BLACK COHOSH:
EFFECTS ON MENOPAUSAL AND PMS SYMPTOMS

SUMMARY

Black Cohosh is a shrub-like plant native to the eastern deciduous forests of North America. The dried root and rhizome is used medicinally. When harvested from the wild, the root is black in colour. Cohosh, an Algonquin Indian word refers to the “rough” appearance of the gnarled root.

Native Americans valued the herb and used it for many conditions, ranging from disorders of the womb to snake bite.

In America during the 19 th century physicians had aready begun to use Black Cohosh to treat menstrual cramps, arthritis, fever and insomnia.

MODERN MEDICINAL USE

As a herbal remedy, Black Cohosh has been known for many years for its therapeutic effect not only on the female sexual system, but on other systems as well, including cardiovascular, immune, metabolic, muscular-skeletal, nervous and respiratory. It is recognised at one of the most important herbs for managing menopause well.

In recent years it has gained wide popularity for the help it provides in regulating menstrual periods, assisting with PMS, helping to reduce the risk of breast cancer and in promoting general well-being. Black Cohosh contains phyto-oestrogens and, as an adaptogen it has the ability to balance hormones in a woman’s body. Rich in phyto-sterols and micronutrients it helps the body to produce the hormones it needs to balance itself while reducing luteinizing hormone (LH) secretions.

It also contains natural salicylates to help relieve aches and pains, and as an adaptogen it can help to increase vital energies and alleviate water build-up in the tissues.

In a German study carried out in 1988, it was shown to relieve hot flushes as effectively as hormone replacement therapy (HRT) but without harmful side effects. For menopausal women who cannot tolerate traditional HRT, Black Cohosh may offer effective alternative benefits. This, of course is subject to the approval of a health care professional.

Black cohosh contains several ingredients, including triterpene glycosides ( e.g., acetin and 27-Deoxyactein) and isoflavones (e.g., formononetin). Other constituents include aromatic acids, tannins, resins, fatty acids, starches and sugars. Specific substances in Black Cohosh ( especially 27-Deoxyaceteine) are believed to mimic the actions of oestriol ( the most beneficial of the oestrogens).

As a woman approaches menopause the signals between the ovaries and the pituitary gland diminish, slowing down oestrogen production and increasing luteinizing hormone (LH) secretions. Hot flushes can result from these hormonal changes. A human clinical trial in 1991 suggested that Black Cohosh had some oestrogen activity in the body and also decreased LH.
(Dűker EM, Kopanski L, Jarry H, Wuttke W. 1991.)

In 1985 and 1987, small German trials supported the usefulness of Black Cohosh for women suffering from hot flushes associated with menopause. A review of eight clinical trials found Black Cohosh to be safe and effective for the relief of menopausal hot flushes. Other symptoms that improved included night sweats, insomnia, depression, nervousness and mood swings.

A clinical trial compared the effect of 40mg versus 130mg of Black Cohosh in menopausal woman with hot flushes, (Liske E, W űstenberg P. 1998). While hot flushes were reduced equally by both amounts, there was no evidence of any oestrogenic effects.

It is recommended that Black Cohosh be taken for six months at a time. After that period women should assess their symptoms as these are known to fluctuate during the menopausal years.

REFERENCES:

Dűker EM, Kopanski L, Jarry H, Wuttke W. Effects of extracts from Cimicifuga racemosa on gonadtropin release in menopausal woman and ovariectomised rats. Planta Medica 1991; 57: 420-4.

Warnecke G. Using phyto-treatment to influence menopause symptoms. Med Welt 1985; 36: 871-4.

Liske E, Wűstenberg P. Therapy of climacteric complaints with Cimicifuga racemosa: a herbal medicine with clinically proven evidence (Abstract #98.002)) North American Menopause Soc.Tornto. Canada. Sept 16-9, 1998.

Bradley PR, ed. British Herbal Compendium, vol 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992, 34-6.