Black Cohosh

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• QWhat is black cohosh?

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  A RealAge answered

  Black cohosh is a hardy plant found in the forests of North America. Extracts of black cohosh are prepared from the plant's dried roots and thickened, underground robot-like stem (rhizome).
  
  In laboratory studies, extracts of black cohosh have shown estrogen-like properties. It is used for treating the following conditions:
  

  • premenstrual discomfort
  • painful menstruation (dysmenorrhea)
  • menopausal symptoms

  Black cohosh is available in a variety of product types. The recommended daily dose of a black cohosh product is the equivalent of 40 milligrams of the crude herbal preparation, which consists of dried roots and rhizome. Use of black cohosh should not exceed six months.

• QWhat are side effects of black cohosh supplements?

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  A MediGuard answered

  Based on information from iGuard.org, a free medication monitoring service, 3% of patients experience side effects while taking Black Cohosh. Some of the side effects reported by iGuard members include: Abdominal Pain/Cramps. Please follow up with your doctor or other healthcare provider if you are experiencing any symptoms that worsen or do not go away.

• QWho should not take black cohosh?

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  A RealAge answered

  The following cautions should be considered before using black cohosh:
  
  Situations in which use of black cohosh is not advised:
  

  • Do not use black cohosh during pregnancy or while nursing.
  • Women with breast cancer and women with a family history of breast cancer should speak with their doctors regarding black cohosh use.

  Side effects: Black cohosh may cause gastrointestinal discomfort or upset stomach. It may also cause miscarriage.
  
  Drug interactions: There are no known interactions of black cohosh with any drugs.

• QDoes black cohosh help reduce hot flashes?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  The herb black cohosh reduces hot flashes in 35 percent of cases—the same as a placebo. Because no harm is caused, and 35 percent is nothing to sneeze at, lots of women are plenty happy to keep using it.
  
  You might think that placebos are useless sugar pills for hot flashes or insomnia, but 35 percent of users get relief from them, which is an example of the power of positive thinking and your mind's control of your body.

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• QCan black cohosh supplements help treat menopause symptoms?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  It's not clear whether black cohosh supplements are helpful for relieving menopause symptoms. Black cohosh has been touted as a treatment for hot flashes, night sweats and irritability due to menopause for hundreds of years, dating back to Native American medicine. In modern times, however, the results of clinical studies looking at the effects of black cohosh on menopausal symptoms have been mixed. In some, black cohosh supplements appear to help reduce hot flashes, but in others, it's been ineffective. If you have menopause symptoms, black cohosh supplements might be worth a try, but don't take it, or any herbal supplement, without consulting your doctor first.

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• QCan black cohosh supplements cause liver disease?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Black cohosh, also known as black snakeroot, has been linked to liver inflammation (hepatitis) or liver failure. However, these kinds of problems have been reported only rarely, and it's not known whether black cohosh actually caused them. Even so, experts recommend that people who have a liver condition steer clear of the herb.
  
  Black cohosh is sometimes used to relieve arthritis, muscle pain and menopause symptoms (such as hot flashes). If you take it for these reasons or to treat any other ailment, be aware that it can have side effects. Call your doctor immediately if you develop signs of a liver problem, such as your skin turning yellow, abdominal pain and/or darkening urine.
  

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• QIs it safe to take black cohosh along with labetalol and Norvasc?

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  A MediGuard answered

  Black cohosh is not tested or regulated by the FDA. Its safety and effectiveness are not clearly documented. As a result, the potential risks and/or advantages of black cohosh are not well known. Since the use of Black Cohosh and prescription drugs in combination is not well studied, it is still possible that you could experience side effects and or an interaction when Blach Cohosh is used with Labetalol and Norvasc. If you are still concerned about menopause symptoms, you should talk to your primary doctor, cardiologist, or gynecologist before taking this supplement.
• QHow does black cohosh work?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Researchers believe the herb, black cohosh, may have estrogenic effects, but studies are not conclusive and more research is needed. One of the compounds found in black cohosh, fukinolic acid, has shown antiinflammatory action. There are several other active compounds in this herb and research is ongoing.
  
  
• QWhat are the potential risks of taking black cohosh?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Individuals with high blood pressure, a seizure disorder or problems with blood clots should be very cautious in using black cohosh. Some cases of hepatitis necessitating a liver transplant have been reported by individuals taking products containing black cohosh, but the correlation between the herb and the liver disease is not clear. Individuals with liver problems should consult their doctor before using black cohosh. The U.S. Pharmacopeia, the organization that sets standards for foods and drugs in the United States, has advised the following warning on black cohosh packaging: "Discontinue use and consult a healthcare practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine or jaundice."
  
  In a few reports, women using black cohosh have experienced a miscarriage or vaginal bleeding, but the correlation between the herb and such adverse events is not clear.
  
  
• QWho should take black cohosh?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  The primary use of black cohosh is to treat menopausal symptoms including hot flashes, night sweats, and vaginal dryness. This herb has been used to induce labor, treat PMS (premenstrual syndrome), and treat irregularities of the menstrual cycle. Historically, black cohosh has been used to treat rheumatism. Many studies are being conducted on the uses and safety of black cohosh.