Black Cohosh

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Herbal Alternative Health

Black Cohosh

The medicinal herb Black Cohosh as an alternative herbal remedy for rheumatism, arthritis - Black cohosh is a plant native to North America.Common Names--black cohosh, black snakeroot, macrotys, bugbane, bugwort, rattleroot, rattleweed

Latin Names--Actaea racemosa, Cimicifuga racemosa Picture of Black Cohosh

  • Black Cohosh (Cimicifuga racemosa) has been used for thousands of years by Native Americans. It has become more well-known in the Western world through research on its supportive effect on hormone functioning and support of the female reproductive system. (Liske E. "Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders".Adv Ther. 1998 Jan-Feb;15(1):45-53. Review.) (Frei-Kleiner S, Schaffner W, Rahlfs VW, Bodmer Ch, Birkhäuser M. "Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial". Maturitas. 2005 Aug 16;51(4):397-404. Epub 2004 Dec 10. PMID: 16039414.)

What Black Cohosh Is Used

For Black cohosh has a history of use for rheumatism (arthritis and muscle pain), but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause. Black cohosh has also been used for menstrual irregularities and premenstrual syndrome, and to induce labor. Herbal remedy for menopausal symptons.

Herbal Remedy Products with Black Cohosh as part of the ingredients

Fertile XX.jpg
  • Fertile XX™ - Herbal remedy to help promote effective female reproductive system support for fertility and healthy natural ovulation
    • Promotes fertility by supporting female reproductive health
    • Helps maintain menstrual cycle regularity
    • Supports healthy, regular ovulation and egg production
    • Encourages healthy fertility hormone levels
    • Tonic benefits support healthy conditions for conception
    • Promotes healthy libido and sexual pleasure
    • Maintains balanced mood for sustained well-being
    • Promotes overall systemic health and functioning
  • MellowPause™ - Herbal remedy to support hormonal balance, healthy sleep patterns and reduce common hot flashes during menopause
    • Reduces common hot flashes
    • Supports balanced mood and routine calmness
    • Maintains healthy sleeping patterns
    • Supports hormonal balance during perimenopause and menopause

How Black Cohosh Is Used

The underground stems and roots of black cohosh are commonly used fresh or dried to make strong teas (infusions), capsules, solid extracts used in pills, or liquid extracts (tinctures).

What the Science Says about Black Cohosh

  • Study results are mixed on whether black cohosh effectively relieves menopausal symptoms.
  • Studies to date have been less than 6 months long, so long-term safety data are not currently available.
  • NCCAM is funding studies to determine whether black cohosh reduces the frequency and intensity of hot flashes and other menopausal symptoms.
  • There are not enough reliable data to determine whether black cohosh is effective for rheumatism or other uses.

Side Effects and Cautions about Black Cohosh

  • Black cohosh can cause headaches and stomach discomfort. In clinical trials comparing the effects of the herb and those of estrogens, a low number of side effects were reported, such as headaches, gastric complaints, heaviness in the legs, and weight problems.
  • No interactions have been reported between black cohosh and prescription medicines.
  • Black cohosh has recently been linked to a few cases of hepatitis (inflammation of the liver), but it is not clear whether black cohosh caused the problem.
  • It is not clear if black cohosh is safe for women who have had breast cancer or for pregnant women.
  • Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides), which has different properties, treatment uses, and side effects than black cohosh. Black cohosh is sometimes used with blue cohosh to stimulate labor, but this therapy has caused adverse effects in newborns, which appear to be due to blue cohosh.
  • It is important to inform your health care providers about any herb or dietary supplement you are using, including black cohosh. This helps to ensure safe and coordinated care.
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News About Black Cohosh

How To Use Black Cohosh To Induce Labor, According To Experts

By Abi Berwager Schreier

The last trimester can seem like an eternity and it’s understandable that a lot of women get to a certain point where they’re willing to do almost anything to speed things along a bit, including inducing labor at home. There are many old wives' tales and tips and tricks that have been spread around about naturally inducing labor, including using black cohosh. I know — it sounds like something from Harry Potter — so knowing how to use black cohosh to induce labor seems essential. But is using black cohosh safe, especially if you’re not being supervised by a professional? What are the risks?

Kristen Burris, L.Ac, a women’s health acupuncturist and infertility specialist, tells Romper that in her opinion, using black cohosh to induce labor isn’t safe. “It is never safe to use herbal medicine to induce labor unless under the specific guidance of a trained and licensed herbalist,” Burris says. “This herb is not effective in inducing most labors because herbal medicine doesn’t work across the board for every person; it must be individualized based off of medical patterns, not generalized health conditions. It is critical to assess the patient’s individual pattern and what the appropriate treatment plan is per the individual,” she explains. “An herb that traditionally raises energy upward and clears heat is not appropriate for the pregnant woman who has stabbing labor pains in her back with blood stasis.”

According to Evidence Based Birth, there have actually been more studies about blue cohosh, rather than black cohosh, and that blue cohosh was used by Native Americans to treat gynecological problems and induce labor and decrease labor pains. Black cohosh comes from the same plant class as blue cohosh, but it’s often used in combination with the blue cohosh when being used by pregnant ladies.

One specific study showed that a woman who “consumed several doses of black cohosh with the intent to induce and augment labor,” ended up experiencing severely low levels of sodium in her blood, a condition called “hyponatremia.” Another case Evidence Based Birth described is one about a 24-year-old first-time mother. She actually drank the blue cohosh in tea form, and ended up having a C-section because her baby had a stroke. However, “the dosage and preparation of her blue cohosh are unknown,” noted Evidence Based Birth.

“When [doctors] tried to figure out the cause of the stroke, they found that both the baby’s urine and meconium were positive for a cocaine metabolite, so they tested the contents of the mother’s bottle of blue cohosh and the contents of a sealed bottle of a different preparation of the herb, and the tests found the same results,” Evidence Based Birth explained about the study. “In correspondence in this journal, the authors clarified that blue cohosh is not known to contain this metabolite of cocaine, and they think that the most likely explanation is maybe that there was some cross-reaction that confused the test results, or that the test data were interpreted incorrectly.”

Another woman was reported taking three times the recommended dosage level and her baby had a heart attack after it was delivered vaginally at 41 weeks, according to the Journal of Pediatrics. “She took three tablets a day for three weeks. The quantity of blue cohosh in the tablets that she took is unknown. The baby was critically ill for several weeks before recovering enough to go home. The child was still receiving therapy for heart failure at 2 years of age. The authors claimed that they ruled out any other possible causes of the heart attack, so they do believe that the heart attack was due to the herb," the article noted.

Yale grad student Aviva Romm published an article titled, “Blue Cohosh: History, Science, Safety, and Midwife Prescribing of a Potentially Fetotoxic Herb," in 2009, and her results from her research weren’t very reassuring either. “What is clear from this study is that blue cohosh has a very long history of use as an herb to prevent and ease the difficulties of childbearing women, and for a variety of philosophical, practical, ideologic[al], political, and medico-legal reasons, its use remains prevalent,” she wrote. “While the constituents in this herb are consistent with some of the observed side effects, and even possible players in one significant adverse event report, the number of plausible reports is very low. However, as with many drugs, it can take tens of thousands of observed/documented administrations to identify even a single causal relationship between a substance and an effect; the numbers of systematically observed uses is too low to quantify whether there are a significant number of adverse events related to use of this herb, if any.”

Romm continued, “While it appears that the risks associated with short term use, for example, for labor induction and augmentation may actually be quite low, and the risk may be mitigated further by using the herb only in tincture form, the preparation with the lowest quantity of the alkaloids and saponins responsible for its pharmacologic actions, at this time, until further research is done, the herb should be used only under the supervision of a qualified obstetric health professional, with proper monitoring, if at all.”

Unless you’re being monitored by a medical professional or a certified herbalist, the risks that seem to emerge from using black cohosh to induce labor, from what researchers have seen, don’t seem worth it. If you do still want to try this induction method, please contact your healthcare provider or a certified herbalist so they can do a full workup of your health profile and medical history to ensure that you’re getting the right dosage and correct combination with other herbs before trying this at home.

12 Impressive Health Benefits Of Black Cohosh

(CureJoy Editorial)

Every culture and every medicinal system across the world, be it traditional Chinese medicine or ayurveda, have testified to the benefits of thousands of herbs, one of them being black cohosh, scientifically known as Actaea racemosa.

Black cohosh was used by Native Americans for over two hundred years after they discovered how beneficial the root of the plant was in relieving menstrual cramps and multiple symptoms of menopause. Today, this herb is still widely recommended by doctors and herbalists to cure menopausal symptoms in not just women, but also in men, since so many symptoms of male menopause (also known as andropause) are found to mimic those of female menopause. The truth, however, is that there are very few studies to suggest the effectiveness of black cohosh for men; most of the recent scientific data leans toward black cohosh and women.

It is important to remember that like all other herbs used in traditional medicine, black cohosh can be responsible for causing some very serious side effects in both men and women, the most common one being liver inflammation and potential hepatitis development. In the case of individuals with cancer or those who are undergoing cancer treatment and taking cancer medication, black cohosh is strongly advised against.

12 Health Benefits Of Black Cohosh

Here’s a closer look at how black cohosh benefits men and women individually, some exclusive benefits for women, and some overall health benefits that are applicable to both genders.

1. For Weight Loss During Menopause

Women: Low estrogen levels during menopause triggers weight gain in roughly 90% of women. This means the body has to look for this essential hormone elsewhere. Because fat cells contain a high amount of estrogen, the body will automatically produce more of these. Ingesting black cohosh helps to raise the estrogen levels in the body, thus stopping the body from producing more fat cells to support its need for estrogen. This way, black cohosh helps in losing weight during menopause.

Men: Just as in menopause, andropause is marked by an accumulation of estrogen-containing fat cells. However, research regarding black cohosh helping men lose weight during andropause is unavailable.

High cortisol and low testosterone levels seem to be responsible for an increase in fat, especially around the midsection, and a marked decrease in muscle mass. The more the increase in body fat, the larger the hormonal imbalance, since it only converts the testosterone into estrogen. Therefore it is unlikely that black cohosh would help reducing weight during andropause since it would only increase the estrogen content in the body and do the opposite.

2. Fighting Weight-Related Illnesses

Women: Since black cohosh is effective in helping reduce weight during menopause, it also helps bring down the risk of illnesses that are caused by weight gain such as heart diseases, cardiac arrests and strokes, breast cancer, high cholesterol, diabetes, and high blood pressure.

Men: Since there is no research to prove whether black cohosh can help lose weight during andropause, it is also not known whether it could help fighting weight-related illnesses in andropausal men.

3. Relieving Menopause And Andropause Symptoms

Women: The estrogen-like compounds present in black cohosh is linked to reducing menopausal symptoms. Supplementing one’s diet with black cohosh in the form of pills or tea can be a good substitute for hormone replacement therapy, which many men and women seek out after andropause and menopause respectively. The use of black cohosh can also help in reducing hot flashes, night sweats, cramps, mood swings, and reduced stress levels for menopausal women.

Since a stark drop in estrogen levels is the main reason menopause in women black cohosh can greatly help in reducing menopausal symptoms.

Men: Since the symptoms of menopause in women and andropause in men are almost similar, black cohosh would be beneficial for relieving symptoms of andropause in men as well.

However, in this case, a certain amount of caution must be practiced while ingesting black cohosh since too much estrogen can actually worsen the hormonal imbalance in men.

4. Natural Labor Inducer

Being a natural analgesic, black cohosh, when eaten by pregnant women, contributes greatly to reducing pain during the labor process by stimulating powerful contractions. For this reason, it is often administered when women face weak contractions and slow, painful labor.

Caution: While it is known to help make the birthing process shorter and less painful, if taken during the early stages of pregnancy, it can induce a miscarriage by causing preterm uterine contractions.

However, there is a high chance of it causing an incomplete miscarriage where parts of the fetus can remain inside the uterus. This can cause sepsis. This infection can be life-threatening because it causes the body to respond by causing injury to its own organs and tissues.

Furthermore, black cohosh is always ingested with a mixture of specific herbs and should never be ingested by itself during pregnancy. The success of black cohosh is completely dependent on dosage and only a certified herbalist or skilled midwife would be able to administer the right amount and determine what other herbs it should be combined with. Hence, it is highly dangerous to self-prescribe this herb be it in the early or the later stages of pregnancy without prior consultation with a medical expert.

5. Fights Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome is an endocrine (hormonal) disorder which causes decreased fertility, excessive growth of body hair, irregular, abnormal or absent menstruation, and obesity. It is caused by an overproduction of testosterone that causes a hormonal imbalance in the body. The estrogen-like compounds in black cohosh help reverse this imbalance by supplying the body with high amounts of estrogen, and can, therefore, be used as an effective remedy for PCOS. 1

6. Treats Infertility

Infertility in women is associated with a naturally low level of estrogen in the body. The estrogen-like compounds present in black cohosh provides feedback to the brain regarding the necessary amount of reproductive hormones needed for ovulation. This pushes the brain to release healthy amounts of luteinizing and follicle stimulating hormones that act on ovaries and cause them to release eggs for fertilization. Thus, black cohosh can greatly help in solving infertility in women.

7. Promotes Healthy Skin

Lowered estrogen levels during menopause can wreak havoc in the body year after year. This causes various skin problems such as rashes, acne, itchy, dry skin, wrinkles, and crow’s feet. By keeping the body’s estrogen levels in check, black cohosh may improve the overall skin texture and is, in fact, one of the top 3 benefits majority of the women talk about when asked about the benefits of black cohosh.

8. Acts An An Antispasmodic

Black cohosh acts as a potent antispasmodic for both men and women. It can help inhibit cramps and pains related to muscle strain, injury, and chronic nervous tension, thus aiding in the normal functioning of muscles and nerves.

9. Fights Inflammation

The salicylic acid found in black cohosh almost directly mimics the effect of aspirin on the body, thus making it a potent natural anti-inflammatory substance. When ingested regularly, black cohosh root can help fight arthritis and osteoporosis in both men and women. This particular property of black cohosh also makes it a good cure for sore throats, high blood pressure, and congestion.

10. Prevents Blood Clots

Black cohosh also acts as a powerful vasodilator in both men and women. Thus, it can greatly help in reducing the stress on the cardiovascular system, further decreasing the risk of blood clots that could cause strokes or heart attacks.

11. Promotes Digestive Health

Black cohosh has been linked with a strong alterative action, which means that it can boost the efficiency of nutrient uptake and speed up the elimination of waste products, thereby reducing the risks of constipation and related conditions such as gastric ulcers. This digestive capacity of black cohosh can also help to fight flatulence, bloating, cramping, morning sickness, and nausea in both men and women.

12. Cures Sleeplessness

Black cohosh is a potent natural sedative and can guarantee long, restful sleep. Hence, it is often recommended for men and women suffering from insomnia, chronic anxiety, stress, and disturbed sleep.

Caution: Do not take black cohosh if you’re already on sleep-inducing medication, as the natural components of this herb are quite potent and may cause dangerous side effects when combined with other medicines. Active Components Of Black Cohosh

Black cohosh is full of active ingredients such as serotonin-like compounds, as well as certain components that mimic estrogen in the human body. Furthermore, black cohosh is packed with tannins, triterpenes, essential fatty acids, isoflavones, and certain starches. The combined activity of all these compounds together makes this an extremely beneficial herb to add to your weekly regimen for both treatment and preventative measures.

