Black cohosh is a popular supplement used mostly by women. It helps alleviate menstrual disorders, hot flashes, vaginal dryness, and conditions related to pregnancy and childbirth. It is recognized as being safe by the U.S. Food and Drug Administration, though it does produce some side effects and contraindications.
Common Side Effects
According to the Mayo Clinic, black cohosh is well tolerated in recommended dosages, but there are some mild side effects that can result. These include headache, constipation, dizziness, low blood pressure, perspiration, nausea and vomiting. Black cohosh may also cause some weight gain, water retention or bloating since it affects estrogen levels.
Anticoagulant
Black cohosh is known to thin the blood and prevent clotting. It is used to treat menstrual cramps, but it may be associated with extended bleeding. This can increase the risk of hemorrhage or anemia. Do not use black cohosh before labor because it could prolong postpartum bleeding or before a surgical procedure, as this can cause a hemorrhage.
Liver Failure
Hepatitis is one of the most serious side effects associated with black cohosh. The necessity for liver transplants have been reported for some patients, but this is rare and many medical professionals cannot guarantee that black cohosh is the culprit. However, those with hepatitis or cirrhosis are advised not to use the supplement except under the guidance of a physician.
Contraindications
No reports suggest that black cohosh interferes with prescription or over-the-counter medication. However, it does affect estrogen and serotonin levels, so it may interact with fertility drugs, birth control pills or antidepressants. Also, the anticoagulant effect of black cohosh may exacerbate blood thinning, so do not use with aspirin or other blood thinners.
Breast-Feeding and Pregnancy
Black cohosh contains phytoestrogens, which may decrease milk supply in nursing moms. It causes estrogen levels in the body to increase and may cause a decrease in breast milk production. Its safety during breast-feeding has not been established, so nursing mothers should consult their physician before use.
It is also used by some midwives in the U.S. to stimulate labor. Black cohosh is believed to relax the muscular wall of the uterus, helping to induce labor. However, caution should be taken since there is one confirmed report of multi-organ damage in a child delivered with the aid of black cohosh.
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