Black Cohosh

Biological Name: Cimicifuga racemosa, Cimicifuga heracleifolia, Cimicifuga dahurica, Cimicifuga foetida

Family: Ranunculaceae (Buttercup family)

Other Names: Black snakeroot, bugbane, squawroot, bugwort, rattleroot, rattleweed, rattlesnale's root, richweed, Black Cohosh, Cimicifuga, Sheng ma, Chinese black cohosh

Parts Used: Root

 

Active Compounds: 

Black cohosh contains several important ingredients, including triterpene glycosides (e.g., acetin and cimicifugoside) and isoflavones (e.g., formononetin). Other constituents include aromatic acids, tannins, resins, fatty acids, starches, and sugars. Formononetin is the active element in the herb that binds to estrogen receptor sites, inducing an estrogen-like activity in the body. As a woman approaches menopause, the signals between the ovaries and pituitary gland diminish, slowing down estrogen production and increasing luteinizing hormone (LH) secretions. Hot flashes can result from these hormonal changes. Clinical studies from Germany have demonstrated that an alcohol extract of black cohosh decreases LH secretions in menopausal women.

History:

Native American Indians valued the herb and used it for many conditions, ranging from gynecological problems to rattlesnake bites. Some nineteenth- century American physicians used black cohosh for problems such as fever, menstrual cramps, arthritis, and insomnia.

Traditional Applications in Herbal Medicine:

Diaphoretic, antipyretic, antifungal, antibacterial, astringent, emmenagogue, diuretic, alterative, expectorant.

Black cohosh helps in the treatment of:
    Menopause
    Painful menstruation
    Uterine spasms

The primary traditional use of black cohosh has been as a relaxant, sedative, and antispasmodic. Its effectiveness as a remedy for dysmenorrhea has not been successfully proven, but research suggests a pharmacological basis for its use in treating rheumatism and neuralgia.

The root of this plant is much used in America in many disorders, and is supposed to be an antidote against poison and the bite of the rattlesnake. The fresh root, dug in October, is used to make a tincture.

Other indications include:
Bitter, tonic, alterative, analgesic, anti-inflammatory, antirheumatic, antispasmodic, antitussive, astringent, diaphoretic, diuretic, emmenogogue, estrogenic, expectorant, febrifuge, hypotensive (effects have not been definitely verified, although some peripheral vasodilation was observed), slightly narcotic, nervine, sedative (arterial and nervous systems), uterine stimulant, and vasodilator. Also a possible cardiac stimulant and is said to increase gastric secretions as well as lower body temperature by dilating blood vessels; plant properties responsible for these and the hypotensive effects is best extracted in alcohol rather than water.

Affects reproductive, nervous, respiratory and circulatory systems. Effects include the ability to bind to estrogen receptor sites. Has been combined with Squaw vine and Raspberry during the last 2 weeks of pregnancy to prepare the body for childbirth, but is not recommended unless under the care of a physician. Has been combined with blue cohosh for uterine conditions.

Has been used internally for arthritis, rheumatoid arthritis, osteoarthritis, muscular and neurological pain, neuralgia, toothache, urine retention, bronchial infections, menstrual problems (dysmenorrhea, amenorrhea, ovarian and uterine cramping, PMS), menopausal problems, childbirth labor, postpartum pain, rheumatism, sciatica, and tinnitus (depresses the central nervous system and inhibits vasomotor centers involved in inner ear balance and hearing explaining its use to ease tinnitus; usually combined with ginkgo or prickly ash).

In a study of menopausal women, the half given the extract of the root showed significant increase in estrogenic activity and a reduction of hot flashes. In another study, vaginal dryness was relieved and compared favorably in effectiveness to pharmaceutical estrogen. However, its use must be monitored carefully by a professional and used for a limited period. Has also been used for premenstrual discomfort and painful periods.

Has often been combined with Bogbean, Parsley and/or Willow bark for arthritis and rheumatism. Was used for rheumatic complaints by early North American settlers and was being used in New York hospitals in the 19th century for this purpose. The whole root was placed in whiskey to extract its properties.

Has been used for high blood pressure and to equalize circulation. Traditionally taken as a capsule, pill, or tincture for high blood pressure.

Its history includes use for scarlet fever, measles, smallpox, asthma, scrofula, St. Vitus dance, epilepsy, convulsions, dropsy, spinal meningitis, delirium tremens, bronchitis, pulmonary conditions, intercostal myalgia, sciatica, whooping cough, pericarditis, angina pectoris, male gonorrhea, spermatorrhea, seminal emission, lack of libido, dyspepsia and hysteria.

