Black cohosh: is it really safe?

Black cohosh. Every article or book you read on perimenopause and menopause suggests black cohosh as an excellent symptom reliever. But is it really the miracle cure it is made out to be?

What is it?

Black cohosh is an herb. It is also commonly known as black snakeroot, macrotys, bugbane, bugwort, rattleroot, rattleweed.

The magic of black cohosh is actually found underground in its stems and roots. It is used fresh or dried in the form of teas, capsules, pills or liquid extracts.

What does it do?

It does just about everything, it seems. Commonly known for relieving night sweats and hot flashes, it is also used for menopausal depression, vaginal dryness and menstrual cramps.

But is it safe?

Ah, now that is a good question! I am a bit cynical by nature when it comes to miracle cures, so I decided to investigate.

First I started with my resource library. Seems my favourite menopause authors are all for black cohosh.

Ann Louise Gittleman, Before The Change, recommends 4 to 8 milligrams daily for hot flashes and vaginal dryness.

Nisha Jackson, Perimenopause: Balance Your Hormones Naturally, also recommends it for hot flashes and night sweats.

Christiane Northrup, The Wisdom of Menopause, suggests using black cohosh for depression, vaginal dryness, hot flashes and menstrual cramps. Although, she does add the warning that it may interact adversely with medicines for high blood pressure.

So, far so good, but …

Next, off to check with Mr. Google. And here is where it starts to get dicey. There are lots of articles hailing the virtues of black cohosh, but some articles questioning it.

There is this from the National Center for Complementary and Alternate Medicine:

United States Pharmacopeia experts suggest women should discontinue use of black cohosh and consult a health care practitioner if they have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice. There have been several case reports of hepatitis (inflammation of the liver), as well as liver failure, in women who were taking black cohosh. It is not known if black cohosh was responsible for these problems. Although these cases are very rare and the evidence is not definitive, scientists are concerned about the possible effects of black cohosh on the liver.

And over at Livestrong.com:

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.

There is also conflicting evidence on whether black cohosh actually does relieve menopausal symptoms or not, as clinical trials have only ever lasted for periods of six months.

Also need to watch for …

As with any supplement, there are potential side effects, even if only mild:

• headaches
• heaviness in the legs
• upset stomach
• nausea
• constipation
• irregular or slow heart rate
• low blood pressure

To black cohosh or not to black cohosh

I am not at the night sweat or hot flashes stage … thank goodness … so, I have not had occasion to try black cohosh. I am not frightened off of it by what I’ve read, as the health risk seems to be fairly low, if any at all. However, like anything new I put into my body, I will very carefully monitor my body’s response to it. Anything out of the norm happens, and I’ll be flushing the supplements down the toilet faster than you can say “Hot flashes suck”.

I will also combine using black cohosh along with other symptom relievers, such as proper exercise and diet. It won’t be my miracle cure, but part of a symptom reliever package. As my mother always says “Everything in moderation”.

Have your say:

Have you tried black cohosh? If so, did it work for you? How long did you take it for? Any adverse symptoms?

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