Black cohosh, (Cimicifuga racemosa), is available as an herbal extract and is a primary ingredient in AM/PM Menopause due to its short term helpful qualities in managing hot flashes and other symptoms of menopause. The research is mixed. Some researchers claim that a placebo effect is solely responsible. But the reality appears to be that it is often helpful in the short term for some women and not for others. It tends to be more effective when combined synergistically with other herbs such as ginseng and green tea.
In a meta analysis of relevant research six out of nine trials assessing the effectiveness of a variety of preparations found that those containing black cohosh were significantly more effective than those that did not. Looking at seven of the trials a 26% improvement in menopausal symptoms was found. However there were marked differences in the various trials.1 Another study looked at 304 women who received a proprietary black cohosh extract, and who reported marked improvements, especially for hot flashes.2
One study looked at the use of black cohosh over 10 years with 128 women, divided into three groups. One group took exercise training, another took exercise training along with black cohosh, and a control group employing neither approach. The researchers found that the use of black cohosh did not improve bone health or menopause symptoms as compared to exercise training alone, and, in fact, slightly increased risk of coronary heart disease.3 We draw two conclusions - 1) exercise is far more important; 2) using black cohosh over a long period is not a good idea.
It is better to not take black cohosh for more than three months at a time, and then give the body a rest for several months. In addition, women taking black cohosh should be monitored for liver health and women who are at risk for breast cancer should not take black cohosh. But even in the case of breast cancer the research has been contradictory, perhaps depending upon estrogen-receptor-negative cells versus estrogen-receptive-positive cells. In some studies, isolated components found in black cohosh inhibited cancer cells and others stimulated cancer cells.
Black cohosh can cause an upset stomach or headache, so it is better taken with meals.
It will be wise to check with your medical practitioner before taking this nutrient.
How Does Black Cohosh Work?
It is not known exactly how black cohosh works. It is possible that it behaves like an estrogen and so replaces loss of estrogen through menopause. Fukinolic acid is one compound found in black cohosh that has been found in vitro to have estrogenic effects.
1. Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis, T. Shams T. et al., Alternative Therapies in Health & Medicine, 2010 Jan-Feb;16(1):36-44.
2. Menopause: a standardized isopropanolic black cohosh extract (remifemin) is found to be safe and effective for menopausal symptoms, S.M. Ross, Holistic Nursing Practice. 2012 Jan-Feb;26(1):58-61
3. Effect of exercise and Cimicifuga racemosa (CR BNO 1055) on bone mineral density, 10-year coronary heart disease risk, and menopausal complaints: the randomized controlled Training and Cimicifuga racemosa Erlangen (TRACE) study, M. Bebenek, Menopause. 2010 Jul;17(4):791-800