Black cohosh grows in North America and is related to the buttercup family. Also known as black snakeroot or bugbane, its scientific name is Cimicifuga racemosa or Actaea racemosa. It was used by Native Americans to treat malaria, rheumatism and women's disorders, among other conditions. People currently use this supplement to treat symptoms of menopause and to bring on labor. However, doctors have not firmly established the effectiveness of black cohosh in treating any condition, and suggested dosages can vary from 40 to 200 mg per day.
Uses
The Mayo Clinic says that instead of taking hormones, many women use preparations of black cohosh as an alternative treatment for symptoms of menopause, including hot flashes, mood swings, night sweats and vaginal dryness. Some women also use it to normalize irregular menstrual cycles, to alleviate premenstrual syndrome and to induce labor. It is not clear how black cohosh works. It does not bind to hormone receptors and studies cited by the Office of Dietary Supplements suggest that it does not significantly increase levels of female hormones.
Forms
Preparations of black cohosh use the underground stems, or rhizomes and roots. They can be used fresh or dried, and taken as tea, a liquid extract or tincture, as a capsule, or extracted and put in a pill. The Office of Dietary Supplements describes one standard manufactured form of black cohosh called Remifemin, an extract of root powder in alcohol packaged into a pill.
Strength
Black cohosh preparations are standardized according to their concentration of 26-deoxyactein, a type of chemical called a saponin. Black cohosh supplements usually have 1 mg of 26-deoxyactein per 20 mg dose, according to the Office of Dietary Supplements. However, because black cohosh sells as a supplement, not a drug, the strength can vary significantly from lot to lot.
Dosage
There is no proven effective dose for black cohosh, says the Mayo Clinic. For adults, daily doses of the dried preparation can range from 40 to 200 mg, although traditional dosing used up to 6 g total per day. For the tincture, the dosage ranges between 0.4 to 2 ml. The Mayo Clinic does not recommend use of black cohosh for children. These doses have been used in studies lasting up to 6 months, and the Mayo Clinic advises not exceeding that duration.
Warnings
Black cohosh might not be safe for women with breast or uterine cancer or endometriosis. Some controversy surrounds the effects of black cohosh on the liver; the safest course is for patients with liver problems to consult with a doctor before using it, and all patients stop using it immediately if they develop signs of liver trouble.
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