How To Take Black Cohosh

Black cohosh is usually ingested in the form of pills, tea, and sometimes even in tincture form.

• Black Cohosh Pills – In the case of pills, it is mixed with other ingredients such as calcium, soy, and lemon bioflavonoid complex.
• Black Cohosh Powder – The root and the leaves are usually ground together to produce a fine, dry powder.
• Black Cohosh Tea – Black cohosh tea is usually made from the dried thick knotty roots and leaves of the plant. These can be found in powdered, or cut form, either in tea bags or in loose form.
How To Prepare Black Cohosh Tea

Traditionally, black cohosh tea is made by boiling 1 teaspoon of black cohosh dried roots and leaves per cup of water for roughly 20 – 30 minutes. Since it can be a little too bitter to taste, it is recommended to sweeten it with a little sugar or honey.

How Much Black Cohosh Should You Take?

There is no clear-cut standard dosage for black cohosh. However, experts suggest a dose of 15 to 30 mg a day for the concentrated extract of this herb. Other forms of black cohosh may suggest that you take roughly 200mg a day.2

Black cohosh dosage amount really depends on a variety of factors such as the specific use of the herb, the manufacturer (in the case of pills), additional ingredients, and the form in which it is taken. Also, bear in mind that it is dangerous to compensate a missed dose with an extra amount during the next dosage time.

It is recommended to consult with your doctor or herbalist to reach a fixed dosage amount. Do not try to self-administer this herb.

Final Word Of Caution: Despite the diverse range of benefits of black cohosh for health, there have been reports of this herb causing liver damage, particularly when ingested over a long period of time. Also, if not taken in the right quantities, some people may complain about side effects like nausea, dizziness, headaches, constipation, and diarrhea.

Black cohosh is not recommended for people suffering from any kind of cancer or undergoing chemotherapy as it may interact with those drugs and cause harmful side effects.

Therefore, before adding this powerful herbal agent into your daily or weekly regimen, it is very important to discuss the decision with a medical professional.

Black Cohosh May Reduce Hot Flashes By Targeting Brain's Thermostat

(American Chemical Society)

NEW YORK — Black cohosh, a medicinal herb increasingly used by women as an alternative to estrogen replacement therapy, may reduce hot flashes by targeting serotonin receptors — some of the same receptors used by the brain to help regulate body temperature — according to a team of researchers from the University of Illinois at Chicago. The finding, the first to demonstrate a possible mechanism of action for the herb other than estrogen, increases the likelihood that the herb is safe to use, they say.

The study was described today during a press briefing on hormone replacement therapy at the 226th national meeting of the American Chemical Society, the world's largest scientific society. The study also will appear in the Sept. 10 print issue of the Society's Journal of Agricultural and Food Chemistry.

Until now, many scientists thought that black cohosh (koh-hawsh) worked by targeting receptors for estrogen, the same hormone used in commercial hormone replacement medicine that has recently been associated with adverse side effects, including breast cancer and stroke.

"This study shows that black cohosh does not appear to be estrogenic whatsoever and, as a result, is less likely to pose some of the dangers associated with traditional estrogen replacement therapy," says study leader Judy L. Bolton, Ph.D., a professor at the university's College of Pharmacy. "We now have new clues to how it might work in the body."

Although preliminary evidence of the herb's efficacy in relieving hot flashes, night sweats and other symptoms of menopause is encouraging, further studies are still needed before it can be recommended, Bolton says. Long-term safety data on black cohosh is also needed, she adds.

To determine whether black cohosh is estrogenic, the researchers used a group of rats whose ovaries had been removed. The rats were divided into different groups and each group was fed a different concentration of cohosh extract daily for two weeks. Extracts of the herb, either alone or in combination with synthetic estrogen, did not produce any changes in uterine weight or vaginal cell differentiation in the animals. This indicates that the herb has no estrogenic effects, the researchers say.

In accompanying lab studies, the researchers also demonstrated that the black cohosh extract is capable of binding to human serotonin receptors, including those that help regulate body temperature. Previous studies have shown that these receptors may play a role in regulating hot flashes. Antidepressant medications, which some people believe may help reduce hot flashes, also bind to the same receptors. The current study may help provide an explanation for this effect, Bolton says.

Researchers still do not know the specific chemical or chemicals in black cohosh that target the serotonin receptors. Nor do they know if the herb may target hot flashes via additional mechanisms. Further studies are underway to find answers to these questions, they say.

A Phase II clinical trial involving women with a high frequency of hot flashes is now underway at the university to determine whether black cohosh actually reduces the frequency and intensity of hot flashes and other menopausal symptoms. The women will either receive black cohosh, red clover, a placebo or estrogen replacement during the one-year trial, which is one of the largest and longest of its kind, according to Bolton. The trial is funded by the National Institutes of Health. Black cohosh is indigenous to North America and is used by many women to treat menopausal problems. Native Americans originally used it to treat a variety of ailments, including gynecological disorders and even depression. Interest in the herb has soared following the recent findings of the Women's Health Initiative study, which showed that the health risks of estrogen replacement therapy, including breast cancer and stroke, might outweigh its benefits for some women.

Is Black Cohosh Safe To Induce Labor?

Moumita Ghosh

As your pregnancy matures, you may be thrilled to meet your baby. Well, this is natural, and this is what all women feel like.

However, it is advisable that you do not disturb the natural process and let things happen when the time is right. Although there are no scientific evidences to support use of black cohosh to induce labor, it is an herbal supplement commonly used for this purpose. This herb is known to strengthen and regulate contractions that promote ripening of the cervix.

What Is Black Cohosh?

Black cohosh works as a uterine tonic. It prepares your uterus for contractions and stimulates labor. According to the reports of Journal of Nurse-Midwifery published in June 1999, 45% of the midwives have used blue and black cohosh for inducing labor in pregnant women.

How To Use Black Cohosh To Induce Labor?

If you are considering inducing labor with black cohosh, you must have a word with your doctor first. It is essential you are well informed and doing everything under supervision to stay safe and healthy.

Here are some things you ought to know:

• If you take black cohosh before your term, you may be in serious danger. You can also put at risk the health of your baby. So, be very careful and try this medicinal herb only under supervision of your doctor.
• You just need 5 drops of black cohosh to promote ripening of your cervix. This will regulate contractions and induce your labor.
• You can add the drops to your coffee and tea and drink twice every day.
• If you do not find any changes in your cervical, you can increase your intake to 10 drops. You must discontinue taking it if you experience any side effects.
• You can take black cohosh capsules from the 38th week of your pregnancy. Each of the capsules generally contains 500 mg of black cohosh.
• You can take 15 drops of the herbal medicine under your tongue to speed up the cervix ripening process.
• You can repeat the process again after an hour if you find no changes.
• For increased effectiveness you can add the black ones with the blue variants. Combination of the two herbs can help induce your labor.
Induction Of Labor:

To be on the safer side, it is always better not to indulge in any practices that disrupt the natural process. You must avoid any techniques until you reach the 40th week of your pregnancy.

• Last few weeks of your pregnancy are crucial for development of the brain of your baby.
• Your baby may suffer from development delays if your pregnancy is cut short by even a week.
• Thus, whether you are thinking of using black cohosh or anything else to induce labor, you must have a discussion with your doctor first.

Since it is all about you and your unborn baby, you cannot afford to take even the smallest of risks. If you use black cohosh, you must be well aware of the risk factors associated with it. Here are the common ones you should keep in mind:

• The FDA does not recommend use of any types of herbal supplements in pregnancy.
• You cannot be sure that products you purchase shall contain all the ingredients listed in the label.
• Black cohosh must be avoided if you are suffering from liver disorders or breast cancer states the National Institutes of Health.

Talk to your doctor and follow what he suggests, as that would free your mind from concerns about your baby. If you are not yet ready for delivery, may be your body needs some more time to hold on and protect your little bundle of joy developing inside. So understand your body timings and do not rush.

Menopause and Black Cohosh

By Christopher Hobbs (L.A.C.)

A woman's herb comes of age.

Many women are plagued by menstrual cramps, premenstrual syndrome, or hot flashes at some point during their lifetimes. Now they can take a tip from European women, who are increasingly turning to one herb more than any other for relief from these discomforts. Known as black cohosh, the herb has been used by more than one-and-a-half million German women, according to one manufacturer of a black cohosh supplement. And the German Commission E, a government-sponsored panel that evaluates herbal therapies, has given black cohosh its stamp of approval, recommending it for treating PMS, painful menstruation, and menopausal problems.

Some predict that black cohosh (Cimicifuga racemosa) will soon become as popular in the United States as it is in Europe. That would bring history full circle, ­because black cohosh was known in North America long before Europeans dis­covered it.

Taking A Cue From Native Americans

At the turn of the century, U.S. medical doctors were of three general persuasions: They prescribed drugs, homeopathic remedies, or herbs. Allopaths used substances such as mercury; homeopaths preferred preparations made with highly diluted herbs and minerals.

The herbally oriented doctors were called the Eclectics, who learned about herbs through interactions with their patients. They observed reactions, both good and bad, of botanical medicines that had been used by Native Americans, including black cohosh, echinacea, wild indigo, osha, cramp bark, snakeroot, lobelia, and pokeroot. The Eclectics, taking their cue from Native Americans, prescribed black cohosh to treat “female complaints”, including menstrual problems, hormonal imbalances, fibroid cysts, and false and true labor pains. They also recommended the herb to calm the nervous system, reduce pain after labor, or relieve painful, late menstrual periods. They combined it with cramp bark to ease menstrual cramps, and used it alone to treat neuralgia, rheumatism, arthritis, and headaches.

After the 1930s, pharmaceuticals replaced herbal remedies as the treatment of choice in the United States, but the experience of the Eclectic physicians wasn’t lost. Their knowledge of many Native American herbs made its way to Europe, where German researchers, aware of the clinical effectiveness of some of these remedies, began looking for marketable drugs among them.

Today, black cohosh remains on a European short list of proven remedies for “women’s conditions”. Thanks to the body of evidence that has accumulated during the past century, we now understand much more about the symptoms and syndromes for which black cohosh is proving beneficial and safe. This includes knowledge about its proper dose, the length of time it should be used, and other therapeutic aspects.

Botanical Background

Black cohosh, Cimicifuga racemosa, is a perennial that grows up to five feet tall. It has sharply toothed palmate leaves and long white spires of small white flowers that attract flies and other pollinators. Abundant in some eastern states, it grows from the Midwest to New England. The plant will do well in the garden nearly anywhere in the United States, and will grow in full sun or complete shade, preferring rich deep soil. The roots are straight and dark brown. Fresh roots are dug in the fall and dried. When cut, the interior of the roots has the appearance of off-white, porous wood.

Dosage: Black Cohosh

• Cimicifuga racemosa (also known as bugbane, black snakeroot, cimicifuga)

• What it does: The German Commission E ­recommends black cohosh for treating PMS, menstrual cramps, and menopausal symptoms such as hot flashes. Herbalists also recommend it as a muscle relaxant and anti-inflammatory for treating rheumatism, muscle spasms, and general pain. In Traditional Chinese Medicine, a similar species is used for prolapse (the slipping or falling out of place of the uterus), ­fatigue, and shortness of breath. Scientifically speaking, black cohosh suppresses the secretion of luteinizing hormone (LH); sudden bursts of LH have been linked to the occurrence of hot flashes, night sweats, heart palpitations, headaches, and drying and thinning of the vagina.

• How we know: Test-tube and animal studies and a limited number of human trials. One human trial involving 110 menopausal women showed that black cohosh significantly reduced depression and hot flashes compared to a placebo. Test-tube and animal studies indicate that black cohosh contains three types of compounds that affect the behavior of estrogen, the female sexual hormone.

• Dosage: 2 to 4 droppersful of black cohosh tincture two to three times daily in a little water or tea, or 2 tablets or capsules daily containing a standardized extract of black cohosh. The German Commission E, a government-sponsored panel that studies and makes recommendations on herbal remedies, advises that the length of use not exceed six months.

• Cautions: There have been so few reported side effects that the German BGA (the German equivalent of the FDA) considers black cohosh to have no contraindications.

The Botanical Safety Handbook (CRC Press, 1997) states that black cohosh shouldn’t be used during pregnancy; its use is particularly cautioned against during the first two trimes­ters, although it is often used during the last two weeks of pregnancy to stimulate labor.

Defining its Effectiveness

In the classic reference book Herbal Medicine (Beaconsfield, 1988), Dr. Rudolph Weiss lists black cohosh as a treatment for conditions caused by lack of estrogen, such as depression associated with menopause. Clinical experience of European practitioners backs this up. Scientific studies show that black cohosh has a balancing effect on hormone production, either by acting as a mild estrogen or regulating estrogen’s production in the body. For that reason, black cohosh is often found in herbal formulas for regulating female hormones, especially those prescribed to reduce hot flashes, which can occur when estrogen levels drop too low. Commercial preparations of the herb, available in the United States, are commonly prescribed in Europe and sold in drugstores to reduce hot flashes.

Researchers have conducted many test-tube and animal studies using black cohosh as well as a few human trials. In one controlled double-blind study, 110 meno­pausal women who complained of unpleasant symptoms and who hadn’t taken estrogen replacement therapy for at least six months took a standardized black cohosh extract. According to the researchers, these women felt less depressed and had fewer hot flashes than those in the placebo group. The researchers theorize that black cohosh extract affects estrogen behavior by changing vaginal cells and suppressing the secretion of luteinizing hormone (LH), both indicators of an estrogenic influence. Sudden bursts of LH have been linked to the occurrence of hot flashes, night sweats, heart palpitations, headaches, and the drying and thinning of the vagina.

At the University of Göttingen’s Department of Clinical and Experimental Endocrinology in Germany, researchers report that black cohosh’s impact on sexual hormones can be traced primarily to three compounds (formononetin, triterpenes, and aceteine). The German BGA (the German equivalent of the U. S. Food and Drug Administration, or FDA) considers black cohosh to be safe because so few side effects have been reported. The Botanical Safety Handbook (CRC Press, 1997) states that black cohosh shouldn’t be used during pregnancy.

Promising Future

Although all of the science defining how black cohosh works isn’t in, modern herbalists in North America use the herb in many of the ways their forebears did, and European physicians recommend it for a variety of gynecological complaints. While still unapproved for use as a drug in the United States, black cohosh appears quite promising as an alternative to conventional hormonal replacement therapy, or HRT, without the serious risk of side effects. 8

Natural Herbs To Treat Menopausal Symptoms

(Lekhaka, Boldsky)

As women approach menopause, the warning signals set in - irregular periods, night sweating, hot flushes and emotional issues like irritability and low sexual drive. Conventional hormone replacement therapies have generally been proven to provide only short term respite from menopausal symptoms.

Hormone replacement therapies have also been found to often increase the prevalence of heart attacks, strokes as well as breast cancer. However, there is nothing to worry as certain herbs and supplements have proved to work wonders in this case.

Certain naturally derived herbal and botanical infusions have been proven to provide the same advantages as bodily hormone replacement therapies. Black cohosh extract has been found to boost levels of energy and reduce hot flushes.

