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

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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 use in traditional herbal medicine, particularly among Native American communities and later in Western herbalism, mainly for women’s reproductive health concerns. Its most common uses are for menopausal symptoms, such as hot flashes and mood disturbances, as well as menstrual irregularities and dysmenorrhea. The rationale for its use in endometriosis is largely extrapolated from its traditional use for menstrual pain and hormone-related symptoms. Black cohosh contains triterpene glycosides and other compounds thought to have mild estrogenic or selective estrogen receptor-modulating effects, though this is still debated in scientific literature.

Scientific research specifically investigating black cohosh for endometriosis is very limited. A few small clinical studies, primarily from China and Eastern Europe, have compared black cohosh with standard hormone therapies for endometriosis, suggesting potential benefit in reducing pain and improving quality of life. However, these studies often lack rigorous methodology, involve small sample sizes, and are not widely replicated. Larger, high-quality randomized controlled trials are lacking. Most expert guidelines do not mention black cohosh as a recommended treatment for endometriosis.

In summary, the use of black cohosh for endometriosis is supported primarily by tradition and some preliminary, low-quality scientific studies. The overall evidence level is low, and more research is needed to determine its efficacy and safety for this specific condition.

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