Throughout history, women have used black cohosh to bring on a late menstrual period, to induce labor, promote lactation, and soothe symptoms of menopause. Evidence for these uses has been largely anecdotal. Today, however, we have the advantage of clinical studies, which not only measure the effectiveness of black cohosh for these various uses, but can also warn of us of potential risks. There are several reasons to avoid the use of black cohosh during pregnancy, despite its traditional associations.
Uterine Contractions
Black cohosh can stimulate uterine contractions, and is sometimes used by midwives at term to induce labor. Herbal induction methods, however, are not without their risks. In a 1999 study published in "Journal of Nurse-Midwifery," 21 percent of nurse midwives who used herbal induction methods reported complications, which ranged in severity from nausea and vomiting to tetanic uterine contractions and precipitous labor. Both tetanic uterine contractions and precipitous labors are likely to be more difficult for mother and child, and are more likely to cause fetal distress. If you are pregnant, you should not self-prescribe black cohosh in an attempt to induce labor.
Emmenagogue
Black cohosh is sometimes used as an emmenagogue to bring on a late menstrual period. In early pregnancy, black cohosh can cause a miscarriage, according to research by Dugoua et al., published in 2006 in the "Canadian Journal of Clinical Pharmacology." If you suspect you may be pregnant and do not wish to continue the pregnancy, it is safer to discuss your options with your health care provider than to use black cohosh as an emmenagogue.
Other Risks
Black cohosh may cause nausea and vomiting, dizziness, circulatory problems and impaired vision, according to Dr. Armando Gonzalez Stuart of the University of Texas El Paso Herbal Safety website. This herb may also cause injury to the liver, and should not be used by anyone with symptoms of liver disease. Black cohosh may have estrogen-like effects, which may be of special concern to pregnant women with a family history of breast cancer; during pregnancy, you should not take any hormones or hormonal products except at the direction of your health care professional.
References
- "Canadian Journal of Clinical Pharmacology"; Safety and Efficacy of Black Cohosh (Cimicifuga Racemosa) During Pregnancy and Lactation; JJ Dugoua et al; 2006.
- "Journal of Nurse-Midwifery"; A National Survey of Herbal Preparation Use by Nurse-Midwives for Labor Stimulation; BL McFarlin et al; May-June 1999.
- University of Texas El Paso Herbal Safety: Black Cohosh; Armando Gonzalez Stuart, PhD (PDF)
- National Institutes of Health Office of Dietary Supplements: Black Cohosh
- "American Family Physician"; Black Cohosh; Benjamin Kligler, MD; July 2003
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