Botanical infusions work harmoniously as a menopausal remedy to support the body's hormones, as opposed to a relatively invasive hormone replacement therapy treatment. Soybean isoflavone proteins have been found to alleviate hot flushes.

Chaste Berry provides mild pain relief, especially to targeted menopausal pain like breast tenderness and edema. Red clover extract has been shown to possess properties comparable to hormone replacement therapy's low levels of oestrogen and so can help to alleviate night perspiration and in addition acts as a sleeplessness aid.

Concerning the psychological after effects of menopause, wild yam root promotes production of sex bodily hormone binding globulin and serum oestrogen, reducing vaginal dryness, and additionally boosting a low sexual drive.

Green tea leaf extract boosts the immunity system and acts as a strong anti-oxidant, but additionally works with guggul gum resin to stimulate thyroid exercise, helping to quell excess appetite cravings. The inclusion of calcium promotes positive bone tissue health to prevent osteoporosis.

These all natural, herbal extracts are a promising change as these provide relief without causing any side effects. These are available in the form of supplements and have proved very useful in treating menopausal symptoms.

Getting to the root of the problem of hot flushes

(Straits Times)

Hot flushes and night sweats are the most common symptoms of menopause.

This female reproductive milestone is also often blamed for a host of other symptoms such as joint pain, insomnia, depression and mood swings, vaginal dryness and difficulty concentrating.

Hot flushes can last for years and be debilitating.

Conventional treatments such as hormone replacement therapy (HRT) and antidepressants come with risks. HRT increases the chance of developing potentially deadly clots in the leg veins, and a small increase in breast cancer risk has also been reported.

Because of these risks, women may turn to herbal products that are purportedly safer and have fewer side effects.

A native American root called black cohosh (Actaea racemosa) is included in many treatments for hot flushes.

The root has a long history of use in Europe and became popular around the world after getting German approval as a non-prescription drug for hot flushes in 2000.

Black cohosh is also used to treat arthritis and premenstrual syndrome.

The root and rhizome (the stalk of the root) of the plant contain a number of active ingredients, but how it works for menopausal symptoms is unclear.


Does black cohosh ease hot flushes? The evidence is inconclusive.

Some studies show it works, while others show that it does not. It is important to note that there is often a high placebo effect with hot-flush treatments.

In 2012, a Cochrane review compiled results from 16 studies that evaluated the effectiveness of black cohosh.

There was no difference in the number of weekly or daily hot flushes among women who received black cohosh and those who received a placebo.

The Cochrane authors were unable to make a definitive conclusion about how effective black cohosh was for menopausal symptoms for a number of reasons.

These included design flaws in many of the trials evaluated, differences in the types of herbal extract used and variations in the way symptoms were reported.

Some trials did not report the dosage for black cohosh, while the duration of treatment ranged from eight weeks to 12 months.

A more recent trial involving 84 menopausal women in Iran showed that those allocated to take a standardised extract of black cohosh (Cimifugol) reported an 82 per cent reduction in daily hot flushes, compared to 24 per cent in the placebo group, after eight weeks.


A 2008 review was conducted by a US dietary supplements expert committee after about 30 reports of liver failure in patients from the European Union, Canada and Australia (one death was reported), were "potentially associated" with black cohosh.

It found the liver toxicity was possibly linked to black cohosh. This means there is a very small risk of liver failure, which is potentially fatal, for those taking black cohosh.

Women should seek urgent medical attention if they develop abdominal pain, fatigue and have dark urine or jaundice.

It should be noted that clinical trials have not reported a link between black cohosh and liver failure, and the association may be due to other factors affecting liver health (such as alcohol consumption) or lack of quality control in commercial preparations.

That is to say black cohosh has not been proven to cause liver failure. Also, side effects from black cohosh are considered rare.


In 2015, a large Australian survey of women aged 40 to 65 reported that 13 per cent of them took a complementary medicine for hot flushes.

Phytoestrogens such as red clover and soya isoflavones were the most popular.

There is evidence that these may reduce the number of hot flushes by 1.3 flushes a day.

Phytoestrogens are considered a relatively safe supplement.

Yoga, meditation and cognitive behavioural therapies also show promise.

Although black cohosh was the fourth-most-popular complementary therapy used, only 1.5 per cent of women used it.

Acupuncture was previously thought to be effective for hot flushes, but a 2016 Australian study reported no difference between real and sham acupuncture.

The inconclusive findings reflect some of the problems with complementary medicine research, includ- ing the use of varying doses and formulations, leading to difficulty in drawing conclusions.

Black Cohosh and Hair Growth

By Karen Frazier

Are you seeking information about black cohosh and hair growth? Below you will find information about the herb, black cohosh, and how it affects hair loss and hair growth.

What Is Black Cohosh

Before discussing black cohosh and hair growth, it is important to know a little bit about this herb.

Black cohosh is also known as Actaea racemosa and Cimicifuga racemosa. It is a member of the butter cup family. It grows in North America and is a perennial.

The root of the plant is used for most herbal preparations. The root is almost black and very thick. The rhizomes (underground stems) are also used in black cohosh preparations. It is available as a tincture, a tablet or a capsule.

Other names for black cohosh include snakeroot, bugbane, bugwort and squawroot.

Black Cohosh and Hair Loss

Because it believed that black cohosh has the ability to regulate levels of the hormone estrogen, many believe that black cohosh is helpful for preventing hair loss in women. Because of this, a number of natural hair loss remedies contain black cohosh as one of their ingredients.

The reason that there is a wide-spread belief that black cohosh has estrogen stimulating properties is because of its effectiveness in treating menopausal symptoms.

According to the National Institute of Health Office of Dietary Supplements, "How black cohosh works is not known. The possibility that black cohosh exhibits estrogenic activity has been studied but the evidence is contradictory."

There is also some evidence that black cohosh relieves menopausal symptoms not by supporting estrogen production, but by targeting the brain's serotonin receptors.

The Relationship of Estrogen to Hair Loss

The female sex hormone, estrogen, plays a number of important roles in the female body to give women their feminine characteristics. One such role is to reduce body hair and promote growth of hair on the head. It does this by blocking levels of DHT from the male hormone, testosterone. DHT from testosterone is the main reason that hair follicles stop producing hair in men with male pattern baldness.

Women with normal levels of estrogen stand very little chance of facing hair loss.

Aging, however, has an effect on the level of estrogen in the body. During menopause, it is common for hormonal levels of estrogen to drop, which can lead to a hormonal imbalance. This allows for DHT from testosterone to flow into the hair follicles, causing the follicles to stop producing hair.

Black Cohosh: 10 Health Benefits and Side Effects

By Tina Lockhart

Are you intrigued by the reported benefits of black cohosh yet scared by the surrounding controversy? We combed through research studies and clinical trials to give you the best available information on the use of black cohosh, so you can decide whether it is right for you. Continue reading to learn about black cohosh safety, uses, health benefits, and side effects.

Black cohosh is a herb of the buttercup family native to North America. It is the root of this tall, yellow and white flower plant that is the star of the show. It has been used for centuries for medicinal purposes. Native Americans first used it to treat menstrual problems, pain, cough, fever, and pneumonia. They then introduced it to European settlers who used it to treat female reproductive issues. Today, it is used in the popular form of a supplement.

Black Cohosh Benefits

Let’s look at the health benefits linked to black cohosh due to its anti-inflammatory, sedative, and analgesic properties. The components of the herb mirror the effects of naturally produced estrogen and serotonin. It is also found to have tannins, isoflavones, triterpenes, and essential fatty acids.

Please note that while some of the following benefits have been backed by scientific evidence, results have been mixed. It is always best to consult with your doctor before taking any medicinal herb.

1. Menopause

Black cohosh menopause effects are primarily responsible for the herb’s popularity in the last century. Research has found the estrogen-like response in black cohosh increases the low levels of estrogen most menopausal women experience. For this reason, it is believed to act as a natural hormone replacement. Studies have also credited the root with treating several menopausal symptoms such as hot flashes.

The University of Maryland Medical Center cites a study following 120 menopausal women taking black cohosh supplements. It found the herb was more beneficial than the prescribed antidepressant fluoxetine, also known as Prozac, in controlling hot flashes and night sweats. Along with other studies, some researchers believe the plant extract can be a safe alternative to medical hormone replacement therapy and also help with sleeping issues in menopausal women.

It should be noted that not all professional research groups agree on the long-term effects of the herb with menopausal symptoms. Many advise use of the herb for short-term periods only. The American College of Obstetricians and Gynecologists (ACOG) acknowledges the menopausal benefits but cautions the results of some studies beyond the six-month period.

2. Menstrual Cycle

Premenstrual symptoms and irregular periods may be treated with black cohosh. Studies suggest it allows muscles to relax, easing tension that causes muscle cramps. Black cohosh may also help encourage bleeding in those who have irregular periods.

3. Spasmodic Pain

The ancient use of the herb was primarily to treat pain from nerve tension, muscle strain, and injuries. It has been used to help ease muscle tension and ensure nerve function by preventing spasms and cramping.

4. Inflammation

Inflammation of body tissue may be treated and possibly prevented with regular use of black cohosh. It contains salicylic acid that some say can replace the use of aspirin for headaches and body pains. Arthritis patients may find less joint pain and inflammation with the use of the natural alternative. Other anti-inflammatory uses may include high blood pressure, congestion, sore throats, cardiovascular disease, and blood clot prevention.

5. Digestion

Black cohosh has been credited with helping digestive issues by increasing the function of nutrient absorption and promoting regular waste removal. With these abilities, you may have less cramping, constipation, nausea, bloating, and gas build-up.

6. Pain

Black cohosh is used by many for pain management as it has natural analgesic properties.

7. Sleep

For times when daily worries rob us of sleep, black cohosh may help. As a natural sedative, herbalists believe this herb relaxes the tension from anxiety, insomnia, and stress to promote a sound sleep. It may assist in creating a regular sleep routine. The powerful components call for the plant to be used on its own— not in conjunction with other sleep aids.

8. Mood

As shown in studies of menopause hormone effects, black cohosh may balance hormones. This may aid in the release and management of hormones for a stable mood, preventing mood swings. As such, it is thought to help with cases of depression and tension from stress. 9. Weight Loss

The possible black cohosh weight loss effects vary depending on the study. As the body increases fat cell production for estrogen access when estrogen levels drop during menopause, it is thought some women gain weight during this time. Those taking it have shown weight loss during this time. Weight loss at any time in life can help prevent high blood pressure, heart disease, high cholesterol, diabetes, and stroke.

The National Institutes of Health’s Office of Dietary Supplements counters with the caution that black cohosh may cause weight gain in some women. Web MD supports this opinion.

10. Osteoporosis

There is research into the benefits of using black cohosh for reducing effects of osteoporosis, mainly bone loss. The biological components and phytoestrogens of the herb are studied to be used in treatment for this condition.

How Much Black Cohosh Should You Take?

With all of the discussion between experts on the use of black cohosh, the common agreement on a beneficial time length is six months to one year. Black cohosh dosage amount clearly depends on the specific use of the herb, the product manufacturer, the additional ingredients as well as the form taken. A missed dose should not be compensated with an extra dosage or additional amounts at the next dosage time.

Mayo Clinic offers the following information on dosage for various conditions based on clinical studies.

1. Menopause

A common result in studies show taking 6.5 to 160 milligrams orally of a form of black cohosh for one year has positive effects on symptoms. Other dosages shown to be effective include 40 drops of black cohosh liquid extract for up to six months and increasing dose from 64 to 128 milligrams over a four-week span.

2. Bone Density

Postmenopausal women may take 40 milligrams orally for three months.

3. Heart Disease

Postmenopausal women have taken 40 milligrams orally for three-month intervals, giving the body a break for a three-month time period in between.

4. Infertility

To boost chances of a successful conception, 120 milligrams orally for 12 to 13 days.

5. Mood

To combat mood swings in postmenopausal women, 128 milligrams of ground black cohosh is recommended. It should be taken orally once a day for one year.

6. Breast Cancer

With breast cancer patients, if black cohosh is used for those symptoms similar to menopause, it is suggested to use one to four doses of 2.5 milligrams in tablet form over a six-month period. This should be taken with tamoxifen. Other recommendations include 20 milligrams daily for one year and 20 milligrams twice a day for up to six months.

There is insufficient evidence on its safety for patients under the age of 18.

Side Effects of Black Cohosh

Black cohosh side effects are currently under study, both on a short-term basis and beyond the one-year period. Some observed side effects include:

• Headache
• Vaginal bleeding
• Nausea
• Reduce blood pressure
• Rash
• Weight gain
• Liver disease
• Allergic reaction
Safety Measures while Taking Black Cohosh

While taking black cohosh, there are several things to keep in mind, based on research results. We do want to note that the U.S. Food and Drug Administration has not approved the herbal remedy for medicinal purposes.

• Use as directed on product label.
• Follow storage instructions, shielding from moisture and light.
• Use one form of the herbal medicine at a time (don’t mix liquid doses with tablets)
• Avoid use if sensitive or allergic to plants of the Ranunculaceae family.
• Be careful if allergic to aspirin
• Use caution if pregnant as many studies suggest it may harm the fetus. There is insufficient evidence on the effects of black cohosh used by breast-feeding mothers.

Black cohosh has gained popularity since the 1950s as a cure-for-all, but mainly for dealing with menopause symptoms. Researchers’ opinions differ on black cohosh safety and medicinal uses, with varying results of clinical studies. Black cohosh pregnancy use is also controversial as it has been used to help with fertility and inducing labor. It is important to understand the properties of any herb and discuss use with a medical health professional or a certified herbalist.

Supplement Smarts: Black Cohosh for Menopause Symptoms

(Vegetarian Times)

Used for years to treat menopause symptoms, this plant has proven beneficial in new studies.

The herb black cohosh is a viable natural treatment for hot flashes and other symptoms of menopause. Also called Actaea racemosa or Cimicifuga racemosa, this buttercup-related perennial is native to North America, and it was Native Americans who discovered its value more than two hundred years ago. While the National Institutes of Health cautiously calls research on black cohosh “encouraging,” the plant has been used in Europe for decades to treat premenstrual, menstrual, and menopausal discomfort. And, according to the University of Maryland Medical Center (UMMC), it has been embraced as a “safe and effective alternative for women who cannot or will not take hormonal replacement therapy for menopause.”

Power Source » Studies have found that black cohosh may improve symptoms of menopause, including hot flashes, night sweats, irritability, anxiety, sleep disturbance, and vaginal dryness. A 2010 review found a 26 percent decrease in hot flashes and night sweats. How does the herb work? Nobody quite knows, though chemicals in black cohosh may have effects similar to estrogen and serotonin.

Use It Right » There is no “official” dose for black cohosh. The handbook British Herbal Compendium suggests a range of 40 to 200 milligrams per day, though traditional doses may be 1 gram or more. Commercial products often standardize extracts to their level of triterpene glycosides, a bioactive phytochemical in the plant; there should be at least 1 milligram per tablet, recommends the UMMC.

Watch Out For » Millions of people have taken black cohosh without adverse effects, though long-term safety is only now being investigated. Consult your doctor before taking black cohosh, particularly if you are pregnant or have liver problems or estrogen-sensitive conditions. Headache and stomach upset have been reported. While interactions with medications are rare, it’s possible that the herb may increase anticoagulant and hypotensive activity.

