Black cohosh is a popular herbal supplement for symptoms of menopause and menstruation. Unfortunately, little medical research exists to confirm the plant's ability to alleviate pain and regulate these occurrences. Always consult a physician before using herbal therapies to treat any medical condition.
Black Cohosh
Actaea racemosa, commonly known as black cohosh, is a member of the buttercup family indigenous to eastern North America. The roots and rhizomes of this plant are used medicinally for their analgesic and anti-inflammatory properties. Recently, black cohosh extracts have been popularly used to treat symptoms associated with menopause and menstruation. The plants contain many organic compounds with purported biological activity. However, several clinical studies have shown an absence of estrogenic effects with results indicating few benefits to lessen pain and discomfort associated with menstruation. There is also a lack of research indicating that this herb can be used to regulate the menstrual cycle. Nonetheless, the use of black cohosh appears to be safe, but also minimally beneficial for treating menopausal symptoms.
Menstruation
Menstruation, or the estrous cycle, is the monthly shedding of the uterine lining, also called the endometrium. The estrous cycle comprises the recurring physiological changes that are induced by reproductive hormones such as follicle stimulating hormone and luteinizing hormone. Estrous cycles begin after puberty in sexually mature females and are disrupted by anestrous phases or pregnancies. The ovaries release sex hormones including estrogens and progesterone. Imbalance of these hormones, especially estrogen, can be controlled by the use of herbal supplements, but with questionable safety and efficacy.
Treatment of Symptoms with Black Cohosh
In a review article appearing in the September 2010 issue of "Seminars in Reproductive Medicine," the authors investigated current medical research for the effects of black cohosh on vasomotor symptoms relating to the nerves and muscles that cause the blood vessels to constrict or dilate. This condition remains the most common complaint of menstruation for which women seek medical help. They found only a small number of alternative options for the alleviation of symptoms, including lifestyle changes and nonprescription remedies such as black cohosh supplementation. The reviewed studies have shown that extracts of black cohosh can provide relief, albeit with mixed results and questionable safety, but regulation of the menstrual cycle has not been indicated in any of the studies reviewed.
Estrogen and Black Cohosh
In the November 2007 issue of the "Journal of Steroidal Biochemistry and Molecular Biology" a study was published to assess the possible estrogenic activity of a commercial extract of black cohosh. The authors used rats as test animals to document the efficacy of extracts to activate estrogen receptors and found that only the lipophillic, or fat-loving, fractions were practical for treatment of symptoms. The lipophilic fraction appeared to induce a dose-dependent inhibitory effect towards the action of oxytocin in the uterus. They concluded that the effectiveness of black cohosh for menstrual distress is possibility due to binding to an unidentified estrogen receptor that is likely inversely involved in inflammation.
Female Sexual Dysfunction
A review article appearing in the November 2010 issue of the "Journal of Sexual Medicine" documented the treatment of female sexual dysfunction, FSD, with black cohosh. FSD is a complex condition, with an increased frequency associated with the decline of estrogen. The researchers identified and described clinical uses of medicinal plants for FSD treatment in women. They found that there is little evidence from the literature to recommend the use of medicinal plants when treating FSD, as the majority of studies with a strong level of evidence are associated with the treatment of the vasomotor symptoms of menopause and not the regulation of the menstrual cycle. However, they concluded that Actaea racemosa may be recommended for treatment of FSD, but there is a need for double-blinded and randomized clinical studies to evaluate the efficacy and safety of this plant for the management of FSD.
References
- "Seminars in Reproductive Medicine"; Vasomotor symptoms: viewpoint from the Indian subcontinent and management of a common menopausal problem; D Shah et al; September 2010
- "Journal of Steroidal Biochemistry and Molecular Biology"; Estrogen-like effect of a Cimicifuga racemosa extract sub-fraction as assessed by in vivo, ex vivo and in vitro assays; P Bolle et al; November 2007
- "The Journal of Sexual Medicine"; Medicinal plants as alternative treatments for female sexual dysfunction: utopian vision or possible treatment in climacteric women?; R Costa-Mazaro et al; November 2010
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