Evidence supporting the use of: Black cohosh
For the health condition: Breasts (swelling and tenderness)

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Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Black cohosh (Actaea racemosa, formerly Cimicifuga racemosa) has a long history of traditional use, especially among Native Americans and later in Western herbal medicine, for various gynecological complaints. Traditionally, it has been used to help alleviate symptoms associated with menstruation and menopause, including breast swelling and tenderness, which are often related to hormonal fluctuations. The rationale behind its use is largely based on its perceived effects on the female reproductive system, possibly due to its influence on estrogenic pathways, although it does not actually contain phytoestrogens. Despite its popularity in folk medicine, the scientific evidence specifically supporting black cohosh for breast swelling and tenderness is limited. Most clinical studies focus on its effects on menopausal symptoms such as hot flashes and night sweats, rather than mastalgia (breast pain or swelling). Some anecdotal reports and small-scale studies suggest a mild benefit for premenstrual symptoms, which can include breast tenderness, but these findings are neither robust nor consistent. Major systematic reviews and meta-analyses generally conclude that black cohosh's efficacy for breast symptoms is unproven. In summary, black cohosh’s use for breast swelling and tenderness is rooted in tradition rather than strong scientific evidence. Its popularity persists, but those seeking relief for these specific symptoms should be aware that clinical support is weak and further research is needed.

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