Top 10 Black Cohosh Benefits


Black cohosh benefits have been widely recognized byNative Americans for several hundred years. Black cohosh was a type of a multi-use herb to help with a myriad of conditions like sore throats, malaria, snake bites, bronchitis, kidney stones and nervous disorders. Black cohosh benefits multiple gynecological problems ranging from menstrual cramps to inducing pregnancy that went past its term. Modern day holistic medicine recognizes black cohosh benefits to treat the following conditions.

1. Black cohosh to induce labor is a popular herbal remedy that promotes your body to produce its own oxytocin to ripen cervix and open it up in preparation for labor and delivery. Only a highly trained mid-wife or a natural obstetrician can prescribe black cohosh to induce labor after determining whether your body is truly ready for labor and just needs a little boost to avoid post term labor complications.

2. Black cohosh as one of the best PMS herbal remedies used to relieve menstrual cramps, water gains, bloating and headaches coming with your monthly period.

3. Black cohosh for menopause has been widely recognized incredibly helpful for women with severe menopausal side effects like hot flashes, mood swings, vaginal dryness, depression and lack or sexual interest. Estrogen-like qualities of black cohosh tea can be effectively used in combination with traditional hormone replacement therapy or even alone to bring back the quality of life your deserve.

4. Black cohosh benefits osteo- and rheumatoid arthritis relief by providing strong anti-inflammatory results.

5. Black cohosh benefits male fertility by protecting delicate sperm cells from damaging effects of free radicals.

6. Black cohosh benefits female fertility by having estrogen-like effect on a female body leading to better ovulation and maximizing chances of egg fertilization. Black cohosh tea could be taken by both a man and a woman to even further increase the likelihood of pregnancy.

7. Black cohosh benefits PCOS (polycystic ovarian syndrome) that is a complex endocrine disorder with multiple and hard to treat symptoms. Black cohosh teahelps regulate ovulation and has overall positive effect on female reproductive system.

8. Bloating is another very common complaint that could be helped by black cohosh due to its mild diuretic-like properties.

9. Black cohosh benefits hypertension by dilating blood vessels and relieving high blood pressure.

10. Black cohosh was also found helpful in lowering bad cholesterol levels and preventing low density lipoproteins from being deposited on the walls of the arteries.

Despite the fact that black cohosh benefits so many health conditions, a note of possible black cohosh side effects must be made. Black cohosh should not be taken by pregnant and lactating women without medical supervision, women with a proven case of breast or any other form of cancer, persons with liver conditions or girls before reaching puberty. Possible black cohosh side effects might include nausea, vomiting, miscarriage and dizziness.

According to multiple medical studies, black cohosh and breast cancer might have quite conflicting relations since this herbal compound might promote cancer cells growth in other organs of the body, do not take black cohosh if you have cancer.

Black Cohosh for Menopause Symptoms

(Healthwise Staff)
Topic Overview

Black cohosh, also known as black snakeroot or bugbane, is a medicinal root. It is used to treat women's hormone-related symptoms, including premenstrual syndrome (PMS), menstrual cramps, and menopausal symptoms.

Black cohosh contains potent phytochemicals that have an effect on the endocrine system. How it works is not yet clear.

Black cohosh is widely used in the United States, Australia, and Germany. The German government has approved it as a prescription alternative to hormone therapy. In Canada, black cohosh is available without a prescription. Be sure to talk to your doctor before you take it, especially if you have liver problems or if you develop symptoms of liver problems after using black cohosh. Symptoms of liver damage can include being more tired than usual, feeling weak, loss of appetite, and yellowing of the skin.

You can buy black cohosh as a standardized extract in 20 mg pill form, which is taken twice a day. Root, extract, and tincture forms are also available in health food stores.

When black cohosh is used at regular doses, its only known side effect is occasional stomach discomfort. But black cohosh may have risks that are not yet known, including possible effects on liver function. More research needs to be done before experts can recommend it for long-term use.

Is it effective?

Studies on black cohosh have had mixed results. Some studies have shown that black cohosh can relieve menopause symptoms such as hot flashes. But other studies have shown that black cohosh does not relieve symptoms.

These mixed results may mean that black cohosh can relieve symptoms in some women, but does not relieve symptoms in others. Or the different results may be because different preparations were used in the studies.

In the studies where black cohosh relieved symptoms, it reduced hot flashes, night sweats, and sleep problems.

Is it safe?

Large, long-term studies have not yet been done to confirm whether long-term use of black cohosh is safe. Because black cohosh has benefits somewhat like estrogen therapy, it may also have some risks like those of estrogen.

Experts do not know for sure if black cohosh causes liver problems. But they have determined that black cohosh products should be labelled with a statement of caution. Stop using black cohosh if you notice that you are weak or more tired than usual, you lose your appetite, or your skin or the whites of your eyes are yellowing. Call your doctor because these symptoms may mean you have liver damage.

If you plan to take black cohosh, talk to your doctor about how to take it safely. You may be able to take it short-term (no more than 6 months), or possibly longer but with regular checkups to look for estrogen-related changes in the uterus and breasts.

Estrogen may increase the risk of cancer in women who have a history of uterine cancer or breast cancer or who are at high risk for breast cancer. Since black cohosh may work in ways similar to estrogen, these high-risk women should avoid using black cohosh until more is known about the long-term risks.

As with any medicine, be careful to avoid overdosing with black cohosh. Symptoms of overdose include vertigo, headache, nausea, vomiting, impaired vision, and impaired circulation.

What to avoid

Black cohosh should not be used during pregnancy or while you are breastfeeding. Do not take black cohosh if there is any chance that you might be pregnant.

Black cohosh should not be combined with birth control pills, hormone therapy, or tamoxifen. It should not be used by women who are allergic to ASA.

Taking black cohosh benefits postmenopausal women, new German study shows

By Emily Courtney

Results from a double-blind, placebo-controlled German study suggest that black cohosh (Cimicifuga racemosa) benefits and is well tolerated by postmenopausal women (Menopause, 2006, vol. 13, no. 2).

Researchers treated 62 postmenopausal women either with black cohosh, conjugated estrogens, or placebo for 12 weeks. Evaluation of blood samples and vaginal smears determined that black cohosh may help prevent osteoporosis by stimulating the activity of osteoblasts, cells responsible for building bone. The herb also demonstrated weak estrogenlike effects in the vaginal mucosa, thereby alleviating the vaginal dryness commonly associated with menopause.

These positive results come on top of some bad press for black cohosh, a member of the buttercup family. In recent months, both Australia and the United Kingdom have issued labeling regulations warning of possible adverse liver reactions to black cohosh products.

However, researchers in the recent study, conducted at the University of Gottingen, found no evidence of increased liver enzymes (a liver damage indicator) in participants.

"Black cohosh has not been shown to cause liver damage," says Michael McGuffin, president of the American Herbal Products Association. "In fact, based on emerging information, we are requesting that our colleagues in other countries review the basis on which their decisions about black cohosh were made and reconsider their positions." As with any medicine, the AHPA advocates that anyone taking herbs talk with their doctor about dosage and any possible symptoms.

Blue Cohosh Vs. Black Cohosh

By Tracey Roizman (DC)

Blue cohosh and black cohosh are both native to North America. Though they are members of different families they share a similar common name and both plants have historically been used to treat women's health conditions. Consult your doctor or qualified health care provider for guidance in the safe and appropriate use of these and other medicinal herbs. Blue Cohosh and Menstrual Disorders

Herbalists use blue cohosh to treat certain menstrual irregularities, including late periods and excessive menstrual flow, and also to relieve cramping or uterine problems, such as fibroids, pelvic inflammatory disease and endometriosis. However, the University of Maryland Medical Center warns that blue cohosh, which has effects similar to nicotine, is potentially toxic and should only be used with your doctor's supervision.

Blue Cohosh and Labor Induction

Blue cohosh, used by as many as 64 percent of midwives to help induce labor, is associated with a wide range of potential adverse effects to the newborn, according to a review of previously published research that appeared in the Winter 2008 issue of the "Canadian Journal of Clinical Pharmacology." This herb causes blood vessels to constrict, which can lead to stroke, heart attack, heart failure and oxygen deprivation to numerous internal organs. Additionally, blue cohosh may cause abnormal fetal development. Researchers concluded that it should be used with extreme caution and only under medical supervision during pregnancy.

Black Cohosh and Menopause

Black cohosh exerts mild estrogen-like effects that may help alleviate menopausal hot flashes without affecting the uterus, implying that it may be a safe alternative to conventional hormone replacement therapy, according to Dr. Steven Bratman, author of "Collins Alternative Health Guide." A double-blind study of 300 postmenopausal women published in the January 2012 issue of the journal "Holistic Nursing Practice" found that black cohosh was effective at reducing a range of menopausal symptoms, including hot flashes, and was well-tolerated with few side effects.

Black Cohosh and Cancer

Black cohosh may help prevent breast cancer, according to a study published in the January 2012 issue of the journal "Anticancer Research." In the laboratory animal study, supplementation with black cohosh for 40 weeks significantly reduced the incidence of breast cancer tumors. Higher doses exerted more protective effects. Black cohosh may also help prevent recurrence of breast cancer when used with the drug tamoxifen, according to Vicki Kotsirilos, co-author of the book "A Guide to Evidence-Based Integrative and Complementary Medicine."

Black Cohosh: Uses, Benefits, and Side Effects

By Rena Goldman (Medically Reviewed by Peggy Pletcher, MS, RD, LD, CDE)
1. Hot flashes and other menopausal symptoms have been the most widely studied uses for black cohosh.
2. Studies are mixed about the effectiveness of black cohosh for easing menopausal symptoms.
3. Liver damage may be one of the more serious side effects of taking black cohosh.
4. Black cohosh is a flowering plant. It grows in parts of the United States and Canada.

The perennial produces white flowers from June to September, but it gets its name from its black roots. The roots are believed to have healing properties.

The black cohosh root has a long history of being used to treat medical conditions. Native Americans used black cohosh in a wide variety of ways, including:

• kidney issues
• malaria
• rheumatoid arthritis
• joint inflammation
• sore throat
• helping with labor
• menstrual cramps
• menopause

Early American colonists used black cohosh to treat snake bites, uterus issues, nervous disorders, and more. Black cohosh was also an ingredient in Lydia Pinkham's Vegetable Compound, an herbal menstrual cramp remedy popular in the early 1900s.

Today, black cohosh is mainly used to help treat symptoms associated with menopause. Read on to learn more about how it’s used and the potential side effects.

How is black cohosh used?

The roots of black cohosh are dried and made into teas, liquid extracts, and put into capsule form. Sometimes, black cohosh is used as one ingredient in an herbal mixture.

Remifemin is an example. It’s a mixture that’s been sold as a menopause tablet for 40 years in Europe. It contains 20 milligrams (mg) of black cohosh extract.

You can buy supplements with black cohosh as a concentrated liquid, in pill form, or as part of an herbal combination formula. It’s available in most drug stores or online.

There’s no standardized dose for the herb. Extracts and mixtures can vary in the amount they contain. Generally, 20 to 40 mg is used to treat menopause symptoms.

What are the benefits of black cohosh?

The most widely studied treatment use of black cohosh has been for hot flashes and other menopause symptoms. But research is still mixed as to whether it’s effective or not.

Some studies say it does help reduce hot flashes and improves mood and sleep patterns for women during menopause. Other research has shown the herb to be ineffective.

Experts aren’t sure exactly how black cohosh works or why it might be helpful for menopause symptoms. One theory is that it may have estrogenic activity, though this has not panned out in studies. For this reason, it’s possible that black cohosh is harmful for women going through treatment for breast cancer, at least for estrogen-positive tumors.

What does research say about the effectiveness of black cohosh?

Studies funded by the National Center for Complementary and Integrative Health reported conflicting findings regarding the effectiveness of black cohosh used alone or in combination with other herbs in reducing hot flashes and/or night sweats. Women in the study were premenopausal or menopausal.

One recent study in the International Journal of Reproductive Biomedicine found black cohosh, along with a few other herbs used in Iranian medicine, to be an effective alternative treatment for women experiencing hot flashes.

Most of the clinical studies have focused on treating menopause symptoms. The women in the studies have only been evaluated for about six months. For this reason, the current American College of Obstetrics and Gynecology guidelines on herbs as treatment for menopause support only using black cohosh for six months or less.

What are the side effects of black cohosh?

Black cohosh is associated with generally mild side effects, though some are more serious than others. One of the major side effects is liver damage.

Don’t use black cohosh if you have a history of liver disorders. Also avoid it if you’re experiencing symptoms that can signal liver trouble, like abdominal pain, jaundice, or dark-colored urine.

Other side effects of black cohosh include:

• upset stomach
• dizziness
• headache
• nausea
• vomiting
• low blood pressure
• changes in heart rhythm

The black cohosh plant is in the same family as the buttercup plant, so people who have allergies to buttercups should not try black cohosh.

Black cohosh isn’t recommended for use during pregnancy or breast-feeding. There’s a risk of causing early labor for women who are pregnant. It’s not yet known if the herb is safe for breast-feeding women. It is also not recommended for use in children.

Other considerations when using black cohosh

Herbs, vitamins, minerals, and other plant extracts are considered dietary supplements. These aren’t required to be regulated by the Food and Drug Administration (FDA). That means these products don’t have to meet standards set by the FDA the way medications and food do.

It’s possible for manufacturers to make misleading claims about the product’s effectiveness. The ingredients can also vary. In some cases, particularly with mixtures, the supplement might not contain what it claims to.

Before buying dietary supplements, check to see if the supplement maker has a large amount of negative reviews or outstanding lawsuits. Buy only from good, reputable sources.

Herbs have the potential to interact with other medications, so you should always talk to your doctor about adding supplements to your treatment plan.

Next steps

There’s some evidence that black cohosh can help treat hot flashes. But experts don’t know enough to say for sure if it will offer relief from menopausal symptoms. It’s likely a safe alternative treatment if used for six months or less.

If you’re considering trying the herb, first talk to your doctor. Taking black cohosh might help, but it’s not a substitute for any recommended treatments.

9 superfoods that can help you trigger labour

By Deepa Balasubramanian

While there is no scientific evidence that certain foods trigger labor, it cannot hurt to try some of these options.

You may want to trigger labor for several reasons – you may have reached your 40th week of pregnancy and you want to see your baby quickly or you may be worried about premature labor. While there is no scientific evidence that certain foods trigger labor, it cannot hurt to try some of these options.

1. Pineapple: The enzyme bromelain present in pineapple, stimulates smooth muscle and softens the cervix. Only fresh pineapple does the trick because the enzyme is destroyed in the canning process.

According to a 2009 study published in Complementary Therapies in Clinical Practice, the concentration of bromelain in pineapple is low. Thus, one would have to eat large quantities of pineapple for the enzyme to take effect. This is more likely to induce diarrhea rather than contractions.

2. Spicy foods: Mexican foods or hot chili can induce labor by stimulating the stomach muscles. Care should be taken to avoid diarrhea.

3. Licorice: Black licorice is said to induce labor by causing cramps in the bowel. This, in turn, may induce uterine contractions. Licorice can be obtained in the form of pills as well.

