Evidence supporting the use of: Black cohosh
For the health condition: Dysmenorrhea

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Synopsis

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

Black cohosh (Actaea racemosa) has a long history of use in traditional herbal medicine, particularly for gynecological conditions. Historically, Native American tribes and later European settlers used black cohosh to address various female reproductive issues, including dysmenorrhea (painful menstruation), menopausal symptoms, and premenstrual discomfort. Its traditional use in dysmenorrhea is largely anecdotal, based on observational reports and longstanding practices, rather than rigorous scientific evaluation. The herb is believed to exert mild anti-inflammatory and antispasmodic effects, which practitioners have thought might relieve menstrual cramps.

Scientific studies investigating black cohosh have mainly focused on menopausal symptoms, such as hot flashes, rather than dysmenorrhea specifically. Only a limited number of clinical trials have examined its effects on menstrual pain, and the results are inconsistent or inconclusive. A few small studies and reviews suggest potential benefit for menstrual pain, but methodological limitations (such as small sample sizes or lack of controls) prevent firm conclusions. Major pharmacological effects—thought to be related to triterpene glycosides and possible serotonergic activity—are not well defined for dysmenorrhea.

In summary, black cohosh is traditionally used to support or treat dysmenorrhea, but there is insufficient high-quality scientific evidence to recommend it for this purpose. Its use remains rooted primarily in traditional practices rather than modern clinical validation.

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