The study noted minimal side effects of black cohosh. However, their results found no real differences between the placebo and black cohosh groups. Their study failed to find any benefits of using black cohosh to treat hot flashes. [3]

However, there are many other studies that have found evidence suggesting that black cohosh does indeed have benefits in alleviating menopausal symptoms and improving quality of life in post-menopausal women. 122 healthy, post-menopausal Spanish women with elevated body weight, aged between 45 and 59 years took part in a black cohosh study in Spain. The treatment with black cohosh improved the quality of life in the participants. [4] The findings of this study suggests that black cohosh can play an important role in reducing symptoms and help improve the quality of life in post menopausal woman.

Studies have found that while black cohosh extract may not exhibit a benefit on all females experiencing post menopausal symptoms, it does helps treat women with menopausal disorders of at least moderate intensity [5]. The effectiveness of Black cohosh has also been compared to fluoxetine (prozac) in the treatment of women with postmenopausal symptoms. The study of 120 female subjects with menopausal symptoms took part in this study. Comparing the study results, the black cohosh group experienced a greater reduction in hot flushes and night sweats. [6] While black cohosh was more effective at reducing night sweats and hot flashes, fluoxetine was more effective in reducing symptoms of depression.

Black Cohosh Extract on Weight Gain & Cancer

While black cohosh is primarily used to treat post menopausal symptoms, limited studies have also found the herb to have benefits on controlling weight gain, and with some evidence suggesting that it may have uses in preventing and treating prostate cancer.

Effects of black cohosh extract on body weight gain, intra-abdominal fat accumulation, plasma lipids and glucose tolerance in ovariectomized Sprague-Dawley rats.
Rachoń D, Vortherms T, Seidlová-Wuttke D, Wuttke W.
Department of Clinical and Experimental Endocrinology, University of Göttingen, Göttingen, Germany.

The objective of this study was to evaluate the effects of dietary black cohosh extract consumption on body weight gain, intra-abdominal fat accumulation, plasma leptin, lipids and glucose tolerance in ovariectomized rats. 27 rats were separated into a black cohosh (6.67g/kg) group and a control group. After a 6 week treatment period, intra abdominal fat was measured, and glucose tolerance test was performed. The results showed that the dietary black cohosh significantly reduced serum lutenizing hormone (LH) levels, the black cohosh treated animals gained less weight, and had less accumulation of abdominal fat. They concluded that treatment with the black cohosh extract helps reduce body weight gain and intra abdominal fat accumulation. [7]

Some studies have also found black cohosh extract to have inhibitory effects on prostate cancer. Studies involving mice have found that treatment with black cohosh extract significantly reduced tumor growth in the mice suggesting the possibility that black cohosh may be efficient in preventing and treating prostate cancer. [8] Other similar studies have found black cohosh extract has an anti-proliferative effect, potently inhibiting the growth of human prostate cancer cells in vitro. [9]

Side Effects of Black Cohosh

Black cohosh is a North American perennial plant that has been used for traditional medicinal purposes by the native Indian population. There are studies that have been done on black cohosh to determine its safety and potential side effects. In a study by the Universities of Exeter and Plymouth in UK, it was stated that black cohosh is a safe herbal therapy for menopausal women taken only for limited period of time. However, the safety and side effects of back cohosh long term use still requires more investigation. [10]

Despite the short term safety statements made in that study, there are some, albeit, rare cases where the use of black cohosh was associated with hepatotoxicity and acute liver failure. One recent study cited 2 cases where the liver problems and hepatitis was related to the usage of preparations containing black cohosh [11]. Another study cited acute liver failure associated with the use of herbal preparations containing black cohosh. [12]

Regulatory agencies in Australia, Canada, and the European Union have released statements regarding the "potential association" between black cohosh and hepatotoxicity. The United States Pharmacopeia made a review of black cohosh case reports of hepatotoxicity, and based on the results of their safety review, the committee determined that black cohosh products should be labeled to include a cautionary statement, which marks a change from their 2002 decision, which required no such cautionary statements. [13]

As stated in these studies, the acute liver failure cases are rare, but the safety concerns merit caution for the end user. Aside from these potential severe adverse side effects, some other side effects of black cohosh include headaches, nausea, dizziness, upset stomach, and a heavy feeling in the legs. While short term use is generally regarded as safe [10], long term use should be avoided.

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