4. Garlic: As long as garlic consumption does not cause indigestion, it may be effective in inducing labor. Garlic stimulates the bowels and helps empty them. Thus, the body becomes ready for labor.

5. Red raspberry leaf tea: Red raspberry leaf tea is said to tone and strengthen the uterus and induce the contraction of the uterine muscles.

A cup of red raspberry leaf tea can be made by pouring 6 ounces of boiling hot water over a teabag in a cup. Let the tea bag steep for 3 minutes. Once cool enough, it can be consumed. During summer, pregnant women can drink red raspberry leaf iced tea.

6. Cumin tea: Cumin is used to treat digestive issues, induce menstruation and provide relief from bloating. A cup of cumin seed tea can be consumed to induce labor. To make the tea palatable, some sugar or honey can be added.

7. Castor oil: Castor oil has been consumed by pregnant women for centuries to induce labor. It is obtained from the bean of the plant. The results of scientific studies on the efficacy of castor oil to induce labor have been inconclusive.

Anthony Kelly and colleagues published a review in 2013 in the Cochrane Database of Systematic Reviews of studies on the efficacy of castor oil to induce labor. The review concluded that further studies need to be done for conclusive evidence of the effect of castor oil in inducing labor.

The consumption of castor oil is safe but causes nausea, vomiting, and diarrhea – which, along with labor, is extremely uncomfortable. Castor oil causes intestinal cramps and stimulates the bowels. When the bowel and intestinal muscles contract, the uterine muscles may also be induced to contract. There are two ways in which castor oil may be taken:

• Drink a mixture of 60 ml of castor oil mixed in a glass of juice.
• Try an enema at home. This method should be used with extreme caution because diarrhea can cause dehydration.

8. Evening primrose oil: Many midwives advise pregnant women who want to induce labor to consume evening primrose oil. This oil contains a substance that the body converts into prostaglandins, whose action mimics that of hormones. It helps the cervix soften and dilate and thus, induces contractions. Evening primrose oil can be taken in three ways:

• Consume 500 mg capsules of evening primrose oil 3 times a day.
• Insert a capsule into your vagina at bedtime. The moist vaginal environment will help dissolve the capsule and distribute its contents throughout the cervix.
• Rub the oil on the cervix during the final few weeks of pregnancy.

Before attempting to use evening primrose oil for inducing labor, it is wise to speak to your doctor. Women with placenta previa, a condition in which the placenta implants low in the uterus and partially covers the cervical opening, should not use this method.

9. Cohosh: Cohosh is a medicinal herb which is considered to have the power to induce labor. It is also used to treat disorders of menstruation, osteoporosis, and menopause. Cohosh is available in two forms – black and blue cohosh root. The roots are usually available in an alcohol-based or water-based tincture. Black cohosh is said to be more effective than blue cohosh. However, some doctors caution against the use of this herb because sufficient studies have not been conducted on its effects. Cohosh has been found to contain plant chemicals that mimic the action of estrogen.

Whatever be the food or herb that you consume, remember to consult your doctor beforehand.

Happy birthing!

Alternatives for Treating Menopause

By Lisa Cappelloni (Medically Reviewed by George Krucik, MD, MBA)
Alternatives for Treating Menopause

Many women reject the risks associated with hormone replacement therapy to treat their menopause symptoms and instead seek relief from alternative sources. As menopausal women face fluctuating levels of estrogen and progesterone, they will likely experience symptoms including hot flashes, insomnia, depression, breast pain, and mood swings.

Luckily, there’s an array of natural remedies available to help you cope. Just make sure to speak with your doctor before you begin taking any supplements or herbs.

Black Cohosh

Black cohosh is among the most popular and longest-studied natural hot flash remedies for women who don’t want to turn to hormone replacement or antidepressants to treat their menopause symptoms.

Black cohosh is derived from a plant in the buttercup family, and it has been used for centuries. You can take black cohosh in many forms: capsules, tablets, or mixed with water.

It is thought to behave similarly to serotonin in the brain. This behavior includes easing feelings of depression and regulating body temperature. Despite this, according to the National Center on Complementary and Alternative Medicine (NCCAM), research to date remains mixed. Overall, the effectiveness of black cohosh as a reliable menopause treatment remains to be demonstrated.

Vitamin D

Vitamin D is an essential building block for a healthy body. It promotes healthy bone renewal, normal cell growth, and hormone balance, which are all important for menopausal women. Vitamin D is often referred to as the sunshine vitamin, as your body produces it in response to sun exposure.

As women age, their ability to absorb vitamin D decreases, heightening their risk of bone density loss. This makes the need to incorporate vitamin D into their diets that much more critical.

To get your recommended daily dose of 600 international units (IU), step outside for a 15- to 20-minute walk. Be sure to wear sunscreen and a hat to protect your skin. If it’s rainy or you can’t get outside, take the sunshine vitamin in capsule form.

It’s also important to pile your plate high with foods containing high vitamin D content. Such foods include sardines, tuna, wild salmon, fortified dairy products, and eggs.


Many women find relief from their menopause symptoms through acupuncture. Skeptics argue that acupuncture benefits are purely the result of the placebo effect, but doctors confirm that acupuncture is a reasonable alternative to hormone therapy for women suffering from menopausal depression and hot flashes.

Many insurance plans cover acupuncture, among other alternative treatments. Check your coverage before you make an appointment.

Mindful Breathing

It’s time to jump on the mindfulness wagon if you haven’t already. Mindful deep breathing such as that practiced during yoga and meditation has a proven calming effect on the mind and can ease menopausal anxiety and hot flashes.

As soon as you feel a hot flash coming on, prepare. Begin by inhaling through your nose to the count of four. Hold your breath for seven counts. Then, exhale completely through your mouth to a count of eight. This is one breath. Try to complete this cycle two more times.

St. John’s Wort

Among the most popular herbs used in the United States, St. John’s wort has long been an alternative treatment for menopausal mood swings, improved sleep, relaxation, and reduced depression and anxiety. Derived from a wild flowering plant called Hypericum perforatum, the leaves and flowers are harvested and dried. They can then be brewed in a tea or taken in a pill or liquid form. Make sure to ask your doctor before you begin taking St. John’s wort, as it might interact with other medications. Scientific studies affirm that while St. John’s wort is effective for treating mild depression, it works no better than a placebo for treating severe depression.


Ginseng is an herb used for its therapeutic health benefits for as many as 5,000 years by the Chinese, Koreans, and Native Americans. It may be used to treat menopausal symptoms of fatigue, anxiety, and stress because it’s considered a “normalizer” and an “energizer.” You can take ginseng in different forms including tea, powder, and extract.


Continual evidence supports the notion that yoga can help relieve irritability and depression brought on by menopause. Women report that yoga relaxation and stretching techniques help stabilize their moods while improving their overall well being.

Try a gentle yoga class once or twice a week to get the most benefits. Once you learn the basics, you can carve out some personal time to practice in the comfort of your own home.

These alternative therapies may offer consumers solutions to assist in treating menopausal symptoms. As with any treatment, it’s a good idea to talk to your doctor first. This is especially true if you plan on taking any herbs or supplements.

General health and fitness go a long way in reducing symptoms. Therefore, stress reduction, exercise, and yoga can be helpful.

Build Bone Health with Black Cohosh

(A Woman's Health)

The herb may strengthen bones in postmenopausal women.

If you’ve turned to black cohosh for help with hot flashes, you could be getting an added bonus—the herb may also help strengthen your bones.

Menopause and Bone Health

Bone health is always important, but especially so after menopause, when estrogen levels drop sharply. During the five to seven years after menopause, women can lose up to 20 percent or more of their bone density—putting them at risk for osteoporosis and subsequently, bone fractures.

There are a variety of ways to prevent bone loss and maintain strong bones, including consuming adequate calcium and vitamin D and participating in weight-bearing exercise. It turns out that menopausal women may inadvertently reach for a supplement that could help them in the fight against bone loss.

Black Cohosh

Black cohosh (Cimicifuga racemosa) is an herbal supplement that has become a popular alternative to hormone replacement therapy for the treatment of menopausal symptoms such as hot flashes, mood disturbances, and vaginal dryness. The supplement is available over the counter in most health stores.

Researchers from Germany conducted a study in 62 postmenopausal women. The women were divided into three groups and received black cohosh, conjugated estrogen, or placebo for 12 weeks. At the end of the 12 weeks, the researchers took blood samples and vaginal smears from all participants. They found that the women who took black cohosh showed nearly four times as many markers of bone growth compared to the women in the other two groups. What’s more—the black cohosh increased the lubrication of the inner lining of the vagina, which can dry as a result of menopause.

The researchers concluded that black cohosh could help stimulate osteoblasts, which are the cells that help reform bone. The results are promising—but it’s important not to overdo it. About 20 mg of black cohosh per day is plenty. As with any supplement, it’s important to discuss the risks and benefits with your doctor.

5 Incredible Foods That Help You Sail Through Menopause with Ease

By Shilpa Arora

Cessation of menstruation in women is associated with complaints like hot flashes, headaches, vaginal dryness, weight gain, mood fluctuations, cold hands and feet, forgetfulness and inability to concentrate. Menopause occurs around the age of 50, but attributing to our modern lifestyle, where things are not so balanced anymore, menopause may start as early as 35 to 40.

During the pre-menopausal period, the pituitary gland increases secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The fluctuations of hormones particularly the decline in estrogen and progesterone, is the cause of many menopause complaints.

However, there are many natural foods that you can include in your diet to help you sail gracefully through menopause.

1. Include Foods High in Phytoestrogens

Phytoestrogens are plant compound that are capable of binding to estrogen receptors and can replace some of the effects of estrogen that is no longer being made. Foods high in estrogens include:

- Soybeans / soy foods
- Flaxseeds
- Nuts
- Whole grains
- Apples
- Fennel
- Alfalfa

A high intake of plant foods that are very rich in phytoestrogens explains why hot flashes and other menopausal symptoms rarely occur in our culture, where we pre-dominantly consume plant based diets. Clinical studies have shown eating soy –foods (the equivalent of 2/3 cups of soybeans daily) to be effective in relieving hot flashes and vaginal atrophy.

2. Load up on the Cabbage Family

Including broccoli, cauliflower, Brussels sprouts, cabbage, kale, mustard and turnip greens are good food choices for women going through menopause, not only for their ability to protect against breast cancer and heart diseases, but also because of their high content of nutrients that are supportive of bone health, such as calcium, magnesium and folic acid.

3. Maca, the Incredible Root

The Peruvian plant root and medicinal herb, Maca is widely recognized by the people of Peru as a herbal remedy for all sorts of hormonal imbalances. Maca helps reduce menopausal symptoms by balancing the body’s fluctuating chemistry and it does this by prompting the adrenal glands to stabilize the diminishing hormones of the thyroid and pancreas.

4. Shatavri

Like Maca, Shatavari is wonderful healing herb supporting the adrenal glands, gently pumping energy levels while nourishing the nervous system. The word Shatavari means “a hundred spouses in Sanskrit”. The Indian herb grows wild in low jungle regions in India, where it has been revered for centuries by women. It also used on the fertility front, this herb can prevent threatened miscarriage and also increase the flow of breast milk. Since Shatavari is cooling and soothing in nature, as well as being a sweet and nourishing herb, our Ayurvedic texts highly recommend it for hot flashes, night sweats, vaginal dryness, anxiety and memory loss.

5. Black Cohosh

A perennial herb native to North America has been used in alternative medicine, as an aid in treating the symptoms of menopause. It has also been used for rheumatism, cough, high cholesterol levels and hardening of the arteries. In one study 80 patients were given either black cohosh extract or placebo for 12 weeks, the black cohosh extract produced the best results. The number of hot flashes experienced each day dropped from an average of 5 to less than 1 in the black cohosh group. Even more impressive was the effect of black cohosh on building up the vaginal living.

A holistic approach not only eases many of the challenges that many menopausal women face, but also empowers them to live a life of fulfillment. So take time, and make peace with yourself, eat easy and practice yoga or any other form of exercise that you love to do.

Plant Extracts Slow Yeast Aging, Could Work in Humans

By Seth Augenstein (Digital Reporter)

A concoction of six plant extracts slowed the aging processes of yeast – and are among the most promising anti-aging materials yet found, according to new research by a team of scientists at Concordia University.

The molecules, they say, also hold a Fountain-of-Youth-like potential for slowing the ravaging march of time in human cells.

The six extracts worked in hormetic response (small, beneficial doses) to apparently increase mitochondrial respiration, reduce concentrations of reactive oxygen and oxidative damage to proteins and genomes, and enhance the cells’ overall resistance to oxidative and thermal stresses, among other purported benefits.

The six extracts were selected from 10,000 trials, according to the study, published today in the journal Oncotarget.

They are: black cohosh, valerian herb, purple passionflower, celery, Ginkgo biloba, and the bark of a white willow tree found in Europe and Asia.

“In total, we found six new groups of molecules that decelerate the chronological aging of yeast,” said Vladimir Titorenko, a professor of biology at Concordia University and the study’s senior author. “These results also provide new insights into mechanisms through which chemical extracted from certain plants can slow biological aging.”

The group of carefully-selected molecules were administered to the yeast in a growth culture at the low levels. The willow bark in particular appeared to have a dramatic response, extending the lifespan of yeast by up to 475 percent, according to the research.

“Our screen revealed six plant extracts that increase yeast chronological lifespan considerably more efficiently than any of the longevity-extending chemical compounds yet described,” the authors conclude.

The work was a collaboration with Éric Simard, who is the founder of the Québecois biotech company Idunn Technologies, named for the Norse goddess of youth.

Simard said the molecules will be available commercially in the near future. The theory, he added, is that the overall molecular effects would potentially even stave off the progression of age-related disease such as cancer.

“This kind of intervention is predicted to have a much larger effect on healthy aging and life expectancy than can be attained by treating individual diseases,” Simard added.

The first Baby Boomers have just started to turn 70, and corresponding disease and mortality increases are expected as they reach old age. The interest in staving off the aging process has never been greater. Metformin, a diabetes drug, was shown to bring an average eight more years of life to people on it, even beyond the people without the chronic condition. A full study of the anti-aging potential of Metformin is underway this year.

The Concordia authors contend the lifespan increases of the willow bark and some of the extracts was even greater than the reported Metformin gains.

Finding real relief

By Kelsey R. Kennedy

The search for an effective dietary supplement

A walk down the supplement aisle of your local health food store can be daunting. There is an incredible array of choices, from the bottles claiming to boost your immune system to the capsules full of exotic herbs. Online, there are countless websites recommending dietary supplements to cure whatever ails you. And Americans are acting on these recommendations; the Food and Drug Administration (FDA) estimates they spent more than $36 billion on dietary supplements in 2014.

But that walk down the supplements aisle is a little like a walk into the Wild West. Despite the claims and official-looking recommendations on those bottles, consumers have no guarantee that what they’re buying will do them any good. Supplement manufacturers face only relatively lax regulations from the FDA and aren’t required to prove that what they’re selling actually does anything.

Congress defined dietary supplements, and the power the FDA has to regulate them, in 1994 with the Dietary Supplement Health and Education Act. Under the law, manufacturers can’t claim their product cures any disease and must prove the supplements were produced following a set of standards known as Good Manufacturing Practices.

