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Black cohosh: an alternative therapy for menopause?
Gail B Mahady1, Daniel Fabricant, Lucas R Chadwick
1UIC/NIH Center for Botanical Dietary Supplements Research, Program for Collaborative Research in the Pharmaceutical Sciences, University of Illinois, Chicago, Illinois, USA.
Summary
Black cohosh (Actaea racemosa) may help menopausal symptoms like hot flashes, but its effectiveness in breast cancer survivors is uncertain. More research is needed to confirm its benefits and safety.
Area of Science:
- Herbal medicine
- Gynecology
- Menopause management
Background:
- Hormone replacement therapy (HRT) carries health risks, prompting interest in alternatives.
- Black cohosh (Actaea racemosa) has a long history of use for gynecologic complaints.
- Existing data suggest potential benefits for menopausal symptoms like hot flashes and insomnia.
Purpose of the Study:
- To evaluate the efficacy and safety of black cohosh for menopausal symptom relief.
- To address the need for high-quality clinical trials due to limitations in current research.
- To investigate the controversial estrogenic or anti-estrogenic effects of black cohosh.
Main Methods:
- Review of published clinical data on black cohosh for menopausal symptoms.
- Identification of ongoing randomized, double-blind, placebo-controlled trials.
- Analysis of data from a recent trial involving breast cancer survivors on tamoxifen.
Main Results:
- Black cohosh may be effective for hot flashes, sweating, insomnia, and anxiety in menopausal women.
- It showed no effectiveness in breast cancer survivors treated with tamoxifen.
- Adverse reactions include nausea, headaches, and dizziness; no drug interactions reported.
Conclusions:
- Black cohosh shows potential for managing menopausal symptoms, but evidence quality is variable.
- Its use in breast cancer survivors on tamoxifen is not supported by recent findings.
- Further high-quality trials are necessary to establish definitive efficacy and safety, especially regarding hormonal effects.