Black Cohosh
Black cohosh (Cimicifua racemosa, Actaea racemosa), also known as Black snakeroot, Bugbane, Bugwort, Rattleweed, and Rattleroot, is a perennial plant that is a member of the buttercup family and is native to North America. Native Americans used it for a variety of conditions, such as gynecological and kidney disorders, rheumatism, malaria, fever, and even depression. Today, Black cohosh is mainly used as an alternative to hormonal therapy in the treatment of climacteric symptoms, such as hot flashes, mood disturbances, and vaginal dryness.
Black Cohosh Medical Uses
Native Americans used Black cohosh for a variety of conditions, such as gynecological and kidney disorders, rheumatism, malaria, fever, depression, cold, cough, constipation, hives, and to induce lactation. In the 19th century, Black cohosh was very popular among a group of alternative American practitioners who gave it the name „Macrotys“ and prescribed it for neurological conditions, lung conditions, rheumatism, and gynecological problems, such as menstrual problems, infertility, inflammation of the uterus or ovaries, and relief of labor pains. Today, Black cohosh is a popular alternative to hormonal therapy for the treatment of menopausal symptoms, such as hot flashes, headaches, sleepdisturbances, mood problems, heart palpitations, perspiration, and vaginal dryness. Preparations of Black cohosh are made from the roots and the underground stems. The most well-known product is Remifemin which contains Black cohosh extract equivalent to 20 mg of root per tablet. It remains unclear how Black cohosh works and there is contradictory evidence on a possible estrogenic activity.
Black Cohosh Side Effects and Risks
Black cohosh has been found to be generally well tolerated in studies up to six months and in recommended doses. High doses may cause dizziness, headache, perspiration, and visual disturbances. Several side effects have been reported, such as intestinal discomfort and constipation, nausea and vomiting, loss of bone mass leading to osteoporosis, low blood pressure, and irregular or slow heart beat. Black cohosh should not be used during pregnancy or lactation. As Black cohosh increases blood flow to the pelvic area and may increase or prolong bleeding, its use is not recommended during menses. Black cohosh is further known to inhibit iron absorption, and it is advised to monitor iron stores when taking Black cohosh. There are no studies published on long-term safety. However, because of the possible estrogen-like effect of Black cohosh, there is a certain risk that it may promote metastasis of estrogen-sensitive cancer tissue. There are also some reported cases of liver damage and even liver failure in women who used Black cohosh. Finally, patients with a history of blood clots or stroke, seizure disorder, liver disease, hormone-sensitive cancer, or known allergy to aspirin, should use Black cohosh only under medical supervision.
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