For dietary supplements that were on the market before 1994, the FDA just has to assume they’re safe. If an ingredient isn’t safe, the FDA must prove it is harmful before it can be taken off the market. Manufacturers aren’t required to standardize their products, so the amount of an active ingredient can vary from batch to batch. They also don’t have to prove their supplements are effective for treating any conditions.

Navigating the supplement aisle may soon be easier and safer for consumers, thanks to academic researchers who are examining the safety and effectiveness of some of these dietary supplements. The National Institute of Health (NIH) launched its Botanical Research Centers Program in 1999 to fund supplement research. Their 2015 round of funding dedicates close to $35 million to labs across the country.

One of these labs, the University of Illinois at Chicago’s Center for Botanical Dietary Supplements Research, has been funded by the NIH since the program started. They’re not looking for new plants to take to market. Instead, they’re looking at supplements already available on store shelves. “The market is primarily women,” says Richard van Breemen, the Center’s director. “They buy them for their families, they buy them for themselves.”

Many women stopped hormone treatments for menopausal symptoms such as hot flashes after the NIH Women’s Health Initiative hormone therapy trials in the early 2000s found elevated risk of breast cancer and stroke. “Women started turning to alternatives like botanical dietary supplements,” says van Breemen. These supplements include red clover, hops, and black cohosh, a flower found in the Eastern U.S. Van Breemen’s team started looking at the safety of these botanical dietary supplements. “There’s concern that if you substitute one estrogen for another, you’ll have the same problems,” he says.

To test the safety and effectiveness of black cohosh and red clover, van Breemen and his team take a stepwise approach. The team makes a standardized sample of a plant extract and then tests it in animals and humans. “We modeled these steps after how drugs are developed for human use,” says van Breemen. Their process is similar to how pharmaceutical companies prove to the FDA that a new drug is safe and effective. The results of their clinical trial were published in 2009. The hormone treatment prescribed by doctors proved most effective at relieving hot flashes in menopausal women, while red clover was nearly as effective as placebo. Black cohosh was only about half as effective as placebo.

“Red clover does contain estrogenic compounds,” says van Breemen, so it was not surprising to find it had some kind of effect. But the black cohosh results suggest the herb is useless for relieving hot flashes. “We could not find an alternate mechanism for black cohosh, other than one that acts on the nervous system,” he says. Black cohosh contains serotonin-like molecules that could have an effect on the nervous system, but van Breemen found there was a key roadblock. Those molecules “won’t reach the blood-brain barrier, they won’t even reach the bloodstream,” he says. This means the molecules won’t be able to reach the brain, so they won’t have any chance to have an effect on the nervous system.

While they couldn’t find any benefits for women from black cohosh, van Breemen’s lab was at least able to establish that it was safe. Concerns have been raised about black cohosh’s potential to cause liver damage, but van Breemen says liver enzyme tests done during the study were all normal. Black cohosh, he says, is “perhaps ineffective for controlling hot flashes, but nevertheless safe.” For van Breemen and his team, safety is paramount. “Ultimately, we want to have a product that is safe, and hopefully effective as well.”

The NIH has also awarded funding to a new research center at the Icahn School of Medicine at Mount Sinai in New York. Led by Giulio Pasinetti and Richard Dixon, the new center will focus on how certain dietary supplements can help alleviate stress-induced depression and mood disorders. The team has already identified several compounds, called polyphenols, found in grapes and grape seeds that help the brain better handle stress. With the NIH funding, they will try to determine exactly how these compounds work in the body.

They will also look at the role bacteria and fungi in the microbiome, especially in the gut, may play in making these compounds available for the body to use. Gut bacteria break down what we eat into metabolites, which are compounds formed during bacterial metabolism. “We are characterizing all of the microbiome that would influence the generation of these metabolites,” says Pasinetti. He hopes this work will lead to a probiotic composed of specific bacteria that help make more polyphenols available for the body to use. Pasinetti is very optimistic about the potential for a combination approach with probiotics and polyphenols. “I think in the framework of the program, over the next five years, we may have a new treatment for major depression.”

Louisiana State University’s Botanical Dietary Supplements Research Center received NIH funds as well, to continue their work with botanical supplements for the prevention and treatment of obesity and diabetes. The center, established in 2005, has discovered several plant products, like a byproduct of sugarcane processing and a type of red lettuce, that may be effective for controlling glucose levels. The center is in the early stages of clinical trials to establish the safety of Russian tarragon for treatment of pre-diabetes.

“We hope this research will advance scientific understanding that will lead to better design of future clinical studies and better-informed decisions by consumers,” says Barbara Sorkin, director of the NIH Centers for Advancing Research on Botanicals and Other Natural Products Program. Sorkin says determining how botanical products work in the human body helps researchers design better clinical trials to test supplements. While the NIH funds research on the effectiveness of dietary supplements, the findings generated by research centers may not make any difference in terms of policy.

While policies may not change, Richard van Breemen hopes his research will at least pressure commercial supplement producers to use clinical trials to test the safety and effectiveness of their products. “I think there’s a place for dietary supplements for many generations to come,” says van Breemen. “But we need to understand how they work and how to make them safe and effective.”

5 ways to keep cool when you’re having a hot flush

By Eleanor Lees

Hot flushes can be horribly uncomfortable. We found out how to make them more bearable with these expert tips.

A hot flush can come on suddenly, or you may have an idea of when they’re about to strike.

The uncomfortable, intense heat of a hot flush affects almost 75% of women during menopause and they are among the most common symptoms of menopause.

Here’s the experts’ advice on how to keep cool during a hot flush.

1. Be comfortable in bed

Use bedclothes made from cotton and layers rather than a big duvet. "Avoid clothes made from synthetic fabrics and wear layers instead so you can adjust your clothing to how you are feeling," says Shona Wilkinson, Nutritonist at

2. You are what you eat

"Hot drinks before bedtime can often trigger night sweats or even make them worse," says Dr Marilyn Glenville, nutritionist and author of Natural Solutions to Menopause.

"Try to stay away from caffeine, alcohol and spicy foods. Remember, that caffeine can be found in both food and drink (chocolate, caffeinated soft drinks, energy drinks, coffee and tea). It can cause your blood vessels to expand making you sweat more, which can increase the hot flushes.

"You can also sip a cold drink during the day. If you feel a hot flash coming on, this can help lower your body's temperature.”

3. Keep active

"Although it may make you feel hotter and sweatier in the short-term, women who exercise regularly, seem to have fewer flushes," says Dr Glenville.

Lynne Robinson, Body Control Studio founder (to find a teacher go to says Pilates has a number of benefits.

"Pilates improves your breathing which will help your stamina and endurance as well as ensure that your core muscles are fit for purpose and that can help prevent back injuries,” she explains.

"Pilates can also help to improve the stability and mobility of your joints so that your body moves efficiently and without strain, restoring balance."

4. Try supplements

Nutritionist Cassandra Barns recommends taking a supplement of Vitamin C.

This is because it’s full of is full of Bioflavonoid which help to strengthen the capillaries, improving blood flow and so reducing hot flushes.

Black Cohosh is another great option for keeping hot flushes at bay.

"What’s important, is that it does not increase oestrogen levels and has no effect on cells in the vagina or womb,” Dr Glenville explains.

"Black cohosh offers relief without oestrogen-like effect.

"It acts as a SERM - selective oestrogen receptor modulator – promoting it in organs where oestrogen is needed, such as the bones, while acting as an ‘anti-oestrogen’ in organs where unnecessary oestrogen can be dangerous, for example the breast and womb. "

5. Limit stress

Stress and anxiety can also bring on a hot flush.

Combat the stress by trying to steady your breathing.

Liquorice root extract also contains substances that have a similar structure to the adrenal cortex hormones.

"It is one of the herbs that can act as an ‘adaptogen’ - assisting your adrenals as ‘shock absorbers’ to cope better with stress, preventing a trigger-happy reaction of excessive adrenaline release,” Dr Glenville explains.

7 Herbs for Asthma

By Jesse Wolf Hardin

Asthma is a condition that troubles many people in this country, but it can often be effectively eased by the use of natural plant medicines. Kiva and I have sought to address the problem both in Plant Healer Magazine, and in a class taught at our annual classes and celebration The Traditions In Western Herbalism Conference by the increasingly popular herbalist teacher Sean Donahue. A detailed essay and notes from that class and many others are available on Amazon in the newly released book Traditions in Western Herbalism, but we also want to share the helpful wisdom with all of you here. Sean tells us:

“From a purely physiological standpoint, asthma is a misfiring of the immune response within the respiratory tract. When the body perceives a threat, the inflammatory aspect of the immune system gears up to heal any potential injuries. In someone with asthma, that aspect of the immune system in the respiratory tract is on a hair trigger alert, and any perceived threat — an infection, an allergen, or emotional stress can kick it into high gear, releasing inflammatory cytokines and histamines at levels far above normal. This in turn causes the mucous membranes to swell up and the smooth muscles of the airway to spasm. Over time this exaggerated immune response can cause damage to bronchial tissue, which in turn exacerbates the response because the body now also has a real set of injuries to respond to. 7 herbs I Use Most Often for Asthma Relief

Hawthorn: If we look at breath as the thread that connects us to the world, it makes sense that in moments of intense stress, for some people the airways can close, keeping the outside world from entering. In many people with asthma, this pattern gets established early on in response to a specific trauma and then becomes the default mode — because the body views any response to stress as successful if a person survives it. And if the body has learned that closing the airways will allow it to survive, then until it learns another equally successful strategy with regards to breathing in stressful situations the pattern will continue.

Traditional Chinese Medicine provides a framework for understanding this as well — the concept of disturbed Shen. David Winston defines Shen as "[ . . ] or your individual spirit. It is a person's mind/consciousness and emotional balance. Disturbances of shen produce anxiety,insomnia, bad dreams, moodiness, listlesness, and poor memory."

I think of disturbed shen as that leap out of the body that happens in a moment of shock. Disturbed shen is most noticeable as an acute condition, but can also become a chronic condition contributing to asthma. If the person with asthma also has ADHD, chronic anxiety, frequent panic attacks, a mood disorder or chronic insomnia, overall health can be helped tremendously by calming the shen.

Shen resides in the heart, and from an energetic perspective, the heart's proximity of the lungs allows disturbed shen to translate into disturbed breathing in those whose lungs are already deficient.

Hawthorn is a tonic for the heart that also has traditional use in TCM for calming disturbed Shen. It is also a plant rich in flavonoids that help to cool inflammation – so especially useful for Pitta asthmatics in combination with Peach or Cherry, but relevant for all constitutions.

Naturopath Deborah Frances pioneered the use of Hawthorn for acute asthma attacks — she recommends 3-4 doses of 30 drops at 1-2 minute intervals. In acute attacks, I've only tried this in combination with an antispasmodic herb, but definitely have had good results.

Schizandra: Shizandra is a plant in the Magnolia family that produces a fruit that exhibits all five of the flavors recognized in the Chinese tradition — sweet, sour, bitter, pungent and salty.

The sour taste is most apparent, suggesting the plant's astringent qualities. In Chinese medicine, it was traditionally used to "astringe the Jing" and help seal a "leaky Jing gate" — addressing problems marked by profuse loss of fluids from diarrhea to excessive urination to turberculosis to excessive sweating to vaginal discharges to premature ejaculation. All of this is associated with the kidneys.

It also serves the same function energetically — when you are leaking life force through the holes left where you jumped out of your skin, Schizandra helps gather the energy back within you and stop the leak. When you are unconsciously giving more of yourself away than you can afford to, Schizandra helps you hold onto some of your life force for yourself.

In Chinese medicine, the kidneys also play a role in breathing, "grasping" the lung to pull in the breath. When the kidneys are two weak "the kidney fails to grasp the lung" and inhalation tends to be incomplete – its impossible to get a deep breath. Schizandra is a traditional remedy for this condition. And for calming disturbed Shen. Schizandra also helps to restore and regulate the adrenals – especially when they have been depleted by the use of steroid medications. I give a strong decoction or 30-60 drops of the tincture daily.

Elecampane: Elecampane is a warm, pungent expectorant that is wonderful for damp congestion in the respiratory tract. Especially well suited when there is also a bacterial infection – and many asthmatics are prone to bronchitis and pneumonia.

At an emotional level, the lungs tend to hold on to grief, which, being a watery thing, tends to flow downward, settle in deep, and become stagnant and cold. Elecampane aids in letting go of old — releasing and cleansing buried grief just as it brings up old, infected mucus. 5-10 drops daily for chronic situations. 30-60 drops in acute situations. Kapha can use continuously. Pitta or Vata may find irritation after a few days' use.

Eastern Skunk Cabbage: is an excellent anti-spasmodic and expectorant that is ideal for Kapha asthmatics whose attacks are typically marked by both spasms and excess mucus secretion (it stops the spasms while at the same time encouraging a non-spasmodic cough to bring up excess mucus. It is also deeply calming due in part to the presence of Serotonin.

William Cook called it a nervine “of the most innocent and effective soothing character.” Too drying for many Pittas and Vatas. I've had a 15 drop doses top an attack. Avoid in pregnancy. Use caution in combination with SSRI's or MAO inhibitors (theoretical possibility of excess serotonin build up in the first case, likelihood in large doses of psychedelic effect in the latter.)

Black Cohosh: Black Cohosh is an excellent anti-spasmodic well suited where asthma is accompanied by periods of deep depression or brought on by panic associated with feelings of doom.

The person who will benefit from Black Cohosh will tend toward melancholy and will be easily and deeply impacted by the emotions of others and often by larger events in the world. When depression sets in it will tend to be deep and seemingly intractable. I give 3-10 drops of the tincture for depression, but up to 30 drops for acute spasmodic asthma attacks.

Lobelia: Lobelia acts almost instantaneously to stop the spasms and open up the airway. It also calms the anxiety associated with an asthma attack. I use an acetract — made by macerating the fresh plant in a combination of alcohol and vinegar. Dosage varies widely from person to person, many will get the desired effect from 5 drops, I use 10-15. More than 30 and vague feelings of nausea generally set in. But actual emetic doses are far higher than nauseating doses — more on the order of 90-120 drops in my case. David Winston suggests that you can find the ideal dose by (not in a moment of crisis of course) taking repeated drop doses and counting them out until you feel the first hint of nausea. The ideal dose is one drop less than a nauseating dose. But in emergency situations I'll just give someone a half dropper or so. Lobelia will also help to encourage healthy expectoration of excess fluids.

Lobelia has a calming and protective energy which is also tremendously helpful in restoring the sense of safety necessary to allow a person to breathe more deeply after an acute asthma attack.

New England Aster: Jim McDonald introduced me to New England Aster, a resinous dark purple aster that flowers in autumn in New England.

A tincture made from the flowering tops can immediately help relieve muscle constriction around the airways. I tend to use about 15 drops in acute situations — most effective when there is tightness around the airway that signals an attack is imminent but spasms have not yet begun. Other sticky, aromatic asters seem to have similar effects. I tend to combine New England Aster in equal parts with False Solomon's Seal which I see as a specific for relaxing the connective tissues associate with these muscles (largely by restoring their pliability).

