Black Cohosh

• Native American Uses: Traditionally used by Native Americans for menstrual and menopausal issues, rheumatic pain, and as a remedy for snake bites.
• Colonial Use: Early settlers adopted its use for similar gynecological and inflammatory conditions.
• Folk Medicine: Known for alleviating symptoms of menopause, PMS, and other hormonal disorders, as well as being a sedative and anti-inflammatory agent.

• Triterpene Glycosides: Actein, cimicifugoside
• Phenolic Compounds: Ferulic acid, isoferulic acid
• Flavonoids: Kaempferol derivatives
• Alkaloids: N-methylcytisine
• Other: Resin, tannins, and starch

• Estrogenic-like Activity: Modulates estrogen receptors without direct hormonal effects.
• Anti-inflammatory: Inhibits pro-inflammatory mediators.
• Antioxidant: Neutralizes free radicals.
• Sedative Effects: Calms the central nervous system.

1. Menopausal Symptom Relief:

• Evidence: Studies indicate efficacy in reducing hot flashes, night sweats, and mood swings.
• Key Study: Mehrpooya et al., 2018 found black cohosh effective for menopausal vasomotor symptoms

2. PMS and Menstrual Cramps:

• Mechanism: Reduces cramping and regulates mood.
• Supporting Study: Kronenberg & Fugh-Berman, 2002

3. Bone Health:

• Evidence: May prevent bone loss in postmenopausal women.

4. Anxiety and Depression:

• Use: Mild sedative properties beneficial in mood regulation.
• Clinical Insight: Supporting data from Cochrane Database reviews.

• Pregnancy and breastfeeding (potential hormonal effects).
• Hormone-sensitive conditions such as uterine cancer.
• Liver disorders (rare hepatotoxicity reported).

• Mild gastrointestinal upset (nausea, diarrhea).
• Headache or dizziness in rare cases.
• Possible liver toxicity with prolonged use (monitor liver enzymes).

• Hormonal Therapies: May enhance or interfere with hormone replacement therapy or contraceptives.
• Sedatives: Potentiates CNS depressants like benzodiazepines.
• Hepatotoxic Drugs: Increased risk of liver damage when combined with drugs like acetaminophen or alcohol.

1. Menopausal Symptoms: Comparative efficacy of black cohosh with hormonal therapy
   (https://pmc.ncbi.nlm.nih.gov/articles/PMC6599854/#:~:text=There%20was%20no%20significant%20difference,in%20menopausal%20symptom%20scores%20(standardised))

2. Bone Health: Effects on bone health.)

3. Liver Safety: Hepatotoxicity associated with herbal remedies

• Effectiveness and safety of the treatment of menopausal syndrome with Cimicifuga racemosa dry extract.
• A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause.
• A systematic review of the safety of black cohosh.
• An isopropanolic extract of black cohosh does not increase mammographic breast density or breast cell proliferation in postmenopausal women.
• Black cohosh (Actaea/Cimicifuga racemosa): review of the clinical data for safety and efficacy in menopausal symptoms.

Black cohosh is a promising herbal remedy for managing menopausal and gynecological conditions. Its unique non-hormonal estrogenic activity, anti-inflammatory properties, and sedative effects make it particularly beneficial for women experiencing menopause or PMS. However, its use requires caution due to potential liver toxicity and interactions with other medications.