Evidence supporting the use of: Black cohosh
For the health condition: PMS Type P

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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 within Native American and early European-American herbal traditions. Its use for menstrual issues, including premenstrual syndrome (PMS), is rooted in these traditions, with more focus on symptoms such as mood swings, irritability, and cramps. PMS Type P refers predominantly to premenstrual symptoms dominated by "pain" (such as cramps, breast tenderness, and headaches), and black cohosh was historically recommended for "female complaints" that overlap with these symptoms. However, most of the robust historical and clinical focus has been on menopause and menopausal symptoms, rather than specifically on PMS Type P.

Scientific evidence for black cohosh’s effectiveness in PMS, and specifically PMS Type P symptoms, is limited. Most clinical trials and systematic reviews have focused on menopausal symptoms such as hot flashes, rather than on PMS. A few small studies and anecdotal reports suggest some benefit for menstrual pain and related symptoms, but these are neither large nor well-controlled enough to be conclusive. As such, its use for PMS Type P is primarily justified by tradition, with limited scientific validation for this specific indication. The evidence rating is therefore moderate-to-low, reflecting traditional use and some plausible but unproven effects.

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