Black Cohosh and Menopause

Menopause is the cessation of menses in women, generally beginning in the early 50’s, characterized by hot flashes, anxiety, headaches, poor concentration, lack of libido, excess sweating, and heart palpitations. One of the most common treatments for menopausal symptoms is hormone replacement therapy, but this can cause side effects such as vaginal bleeding and cancer. “Given the persistent confusion about the risks and benefits of hormone therapy since 2002 and the first publication from the Women’s Health Initiative’s primary findings, women and health care providers are increasingly motivated to find effective, nonhormonal approaches to treat menopause-related symptoms” (Taylor, 2015).

Black cohosh is a North American herb historically used for snakebites. Although the specific mechanisms behind it have not yet been determined and the research has been inconsistent, black cohosh may be used to treat the symptoms of menopause, such as hot flashes, sleep disturbances, and anxiety. Generally, black cohosh’s effects are due to the triterpene glycosides in its roots and rhizomes, which have serotogenic effects, bind to estrogen receptors and suppress luteinizing hormone secretion without effecting follicle stimulating hormone.  One study showed that black cohosh reduced the frequency of hot flashes compared to a placebo. Another saw that those who took black cohosh daily saw improved sleep through sleep efficiency and longer sleep times without waking. This relief may be experienced more by women in the early stages of menopause than later, according to a 2005 study.

What does this mean for perimenopausal women? Black cohosh can be used to treat hot flashes, get you better sleep, decrease your irritability, and stabilize your mood! 

Ghazanfarpour, M., Sadeghi, R., Abdolahian, S., & Roudsari, R. (2016). The efficacy of Iranian herbal medicines in alleviating hot flashes: A systematic review. Int J Reprod Biomed (Yazd), 14(3), 155–166.

Jiang, K., Jin, Y., Huang, L., Feng, S., Hou, X., & Du, B. et al. (2015). Black cohosh improves objective sleep in postmenopausal women with sleep disturbance. Climacteric, 18(4), 559-567. http://dx.doi.org/10.3109/13697137.2015.1042450

Mohammad-Alizadeh-Charandabi, S., Shahnazi, M., Nahaee, J., & Bayatipayan, S. (2013). Efficacy of black cohosh (Cimicifuga racemosa L.) in treating early symptoms of menopause: a randomized clinical trial. Chinese Medicine, 8(1), 20. http://dx.doi.org/10.1186/1749-8546-8-20

Osmers, R. & Schnitker, J. (2005). Efficacy and Safety of Isopropanolic Black Cohosh Extract for Climacteric Symptoms. Obstetrics & Gynecology, 106(5, Part 1), 1111-1112. http://dx.doi.org/10.1097/01.aog.0000186253.14228.d2

Taylor, M. (2015). Complementary and Alternative Approaches to Menopause. Endocrinology And Metabolism Clinics Of North America, 44(3), 619-648. http://dx.doi.org/10.1016/j.ecl.2015.05.008