Black cohosh is one of the most popular herbal supplements currently on the market, most commonly used for the treatment of diseases and conditions relating to the female reproductive system. The many medicinal uses of black cohosh have been the topic of extensive medical research. Because of its rich history in both traditional and modern alternative medicine, black cohosh receives significant attention from both alternative-health practitioners and mainstream medical professionals.
Like many herbal supplements, black cohosh contains phyoestrogens–natural compounds that mimic the role of estrogen in the human body. The primary, active phytoestrogen in black cohosh is fukinolic acid, which produces noticeable effects in the uterus, ovaries, breasts and endometrium. Because fukinolic acid stimulates an estrogen-like response, it is sometimes used as a substitute for standard hormone replacement therapy.
Black cohosh supplements can relieve the common discomforts associated with the decreased estrogen levels caused by menopause. It is most commonly used to help eliminate hot flashes and night sweats, but it may also address common menopause-related issues like depression, osteoporosis and chronic fatigue.
Black Cohosh in Pregnancy
Commonly used by traditional midwives, black cohosh is one of the most well-known herbal supplements for the last trimester of pregnancy. Black cohosh increases the amount of blood flow to the pelvis and stimulates contractions in the uterus. During the final weeks of pregnancy, it can be used to trigger stronger Braxton-Hicks (“practice”) contractions. These help to ripen the cervix and prepare the uterus for labor.
When pregnancy has gone past term, some midwives use larger doses of the herb to stimulate labor. Black cohosh administered during childbirth can treat stalled or slowed labor, or “failure to progress.” Though effective, black cohosh used during pregnancy may be associated with prolonged postpartum bleeding. It should be entirely avoided during the first and second trimesters because of its potential ability to trigger miscarriage.
Black cohosh’s estrogenic and contraction-inducing effects make it ideal for treating some menstrual disorders. Women suffering from amenorrhea (late or absent periods) often use black cohosh to induce menstruation, and it is commonly recommended as a home remedy to regulate or “schedule” menstrual cycles. This makes it a popular choice for women with PCOS and other diseases associated with menstrual irregularity.
Additionally, because it helps to dilate the cervix, black cohosh is a popular herbal remedy for menstrual cramping. While it is effective in this capacity, it can also be counterproductive: Black cohosh can cause severe or prolonged bleeding, possibly increasing the duration of a menstrual period by several days.
Traditionally, black cohosh has been used in the American Southeast as a remedy for rheumatoid arthritis. More recently, some herbalists and naturopathic physicians have expressed interest in using black cohosh as a treatment for fibromyalgia. While it may have noticeable anti-inflammatory properties, it has not yet been studied for its effects on joint inflammation or chronic pain.
Black cohosh may hold some promise as a preventative for breast cancer; however, it is possible that the estrogenic effects of the herb may actually increase the risk of breast tumors. Until more is known, long-term use of the supplement is not generally recommended for preventative nutrition.
Black cohosh’s primary active components are metabolized by the liver, and long-term use has been associated with liver problems in some people. Although this complication is rare, people with hepatitis, cirrhosis or other diseases of the liver are encouraged to avoid black cohosh. To prevent excessive strain on liver function, it is best to avoid taking black cohosh continuously for more than six months.
Because of its anticoagulant properties, black cohosh is best avoided by people taking blood thinners, including warafin, and it should be used only with caution by those with platelet disorders. Except under the guidance of a qualified physician or midwife, black cohosh should be avoided by pregnant women, nursing mothers and women with a history of breast cancer.