What we know about black cohosh
A continuing education article on Medscape presents a nice summary on the use of black cohosh to treat the symptoms of menopause.
Current use
- It’s an alternative to hormonal therapy to treat hot flashes, mood disturbances, sweating, heart palpitations, and vaginal dryness.
- Supporting evidence is mixed, especially beyond 6 months of treatment.
- Most studies use the black cohosh product Remifemin (Schaper & Brümmer).
What we know.
- Black cohosh is well tolerated for up to 6 months.
- Side effects include rash and gastrointestinal symptoms, headache, nausea, dizziness, seizures, sweating, or constipation.
- Low blood pressure has been reported.
- Hepatitis and liver toxicity have been reported.
- There are reports of interactions with drugs that are metabolized via the CYP450 liver enzyme system.
- CYP450 enzymes account for almost half of the elimination of commonly used drugs, although that does not mean they are all significantly affected.
- Use with salicylates and medicine associated with bleeding risk, including anticoagulants or herbs such as garlic and ginkgo biloba, is not recommended.
What we don’t know.
- The mechanism of its action is not known.
- Safety during pregnancy and breastfeeding is not known.
- The effect of black cohosh with estrogens, evening primrose oil, soy, and other products that have purported estrogenic properties is not known.
Now you know.
2/14/08 15:10 JR