Black Cohosh: An effective treatment of menopausal symptoms?

As seen in Tonic Magazine
By Guy Chamberland

The root or rhizome of Black cohosh has been used for centuries to treat pain, premenstrual and menopausal symptoms. Are such treatments effective?

In May 2002 the Women’s Health Initiative concluded a randomized controlled trial of hormonal therapy for menopausal symptoms. The study, involving more than 16,000 post-menopausal women, showed an increased risk of coronary disease, stroke and blood clots in the women who received hormone therapy. After the trial was halted, many women stopped taking hormones and researchers began to report a decreased rate of breast cancer (a drop of 8.6% in 2004) in the United States. Since then, many women have turned to natural medicine, such as Black cohosh (Cimicifuga racemosa), to help manage their menopausal symptoms.

Short term studies demonstrated that the use of supplements made from the Black cohosh root or rhizome appear to be safe and efficient to treat menopausal symptoms. It was assumed historically that it acted estrogenically (as a hormonal therapy), because of its benefits in relieving specific symptoms like hot flushes. However to date, no estrogenic component has been identified in Black cohosh. Researchers are currently attempting to clarify how it works. Studies demonstrate that while Black cohosh is not directly estrogenic, it may be acting instead on the central nervous system to produce the clinical benefits associated with premenstrual and menopausal conditions. Menopausal symptoms like hot flushes, mood swings, anxiety and insomnia are controlled by the central nervous system. Using human volunteers, one group was able to demonstrate that it was the activity of Black cohosh on the HPO (hypothalamus-pituitary-ovarian) axis that led to the benefits observed on symptoms like hot flushes. These studies also demonstrated that Black cohosh acted on the brain serotonin receptors associated with neurological cognitive, emotional functions and pain control. Other studies suggested a mechanism involving neurotransmitters, such as serotonin, and inflammatory pathways.

In addition, an epidemiological retrospective study published in 2007 suggested that Black cohosh had a breast cancer protective effect in women. Black cohosh is also recognized in herbal medicine for its benefits in relieving not only menstrual and premenstrual symptoms, but also rheumatic conditions, and neuralgia. Caution is recommended for women who are genetically predisposed or have a diagnosis of breast cancer since no long-term studies are available in this high-risk population.

Guy Chamberland is the Vice President of Research at CuraPhyteTechnologies. He can be contacted at