Best wishes with your healing efforts, from the Plant Healer family! – Jesse Wolf & Kiva Rose

Information About Black Cohosh Plant Care And Uses

By Amy Grant

You’ve probably heard about black cohosh with respect to women’s health. This interesting herb plant has much to offer for those wishing to grow it. Keep reading for more information on black cohosh plant care.

About Black Cohosh

Plants Found in the eastern United States, black cohosh plants are herbaceous wildflowers with an affinity for moist, partially shaded growing areas. Black cohosh is a member of the Ranunculaceae family, Cimicifuga reacemosa, and commonly referred to as black snakeroot or bugbane. Growing black cohosh gets the name ‘Bugbane’ in reference to its unpleasant odor, which renders it repellent to insects.

This wildflower has small plumes of star-shaped white flowers that soar upwards of 8 feet (more commonly 4 to 6 feet tall) above deep green, fern-like leaves. Growing black cohosh plants in the home landscape will definitively lend some drama due to its spectacular height and late summer blooms. Black cohosh perennials have foliage similar to that of astilbe, sharply serrated, and show themselves off nicely in shade gardens.

Black Cohosh Herb Benefits

Native American people once used growing black cohosh plants for a medley of medical issues, from snake bites to gynecological conditions. During the 19th century, physicians availed themselves of black cohosh herb benefits with regards to fever reduction, menstrual cramping, and arthritis pain. Additional benefits deemed the plant useful in the treatment of sore throats and bronchitis.

Most recently, black cohosh has been utilized as an alternative medicine in the treatment of menopausal and premenopausal symptoms with a proven “estrogen-like” balm to reduce disagreeable symptoms, most especially hot flashes and night sweats.

The roots and rhizomes of black cohosh are the medicinal portion of the plant and will be ready for harvesting three to five years after planting.

Black Cohosh Plant Care

In order to plant black cohosh in the home garden, either purchase seeds from a reputable nursery or collect your own. To collect seeds, do so in the fall when the seeds are mature and have dried out in their capsules; they will have started to split open and when shaken make a rattling sound. Sow these seeds immediately.

Seeds for growing black cohosh plants must be stratified or exposed to a warm/cold/warm cycle to stimulate germination. To stratify the black cohosh seeds, expose them to 70 degrees F. (21 C.) for two weeks, and then 40 degrees F. (4 C.) for three months.

Once the seeds have gone through this process, plant them 1 ½ to 2 inches apart and about ¼ inch deep in prepared moist soil that is high in organic matter and covered with a 1-inch layer of mulch.

Although this herb prefers shade, it will grow in full sun; however, the plants will be of a lighter shade of green and may have more of a propensity for scalding of the foliage. You may want to sow seeds in a cold frame for germination the following spring if you have a particularly hostile climate.

Black cohosh may also be propagated via division or separation in the spring or fall but not sooner than three years after planting.

Maintain a consistently moist soil for your black cohosh plants, as they dislike drying out. Additionally, tall flower stalks may likely need staking. These perennials are slow growers and may require a little patience but will lend visual interest in the home landscape. Even the spent seed casings may be left throughout the winter to add texture to the garden.

Is Black Tea the Same Thing As Black Cohosh Tea?

By Kathryn Meininger (Demand Media)

Confusing the benefits of black tea with those of black cohosh tea could prove disastrous. Black tea and black cohosh are two very different types of teas. A refreshing cup of black tea is often enjoyed in the morning in place of a cup of coffee, or in the evening to relax and wind down. Black cohosh tea is not a culinary beverage, but a tea used as an herbal remedy to combat some of the symptoms of menopause. Both teas may offer health benefits, but consult your physician before using either tea to treat a health condition.

What is Black Tea?

Second only to water, black tea is one of the most popular beverages worldwide, according to Janet Tietyen, a nutritionist at the University of Kentucky Cooperative Extension Service. Black tea is brewed from the leaves of the Camellia sinensis plant, which have been allowed to ferment, or oxidize, fully before drying. This accounts for black tea's high concentrations of the amino acid theanine and certain antioxidants called theaflavins, as well as thearubigens, which give black tea its dark reddish-black color. Drinking black tea may also offer you some health benefits, although scientific evidence hasn't proved this conclusively.

Black Tea Effects

Black tea contains the stimulant caffeine, with 11 to 61 milligrams of caffeine in an 8-ounce cup, according to Although more scientific studies on its health effects are needed, drinking black tea appears to offer you some protection against developing heart disease and atherosclerosis, or hardening of the arteries, according to the Linus Pauling Institute. It may also retard the growth of some cancers, including skin, liver, lung, esophageal, stomach, colon and breast cancers. Hold the milk if you drink black tea for its health benefits. A 2006 study published in "The European Heart Journal" found adding dairy products to black tea counteracted its positive effects on the vascular system. Possible side effects of black tea are associated with its caffeine content and include heartburn, rapid heartbeat and insomnia.

What is Black Cohosh Tea?

Although in name it appears similar, black cohosh tea is a completely different type of tea than black tea. Also known in folk medicine as bugbane and rattleroot, black cohosh is harvested from the roots and rhizomes, or underground stems, of the Actaea racemosa plant. Black cohosh, a relative to the buttercup, grows in the forests of North America. It contains different active substances than black tea, offering high concentrations of sugar compounds called glycosides and fukinolic acid, a substance which may have some estrogen-like properties.

Black Cohosh Tea Effects

Black cohosh tea has no caffeine and isn't a stimulant. Its estrogen-like effects may help relieve menopausal symptoms, such as hot flashes, night sweats, vaginal dryness and anxiety. It is also used to alleviate inflammation due to arthritis and pre-menstrual symptoms, according to the University of Maryland Medical Center. Keep in mind that the efficacy of black cohosh hasn't been proven and there are some safety concerns. Black cohosh can cause intestinal distress, headache and slow heart rate. Never take black cohosh without your doctor's approval, especially if you have had a hormone-sensitive cancer, such as breast cancer, or are taking medication that affects your liver.

Black Cohosh for Hot Flashes?

By Cathy Wong, ND (Reviewed by a board-certified physician)

Black cohosh is an herbal remedy often recommended for the treatment of hot flashes. A common symptom of menopause, hot flashes are thought to result from changes in estrogen levels. While some proponents claim that black cohosh can act as a phytoestrogen, studies testing black cohosh's effects on hot flashes have yielded mixed results so far. The Science Behind Black Cohosh and Hot Flashes

For a 2010 report published in Alternative Therapies in Health and Medicine, researchers analyzed nine clinical trials on the use of black cohosh for the treatment of menopausal symptoms (including hot flashes).

Results revealed that herbal formulas containing black cohosh improved overall menopausal symptoms by 26 percent. However, in a research review published in Drugs & Aging the previous year, scientists sized up 16 studies on black cohosh and menopausal symptoms and deemed their results inconclusive (largely due to flaws in study design).

There is also limited support for the theory that black cohosh can cool hot flashes among postmenopausal women undergoing or finished with breast cancer treatment. In a 2006 study published in the Journal of Clinical Oncology, for instance, researchers found that taking black cohosh for four weeks failed to reduce hot flashes among breast cancer patients. While participants given a placebo reported a 27 percent decrease in hot flashes, those treated with black cohosh reported only a 20 percent decrease in hot flashes.


The safety of long-term use of black cohosh is uncertain, according to the National Center for Complementary and Alternative Medicine (NCCAM).

In fact, the NCCAM warns that there have been several reports of hepatitis and liver failure among women who were taking black cohosh. In addition, black cohosh may cause a number of minor side effects (such as stomach pain, headache, and rash).

Supplements haven't been tested for safety and due to the fact that dietary supplements are largely unregulated, the content of some products may differ from what is specified on the product label.

Also keep in mind that the safety of supplements in pregnant women, nursing mothers, children, and those with medical conditions or who are taking medications has not been established. You can get additional tips on using supplements here.

Using Black Cohosh for Hot Flashes

For help in soothing hot flashes, the National Institutes of Health (NIH) recommends avoiding caffeine, alcohol, and spicy foods; eating soy foods; exercising regularly; and practicing slow, deep breathing whenever you feel a hot flash coming on. Receiving acupuncture or taking up tai chi, yoga, or meditation may also help ease menopausal symptoms, according to the NIH.

If you're considering the use of black cohosh in treatment of hot flashes (or any other condition), make sure to talk to your primary care provider before starting your supplement regimen. Keep in mind that alternative medicine should not be used as a substitute for standard care. Self-treating a condition and avoiding or delaying standard care may have serious consequences.

5 natural, non-hormonal solutions for menopause symptoms

By Julie Revelant

Between those dreaded hot flashes, night sweats, mood swings and hours spent tossing and turning at night, menopause is downright miserable. Hormone replacement therapy is one option, but if you’re concerned about the risks or want to try natural fixes first, the good news is that there are non-hormonal remedies that can help.

Here are five of the most common symptoms of menopause and natural remedies to try.

1. Hot flashes It’s unclear what causes hot flashes, but they might be linked to the adrenal glands. When estrogen falls during menopause, the adrenal glands can become deficient, which then causes a surge of cortisol to be released and, in turn, hot flashes, said Dr. Prudence Hall, founder of The Hall Center in Santa Monica, Calif.

Approximately 80 percent of women will experience hot flashes and about 10 percent will have significant hot flashes that last for over 10 years, said Dr. Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine in New Haven, Conn. and author of “A Woman’s Guide to Sexual Health.”

Herbs such as black cohosh, wild yam, Korean ginseng and red clover can help, but you should consult with a physician, naturopath or herbalist to make sure you choose a reputable brand. Also, avoid triggers like wine and spicy foods, try adding soy foods to your diet and dress in layers.

Although exercise will likely make your hot flashes worse while you’re doing it, it can help alleviate symptoms throughout the day. In fact, women who reported less than three sessions a week of physical activity had more severe symptoms of menopause, including hot flashes, compared to women who were more active, a study in the journal Menopause found. Losing weight can also help hot flashes since heavy women have worse hot flashes than slimmer women, Minkin said.

2. Night sweats Approximately 95 percent of women will also deal with night sweats, which is not only uncomfortable, but it makes getting a good night’s sleep nearly impossible.

To feel better, adjust the thermostat, try cooling sheets, pillows or blankets and wear moisture-wicking pajamas.

3. Vaginal dryness Unlike hot flashes that tend to get better with time, unfortunately vaginal dryness gets worse. The decrease in estrogen levels cause the vaginal tissues to become thin and dry, which leads to discomfort, itching, irritation and pain during sexual intimacy. If it’s not treated, vaginal dryness can lead to atrophic vaginitis, a condition that causes the walls of the vagina to become inflamed.

Some things to try include long-lasting over-the-counter moisturizers that can be used two to three times a week, or coconut oil and personal lubricants when you have sex.

4. Insomnia Restlessness, waking up several times throughout the night, or trouble falling asleep are all common during menopause.

Questioning who you are or your life’s purpose— which is common during this stage of life— can cause anxiety and also make sleeping difficult, Hall said.

Make a point to exercise every day, which can help you sleep, but do it too close to bedtime and it might keep you up.

Avoid known triggers like alcohol and caffeine, and practice good sleep hygiene by keeping your bedroom cool and dark and powering down electronics one to two hours before you get into bed.

Acupuncture can help relieve sleep disturbances associated with menopause too, according to a systematic review and meta-analysis published in the journal Obstetrics & Gynecology.

5. Irritability During menopause, there are many factors at play that can cause you to feel on edge.

For starters, when estrogen is low, it can affect the neurotransmitters in the brain and lead to irritability and mood swings. If your libido is low and your body isn’t releasing oxytocin, the “love hormone” during an orgasm, your mood can suffer. Not to mention that if you’re not sleeping, you’re bound to feel crabby.

To cope, find opportunities to de-stress and relax, whether it’s heading to the spa for a massage, meditating or meeting friends for dinner. If your poor mood persists, it’s important to see your doctor because thyroid levels can plummet during menopause, which might be the real reason you’re feeling low.

Although menopause is no walk in the park, it’s important to take time to take care of yourself.

“Even if we’ve given our care, our love and our attention to everyone else, now is the time for ourselves so we stay full of light, love and life,” Hall said.

Going the alternative route in menopause

(The Star)

Complementary and alternative therapies to help women with menopause are popular in many countries. However, there’re a few things to keep in mind.

MENOPAUSE is the cessation of a woman’s reproductive life, and its diagnosis is made when there has been no periods for 12 continuous months.

Complementary and alternative medicines (CAM) to help women with menopause are popular in many countries. However, the marketing claim that CAM are “natural” is no guarantee of its safety or efficacy.


Studies have reported that acupuncture reduces the severity and frequency of hot flushes for up to three months. – AFP

Studies have reported that acupuncture reduces the severity and frequency of hot flushes for up to three months. – AFP

Complementary and alternative therapies to help women with menopause are popular in many countries. However, there’re a few things to keep in mind.

MENOPAUSE is the cessation of a woman’s reproductive life, and its diagnosis is made when there has been no periods for 12 continuous months.

Complementary and alternative medicines (CAM) to help women with menopause are popular in many countries. However, the marketing claim that CAM are “natural” is no guarantee of its safety or efficacy.

Pao Shen or American Ginseng, which used to cost RM9,000 per kg, now has a price tag of RM13,000 per kg. Ginseng has not been found to be better than placebo for menopausal symptoms in a randomised trial, but indicators of wellbeing and depression were reported to have improved. – Filepic

Yet, they are perceived by many as a safe alternative to hormone therapy (HT) when they should be used with the same caution as with all other medicines.

Some of the commonly used CAM are discussed below.


Phyto-oestrogens are plant substances, which have weak oestrogen-like effects, because they have a similar chemical structure as oestrogen. They are found in soybeans, soy products, red clover, oilseeds, whole cereals and legumes. The main groups are isoflavones and lignans.

Most Asian diets have a high concentration of isoflavones and many Asian women have been reported to have lower rates of menopausal symptoms.

However, the results of randomised controlled trials of soy and red clover derivatives in Caucasians are conflicting. Reviews of studies of soy products on menopausal symptoms has had inconsistent results.

Breast mammographic density, which is a risk marker of breast cancer, is not affected by phyto-oestrogens in short-term studies. Long-term studies of its effect on the breast are lacking.

Some concern has been raised about an association between soy products and breast cancer, but there is no evidence in the scientific literature to suggest this.

Although there is no evidence that it increases the risk of breast cancer recurrence, women who are at increased risk of breast cancer, or are breast cancer survivors, are advised to avoid highly processed soy supplements, isoflavone-rich soy extracts or isoflavone capsules, as they appear to act differently in the body than foods made from soy beans or soy flour.


A number of plant-based products (herbs or botanicals) have been used to treat menopausal symptoms like hot flushes. Some of the commonly used products are black cohosh, dong quai and ginseng.

Black cohosh has been licensed in some countries for short-term treatment of menopausal symptoms like hot flushes. A recent Cochrane review of clinical trials on black cohosh reported that it was not better than placebo in reducing the frequency of hot flushes or in improving menopausal symptoms.

The quality of the research was not of a sufficient standard to determine its effectiveness.

Side effects, which are uncommon, include transient gastrointestinal upsets and rashes, typically with first-time use, and if it is taken for a limited period of time at the recommended dose.

