Generations of American women have relied on the gnarled root of black cohosh (Cimicifuga racemosa) to relieve various "female problems," from PMS and menstrual cramps to menopausal symptoms. In the 1900s, this indigenous American wildflower, a member of the buttercup family, provided the main ingredient in a popular tonic for women. (The concoction--Lydia Pinkham's Vegetable Compound--is still sold, but it no longer contains the herb.) Black cohosh has also been used to treat a variety of other complaints, including insect bites and eczema.

After falling out of favor for several decades, black cohosh is once again being heralded as an herbal antidote for such menopausal symptoms as hot flashes. It has even been recommended as an alternative to standard hormone replacement therapy (HRT), which can produce unwanted side effects in many women.

The apparent healing properties of black cohosh root extend beyond its use for "women's problems." Thought to work as an anti-inflammatory and mild sedative, black cohosh may relieve muscle aches and pains. It has also been used to clear mucous membranes and lessen associated congestion and bothersome coughs.

Specifically, black cohosh may help to:

Relieve hot flashes and other menopausal and perimenopausal symptoms. As estrogen levels decline in a woman's body during middle age, she may experience hot flashes, vaginal dryness, depression, and other unpleasant symptoms. Black cohosh may offset this decline in estrogen by providing powerful plant compounds called phytoestrogens that mimic the hormone's effects. These phytoestrogens bind to hormone receptors in the uterus, breast, and other parts of the body, possibly lessening hot flashes, vaginal dryness, headache, dizziness, depressive mood, and other hormone-related symptoms as a result.

A 1991 study women found that black cohosh may also help to minimize hot flashes by reducing levels of luteinizing hormone (LH), a compound produced by the brain's pituitary gland that regulates the activities of a woman's ovaries. The rise in LH has been been implicated as a cause of hot flashes.

Some women take black cohosh as an alternative to hormone replacement therapy. Unlike HRT, which has been linked to a slightly increased risk of breast cancer when taken long-term, black cohosh doesn't appear to stimulate the growth of breast tumors. Some researchers even think the phytoestrogens might prevent tumor growth by keeping the body's own estrogen from locking onto breast cells. Keep in mind, however, that the phytoestrogens in black cohosh will not offer the protection from heart disease or osteoporosis that prescription HRT can provide.

Ease menstrual cramps. Black cohosh has antispasmodic properties that may lessen menstrual discomforts. In addition, by possibly increasing blood flow to the uterus, it may reduce the intensity of particularly painful cramps. By stabilizing hormone levels, the herb's phytoestrogens may even benefit women with premenstrual syndrome (PMS).

Forms

• tincture
• tablet
• dried herb/tea
• capsule

Special tips:

--Look for capsules or tablets with extracts standardized to contain 2.5% triterpenes glycosides, the active components in black cohosh root and the amount that has proved effective for many women in clinical trials.

--However, when buying the liquid form of black cohosh, look for products standardized for a slightly higher percentage--5%--of triterpene glycosides.

--Capsules containing the freeze-dried root are a smart choice because they're most likely to contain all of the herb’s key ingredients, including any compounds that scientists still haven't identified.

 

For menopausal or PMS symptoms, including menstrual cramps: Take 40 mg of black cohosh twice a day. Begin the regimen for PMS a week to 10 days before your period.

 

For muscle aches and pains: Apply warm compresses soaked in black cohosh tea to the affected area for 20 minutes. Make the tea by boiling the dried root in water for 20 to 30 minutes; allow the tea to cool slightly before using.

 

 

You can use black cohosh at any time of day, but to reduce the chance of stomach upset, take it with meals. Try it with honey or lemon to disguise the bitter taste.

 

Allow up to eight weeks to see benefits for menopausal problems.

 

Black cohosh may interfere with the action of hormonal medications (birth control pills or HRT). Consult your doctor before combining.

Possible Side Effects

Cautions