Native to eastern
North America, black cohosh thrives in moist, shaded woodlands. Over
time, it has also become a popular garden perennial that rarely goes
unnoticed. Shortly after midsummer, black cohosh begins sending up tall
flower stalks covered with tiny, pearl-shaped buds. As the buds open,
the stalks take on the look of soft, white bottlebrushes towering above
the dark green foliage. The fact that honeybees scorn the flowers but
flies and beetles love them may be the source of at least two of black
cohosh’s other common names, bugbane and bugwort, respectively. Another
is black snakeroot. To understand this nickname’s source, dig around the
base of the plant and expose its twisted rhizomes, which look like dark
little snakes.
Therapeutic Uses
Menopause
Premenstrual syndrome
Menstrual cramps
Arthritis
Mild depression (melancholy)
The primary use for black cohosh is to treat
menopause-related symptoms. Germany’s health authorities recognize its
use for menopausal symptoms (hot flashes, night sweats, and sleep
disturbances), as well as for premenstrual syndrome and menstrual
cramping. Early studies suggested that black cohosh acted like a natural
estrogen, or phytoestrogen, gently reducing hot flashes and vaginal
dryness. But newer research has found no hormonal effects of black cohosh in menopausal women.
More than 20 published clinical trials have evaluated
the effectiveness of black cohosh for menopausal hot flashes. While some
studies show a modest reduction in symptoms, not all clinical trials
have been positive. There may be added benefit when black cohosh is
combined with St. John’s wort. One clinical trial of 301 women reported a
50 percent reduction in symptoms with the combination, compared with 19
percent reduction in the placebo group. Current research has not yet determined the effectiveness of black cohosh for hot flashes.
Scientists at the University of Illinois at Chicago
have demonstrated that compounds in black cohosh act as antidepressants
and reduce pain sensitivity, lending support to the traditional use of
black cohosh as a treatment for melancholy, or depressed mood, as well
as its widespread use as a remedy for arthritis and menstrual pain. No
clinical trials have evaluated its effectiveness for these conditions.
How to Use
Tea: Simmer 2 teaspoons of chopped root and rhizome in 2 cups water for 10 minutes. Strain. Drink ¼ cup, 2 to 3 times per day.
Capsules: 40 to 200 mg of dried rhizome taken daily, in divided doses.
Tincture: Generally, 1 to 2 ml, 3 times per day.
Standardized extract: 20 to 40 mg black cohosh extract twice daily.
Products are often standardized to provide 1 to 2 mg of 27-deoxy-actein.
Precautions
Except for minor gastrointestinal upset, clinical
trials have shown black cohosh to be free of side effects. A few reports
have suggested black cohosh may, in rare cases, cause damage to the
liver, prompting European, Australian, Canadian, and
British health authorities to require product labels suggesting
conferral with a health-care provider by anyone with any type of liver
disease. Safety during pregnancy and breast-feeding is not known.
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