Black cohosh root is an herbal remedy primarily used by women to relieve unpleasant effects of menopause and perimenopause. It also can be taken to relieve menstrual cramps and irregularities, and may have possible benefits for treating colds, sore throat and high blood pressure. Several disadvantages are associated with black cohosh, including lack of consistent research and possible side effects.
Lack of Research
Research does not yet support the use of black cohosh to relieve menopausal symptoms, according to the U.S. National Institutes of Health (NIH). Studies have shown conflicting results. Research also has not determined whether this herb has similar effects as hormone replacement therapy such as beneficial effects on bone mass, or negative effects including increased risk of stroke and hormone-related cancers. Published studies on black cohosh have lasted only six months or less, as explained by the NIH, so long-term safety information is not available.
Side Effects
Numerous relatively minor side effects have been reported in clinical studies with black cohosh. They include headaches, heaviness in the legs, upset stomach, nausea, constipation, irregular or slow heart rate, and low blood pressure. The University of Maryland Medical Center notes that high doses of this herbal remedy are associated with abdominal pain, diarrhea, nausea, dizziness, joint pain, slow heartbeat, tremors, vision problems and weight gain.
Possibility of Liver Damage
People have reported liver damage while taking black cohosh, although studies have not determined that the herb actually causes this effect, according to the NIH. These reports have prompted some countries to require or recommend cautionary or warning labels on black cohosh products. In 2006, Australia, Canada and the United Kingdom all took such actions, and in 2008, the U.S. Pharmacopeia (an organization that sets standards for foods, supplements and drugs) recommended that black cohosh products include a cautionary statement about the possibility of liver toxicity.
Pregnancy and Breastfeeding Considerations
Some nurse-midwives use this herb to stimulate labor, according to the Mayo Clinic, but pregnant women should not take black cohosh too early or it might result in miscarriage or premature delivery. Because black cohosh may have hormonal effects, breastfeeding women may need to avoid taking this product.
Allergic Reaction
As with any herbal remedy, black cohosh may cause allergic reactions in some people. Additionally, this herb contains small amounts of salicylic acid, a substance found in aspirin, so the Mayo Clinic advises people allergic to aspirin or other salicylates to use black cohosh with caution. Signs of an allergic reaction include a rash or hives, itching, throat or mouth swelling, and wheezing or trouble breathing. An allergic reaction to black cohosh calls for immediate medical attention.
Lack of Regulation
Black cohosh is considered a dietary supplement in the United States, and manufacturers are not required to provide evidence that these supplements are effective or safe before marketing, as noted by the NIH. Supplements are not always tested for consistency, so the amount of the active ingredient may vary a great deal by brand and lot number. The product also might not contain the amount stated on the label. EMedTV cautions that heavy metals and prescription drugs have been found in some herbal products. Consumers should only buy commercial formulations from a reputable manufacturer.
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