Synopsis

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

Black cohosh (Actaea racemosa, formerly Cimicifuga racemosa) has a long history of traditional use, particularly among Native American groups and later in European herbal medicine, to help ease symptoms associated with menopause, such as hot flashes, night sweats, and mood disturbances. The root of black cohosh has been prepared as teas, tinctures, and extracts and was historically used as a "women's herb" for various reproductive health concerns.

Scientific research evaluating black cohosh for menopause has produced mixed results. Some randomized controlled trials and meta-analyses suggest a modest benefit in reducing vasomotor symptoms (such as hot flashes), but other well-designed studies have failed to show significant effects compared to placebo. The variability in study results may be due to differences in the preparation of the extract, dosages, and study populations. The mechanism of action is not fully understood; black cohosh does not appear to have estrogenic activity, but may act on serotonin receptors in the brain.

Overall, while there is a strong tradition supporting black cohosh’s use for menopause, scientific validation remains inconclusive and the quality of evidence is moderate at best. Leading medical organizations consider it possibly effective and generally safe for short-term use, but recommend discussing with a healthcare provider due to potential liver toxicity concerns and contraindications.

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