Evidence supporting the use of: Black cohosh
For the health condition: Menstruation (scant)

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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 and European herbalists. It has been used to address various female reproductive health concerns, including scant menstruation (hypomenorrhea). In traditional practice, black cohosh root was believed to possess emmenagogue properties—that is, to stimulate menstrual flow—making it a remedy for delayed, absent, or scanty periods. This usage is referenced in early American herbal texts and is supported by anecdotal reports and historical documentation.

However, contemporary scientific studies primarily focus on black cohosh for menopausal symptoms such as hot flashes and not specifically for scant menstruation. The presumed mechanism involves phytoestrogenic effects or modulation of serotonergic pathways, but evidence directly relating to menstrual flow is minimal. No high-quality clinical trials have evaluated its efficacy for hypomenorrhea, and major reviews note a lack of scientific support for this specific indication. Thus, while tradition supports its use for scant menstruation, scientific validation is lacking, and safety data for this use is also limited. Women considering black cohosh for menstrual issues should consult a healthcare provider, as underlying causes of scant menstruation may require medical evaluation.

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