Black/Blue CohoshCancerHeart DiseaseMenopause

Black cohosh, menopausal symptoms, and the risk of breast cancer and heart disease

Hormone replacement therapy may increase breast cancer and cardiovascular disease risk in menopausal women. But what is the effect of black cohosh extract — a popular alternative for reducing menopausal symptoms?

First, the details.

  • 2 black cohosh preparations were analyzed to document their triterpene content (the main active ingredient).
  • Postmenopausal women took black cohosh for 12 weeks and were followed for 12 weeks longer without the herbal (washout).
  • One black cohosh preparation contained trace amounts of triterpenes, and another contained 2.5% triterpenes.

And, he results.

  • Women taking black cohosh with 2.5% triterpenes experienced relief of menopausal symptoms.
  • This was followed by a return of their symptoms by the end of the washout period.
  • Black cohosh had no effect on estrogen markers in blood and no effect on pS2 protein levels in breast nipple fluid (pS2 is a protein that increases in response to higher estrogen levels).

The bottom line?
Reports of success using black cohosh to control menopausal symptoms are inconsistent. The authors point out that this might be due to variability in the content of triterpene among products.

In this study, the higher concentration of triterpene had a positive effect on menopausal symptoms and no effect on estrogen levels. It suggests, but does not prove, that black cohosh should not affect the risk of cardiovascular disease or breast cancer in menopausal women.

11/16/07 22:03 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.