Has been used at times for panic attacks (often combined with skullcap, passionflower, valerian, or lemon balm).

Once used in syrup form for coughs, whooping cough, liver and kidney problems. Was traditionally taken as a tea for lung complaints.

Used by Native Americans for snakebite and has been used externally to heal sores and puncture wounds. The bruised root was applied locally to snakebite as an antidote.

Traditional Chinese Medicine:
Clears wind heat, regulates the circulation of qi, relieves pain. It can be used for headache caused by wind heat; gingivitis; hives; diarrhea; venting eruptive skin diseases, such as measles, in the early stages; and prolapsed internal organs, such as the anus and uterus. The Chinese say that this herb "lifts the sunken"; therefore, it is used to direct other herbs upward and is also indicated for prolapsed organs. North American cimicifuga may be similar though not identical to the Chinese variety.

 

Studies and Reports

Menopausal Symptoms
A dozen studies or more conducted throughout the 1980s and 1990s confirm that the long-standing use of black cohosh for menopausal symptoms has scientific validity. For example, in a German study involving 629 women, black cohosh improved physical and psychological menopausal symptoms in more than 80% of the participants within four weeks. In a second study, 60 menopausal women were given black cohosh extract, conjugated estrogens, or diazepam (a leading anti-anxiety medication) for three months. Those who received black cohosh reported feeling significantly less depressed and anxious than those who received either estrogens or diazepam. In another study, 80 menopausal women were treated for 12 weeks with black cohosh extract, conjugated estrogens, or placebo. Black cohosh improved anxiety, menopause and vaginal symptoms. In addition, the number of hot flashes dropped from 5 to less than 1 average daily occurences in the black cohosh group compared to those taking estrogen in whom hot flashes dropped from 5 to 3.5 daily occurences.

Given these examples, and results of other studies, some experts have concluded that black cohosh may be a safe and effective alternative to estrogen replacement therapy (ERT) for women who cannot or will not take ERT for menopause.

The American College of Obstetricians and Gynecologists (ACOG) reports, however, that many of these studies were poorly designed and did not evaluate the safety and effectiveness of black cohosh beyond 6 months of use. Despite this limited evidence, the ACOG still recognizes the value of black cohosh for menopausal symptoms. Until further studies are conducted, however, the ACOG recommends only short-term (less than 6 months) use of this herb for the relief of hot flashes specifically.

Hot Flashes with treatment for Breast Cancer
Many breast cancer patients use black cohosh to ease hot flashes, a common side effect of medications used to treat breast cancer such as tamoxifen. While black cohosh may reduce the number and intensity of hot flashes in breast cancer patients, two well-designed studies recently concluded that the herb is no more effective than placebo.

In addition, although there is some debate about this, black cohosh may contain plant based estrogens, called phytoestrogens. Therefore, there is some concern that if there are phytoestrogens in black cohosh, they may stimulate the growth of breast tumors. This idea has not been substantiated scientifically; in fact, some studies suggest that black cohosh may inhibit the growth of breast cancer cells in test tubes. Additional research is needed before conclusions can be drawn about use of black cohosh in women with a history of or risk for developing breast cancer (such as strong family history).

Arthritis
Preliminary studies also suggest that black cohosh may help reduce inflammation associated osteoarthritis and rheumatoid arthritis. In a review of scientific studies, researchers concluded that a combination of black cohosh, willow bark (Salix spp.), sarsaparilla (Smilax spp.), guaiacum (Guaiacum officinale) resin, and poplar bark (Populus tremuloides) may help relieve symptoms of osteoarthritis.

Osteoporosis
Some experts suggest that the plant based estrogens in black cohosh, in theory, could help prevent osteoporosis. This theory has yet to be tested scientifically.

 

Dosage:
Black cohosh can be taken in several forms:

Crude, dried root, or rhizome (300-2,000 mg per day)
Solid, dry powdered extract (250 mg three times per day).
Tinctures can be taken at 2-4 ml per day.

Standardized extracts of the herb are available and contain 1 mg of deoxyacteine per tablet. The usual amount is 40 mg twice per day. Black cohosh can be taken for up to six months, and then it should be discontinued.

Safety:
Black cohosh has an estrogen-like effect, and women who are pregnant or lactating should not use the herb. Large doses of this herb may cause abdominal pain, nausea, headaches, and dizziness. Women taking estrogen therapy should consult a physician before using black cohosh.

Large doses of black cohosh cause symptoms of poisoning, particularly nausea and dizziness, and can also provoke miscarriage.

Black cohosh should not be used by those who have full-blown measles or those who are having trouble breathing. It should also not be used by those with excess in the upper regions and deficiency in the lower part of the body.