More serious adverse events have included liver damage, which is thought to be very rare.

Black cohosh should not be used in combination with HT or antihypertensive medicines, or when there is liver disease.

Little is known about its long-term safety and toxicity.

Dong quai, which is commonly used in traditional Chinese medicine, has not been found to be better than placebo in relieving menopausal symptoms in a randomised trial.

Interaction with warfarin, a blood-thinning medicine, and photosensitivity reactions have been reported.

Ginseng has not been found to be better than placebo in a randomised trial, but indicators of wellbeing and depression were reported to have been improved.

It may increase high blood pressure. It should not be used with stimulants, blood-thinning products, diuretics or alcohol, as interactions have been reported.

There are also reports associating ginseng with postmenopausal bleeding.

Evening primrose oil contains large amounts of the fatty acid gammalinolenic acid. There is no evidence of its effectiveness in treating menopausal vasomotor symptoms.

It should not be used in epilepsy sufferers, or users of phenothiazines or blood-thinning products like aspirin, warfarin, vitamin E supplements, garlic and ginger.

St John’s wort is effective in the treatment of depression in menopausal women. Its use in the treatment of vasomotor symptoms has not been proven. It should not be used with several medicines like antidepressants, blood-thinning and HIV medicines, theophylline, digoxin and some cancer medicines, because of drug interactions.

It may also cause breakthrough bleeding and contraceptive failure when used with oral contraceptives.

Wild yam has not been found effective. It is dangerous for women to substitute wild yam or progesterone creams for prescribed progestogens when using combined oestrogen/progestogen HT, because such creams cannot counter the effect of oestrogen on the endometrium, which increases the risk of endometrial cancer.

Prego Studies have reported that acupuncture reduces the severity and frequency of hot flushes for up to three months. – AFP

Studies have reported that acupuncture reduces the severity and frequency of hot flushes for up to three months. – AFP

Complementary and alternative therapies to help women with menopause are popular in many countries. However, there’re a few things to keep in mind.

MENOPAUSE is the cessation of a woman’s reproductive life, and its diagnosis is made when there has been no periods for 12 continuous months.

Complementary and alternative medicines (CAM) to help women with menopause are popular in many countries. However, the marketing claim that CAM are “natural” is no guarantee of its safety or efficacy.

Pao Shen or American Ginseng, which used to cost RM9,000 per kg, now has a price tag of RM13,000 per kg. Ginseng has not been found to be better than placebo for menopausal symptoms in a randomised trial, but indicators of wellbeing and depression were reported to have improved. – Filepic

Yet, they are perceived by many as a safe alternative to hormone therapy (HT) when they should be used with the same caution as with all other medicines.

Some of the commonly used CAM are discussed below.


Phyto-oestrogens are plant substances, which have weak oestrogen-like effects, because they have a similar chemical structure as oestrogen. They are found in soybeans, soy products, red clover, oilseeds, whole cereals and legumes. The main groups are isoflavones and lignans.

Most Asian diets have a high concentration of isoflavones and many Asian women have been reported to have lower rates of menopausal symptoms.

However, the results of randomised controlled trials of soy and red clover derivatives in Caucasians are conflicting. Reviews of studies of soy products on menopausal symptoms has had inconsistent results.

Breast mammographic density, which is a risk marker of breast cancer, is not affected by phyto-oestrogens in short-term studies. Long-term studies of its effect on the breast are lacking.

Some concern has been raised about an association between soy products and breast cancer, but there is no evidence in the scientific literature to suggest this.

Although there is no evidence that it increases the risk of breast cancer recurrence, women who are at increased risk of breast cancer, or are breast cancer survivors, are advised to avoid highly processed soy supplements, isoflavone-rich soy extracts or isoflavone capsules, as they appear to act differently in the body than foods made from soy beans or soy flour.


A number of plant-based products (herbs or botanicals) have been used to treat menopausal symptoms like hot flushes. Some of the commonly used products are black cohosh, dong quai and ginseng.

Black cohosh has been licensed in some countries for short-term treatment of menopausal symptoms like hot flushes. A recent Cochrane review of clinical trials on black cohosh reported that it was not better than placebo in reducing the frequency of hot flushes or in improving menopausal symptoms.

The quality of the research was not of a sufficient standard to determine its effectiveness.

Side effects, which are uncommon, include transient gastrointestinal upsets and rashes, typically with first-time use, and if it is taken for a limited period of time at the recommended dose.

More serious adverse events have included liver damage, which is thought to be very rare.

Black cohosh should not be used in combination with HT or antihypertensive medicines, or when there is liver disease.

Little is known about its long-term safety and toxicity.

Dong quai, which is commonly used in traditional Chinese medicine, has not been found to be better than placebo in relieving menopausal symptoms in a randomised trial.

Interaction with warfarin, a blood-thinning medicine, and photosensitivity reactions have been reported.

Ginseng has not been found to be better than placebo in a randomised trial, but indicators of wellbeing and depression were reported to have been improved.

It may increase high blood pressure. It should not be used with stimulants, blood-thinning products, diuretics or alcohol, as interactions have been reported.

There are also reports associating ginseng with postmenopausal bleeding.

Evening primrose oil contains large amounts of the fatty acid gammalinolenic acid. There is no evidence of its effectiveness in treating menopausal vasomotor symptoms.

It should not be used in epilepsy sufferers, or users of phenothiazines or blood-thinning products like aspirin, warfarin, vitamin E supplements, garlic and ginger.

St John’s wort is effective in the treatment of depression in menopausal women. Its use in the treatment of vasomotor symptoms has not been proven. It should not be used with several medicines like antidepressants, blood-thinning and HIV medicines, theophylline, digoxin and some cancer medicines, because of drug interactions.

It may also cause breakthrough bleeding and contraceptive failure when used with oral contraceptives.

Wild yam has not been found effective. It is dangerous for women to substitute wild yam or progesterone creams for prescribed progestogens when using combined oestrogen/progestogen HT, because such creams cannot counter the effect of oestrogen on the endometrium, which increases the risk of endometrial cancer. There are very few studies of the use of reflexology in menopause. It has been reported to reduce sleep disorders in menopausal women. There are very few studies of the use of reflexology in menopause. It has been reported to reduce sleep disorders in menopausal women. – Filepic

Dehydroepiandrosterone (DHEA)

DHEA, which is produced by the adrenal gland, is a precursor of oestrogen and testosterone. Its blood levels drop dramatically with age.

DHEA is classified as a food supplement in some countries. It is often used for anti-ageing effects, but there is no supporting evidence.

Some studies have reported benefits on the skeleton, cognition, well-being, libido and the vagina, but no effect on hot flushes. The short-term side effects are still controversial and possible harmful effects of long-term use are, as yet, unknown.

Complementary therapies

There are various complementary techniques that purport to treat menopausal symptoms. They include acupuncture, reflexology, hypnotherapy, etc.

There is very limited data available on these techniques and more research is needed to understand their possible effects.

Acupuncture has been used in various ways and has been shown to be effective in pain relief. Studies have reported that acupuncture reduced the severity and frequency of hot flushes for up to three months. Adverse effects, although infrequent, have been reported, and include hepatitis and air in the chest (pneumothorax).

Reflexology involves the application of pressure to specific sites on the feet to treat various conditions. There are very few studies of its use in menopause. It has been reported to reduce sleep disorders in menopausal women.

It is advisable for anyone considering CAM for menopausal symptoms to remember that:

– Although many dietary supplements and some prescription medicines originate from natural sources, “natural” does not always mean “safe”, because adverse effects have been reported. This has led to the issuance of warnings for some products by many drug regulators worldwide.

– A dietary supplement may contain several compounds, and its active ingredients may be unknown. It is essential to remember that what is on the label may not be what is in the bottle as analyses have found differences between the labelled and actual ingredients.

– It is vital to inform doctors and nurses of any CAM that one is using so that drug interactions can be avoided.

Regulatory mechanisms have been put in place by which medicines are registered for human use. The contrast between requirements in the assessment and development of pharmaceutical medicines and the minimal research with CAMs is striking.

A woman who is prescribed and dispensed CAM for menopause is entitled to be protected by regulators and provided information about the evidence upon which the CAM is believed to work.

Until research data that stands up to scientific scrutiny are available, the consumer has to remember to apply the same caution with CAM as with all other medicines.

The Benefits of Black Cohosh

By Cathy Wong, ND (Reviewed by a board-certified physician)

Black cohosh (Cimicifuga racemosa) is a plant used in herbal medicine. A member of the buttercup family, it has a long history of use in the treatment of arthritis and muscle pain. Today, however, black cohosh is commonly taken for relief of symptoms associated with menopause.

Fukinolic acid (a compound found in black cohosh) appears to have estrogen-like activity. Proponents suggest that black cohosh's potentially estrogen-like effects may be beneficial to women as they experience menopause-related declines in their estrogen levels (a key factor in the development of menopausal symptoms).

To that end, black cohosh is sometimes touted as a natural alternative to hormone replacement therapy.

Uses for Black Cohosh

Black cohosh is used as a natural remedy for a number of menopause-related symptoms, including hot flashes, night sweats, disturbances in mood, and vaginal dryness.

In addition, black cohosh is sometimes used to treat menstrual irregularities and alleviate symptoms of premenstrual syndrome.

Research on Black Cohosh

While black cohosh is among the most popular natural remedies for menopausal symptoms, studies testing its effectiveness have produced conflicting results.

The most comprehensive research on black cohosh and menopausal symptoms includes a report published in the Cochrane Database of Systematic Reviews in 2012. For this report, scientists looked at 16 previously published clinical trials (with a total of 2,027 women) that compared the effects of black cohosh to those of a placebo, hormone replacement therapy, red clover, and other interventions in the treatment of menopausal symptoms.

In their analysis, the review's authors found no significant difference between black cohosh and placebo in the relief of hot flashes. What's more, hormone replacement therapy appeared to be more effective than black cohosh for hot flash relief. Due to insufficient data, no firm conclusions could be drawn as to black cohosh's effectiveness in treating symptoms such as vaginal dryness and night sweats.

Since the reviewed studies were of "uncertain quality," the report's authors concluded that further research on the use of black cohosh in treatment of menopausal symptoms is warranted.

It should also be noted that very few studies have evaluated black cohosh's effectiveness as a treatment for menstrual problems. Still, some preliminary research (including a rat-based study published in the Journal of Steroid Biochemistry and Molecular Biology in 2007) indicates that black cohosh may help reduce menstrual pain.

Side Effects & Safety Concerns

Use of black cohosh may trigger a range of side effects, such as: headache, heaviness in the legs, indigestion, low blood pressure, nausea, perspiration, vomiting, and weight gain.

Excessive doses of black cohosh may cause seizures, visual disturbances and slow or irregular heartbeat.

There have been several case reports of hepatitis and liver failure among women taking black cohosh. Although it's not known whether black cohosh contributed to the development of these conditions, United States Pharmacopeia experts urge women to discontinue use of black cohosh and seek medical attention if they experience symptoms such as abdominal pain, dark urine, and jaundice.

Additionally, black cohosh should be avoided by people with hormone-sensitive conditions (such as breast cancer, prostate cancer, endometriosis, and uterine fibroids), as well as by those with a history of blood clots, stroke, seizures, and/or liver disease. Individuals taking medications for high blood pressure should also avoid black cohosh.

Due to its possible estrogen-like activity, there's some concern that black cohosh could interfere with the effectiveness of hormone replacement therapy or oral contraceptives.

The safety of black cohosh in pregnant or breastfeeding women or children hasn't been established. Black cohosh could stimulate uterine contractions and result in miscarriage.

In August 2006, Health Canada advised consumers of the possible link between black cohosh and liver damage. In June 2007, the United States Pharmacopeia proposed that black cohosh product labels contain a cautionary statement. The American Botanical Council has countered that there is insufficient evidence to warrant the proposed caution.

Black cohosh should not be confused with the herb blue cohosh (Caulophyllum thalictroides), white cohosh, bugbane, Cimicifuga foetida, sheng ma or white baneberry. These species have different effects, and blue cohosh and white cohosh, in particular, can be toxic. There is a case report of neurological complications in a post-term baby after labor induction with a herbal blend of black cohosh and blue cohosh.

People with allergies to plants in the buttercup (Ranunculaceae) family should avoid black cohosh.

Black cohosh contains small amounts of salicylic acid, so people with allergies to aspirin or salicylates should avoid black cohosh.

People with a history of blood clots or stroke, seizures, liver disease and those who are taking medications for high blood pressure should not use black cohosh.

Black cohosh may interfere with the effectiveness of the chemotherapy drug cisplatin.

Black cohosh supplements haven't been tested for safety and keep in mind that the safety of supplements in pregnant women, nursing mothers, children, and those with medical conditions or who are taking medications has not been established. You can get tips on using supplements here, but if you're considering the use of black cohosh, talk with your primary care provider first. Alternatives to Black Cohosh

There's some evidence that alternative therapies like acupuncture may be of some benefit to women going through menopause. Studies suggest that acupuncture may help reduce hot flashes and improve sleep quality in menopausal women.

Natural remedies such as red clover, soy, St. John's wort, progesterone cream, and evening primrose oil also show promise in the treatment of menopause-related symptoms. However, as in the case of black cohosh, more research is needed to determine the effectiveness of these remedies.

Women's health: Menopausal symptoms and nonhormonal therapy

(Mayo Clinic News Network)

Q: Is there anything that can be done for menopausal symptoms that doesn’t include taking hormones? I’ve had breast cancer in the past so am unable to take hormones, but I wake up nearly every night because of night sweats and have occasional hot flashes during the day.

A: There are options for managing night sweats and hot flashes that do not involve taking hormones. Many women find that making some lifestyle changes can make a big difference. In addition, several prescription medications that do not contain hormones are available to treat hot flashes.

As you mention, doctors often advise women who have had breast cancer not to take hormone therapy for menopause symptoms. But that does not mean you have to simply suffer through those symptoms.

A good first step is to take a look at adjustments you can make in your day-to-day routines. For example, staying cool and lowering your stress can reduce the likelihood of hot flashes and night sweats. Some tips that may help include the following:

Try to avoid hot, spicy foods, warm beverages, caffeine and alcohol, as these are common hot flash triggers. When choosing clothing in the morning, dress in layers, so you can remove a layer if you get too warm. Pick light, breathable fabrics.

To minimize night sweats, make your bedroom cool and comfortable. Lower the temperature in your room and use layers of bedding you can remove easily during the night. Keep a small fan near your bedside, along with a glass of cold water. Some women put a frozen cold pack under their pillow, too.

To lower your stress and to help you sleep better, exercise regularly. Other stress reduction techniques such as meditation, yoga, qigong, tai chi, acupuncture and massage can also be useful. When used during hot flashes, a form of deep breathing called paced respirations may also reduce your symptoms.

Making choices to improve your health can make a difference, too. For example, along with other serious health problems, smoking raises your risk for hot flashes. If you smoke, talk to your health care provider about programs and resources in your area that can help you stop smoking. Your weight can also have an impact. Women who are overweight tend to have more hot flashes, so try to get to and stay at a healthy weight.

If lifestyle changes are not enough to give you relief from hot flashes, you may want to consider taking a prescription medication that does not contain hormones. A number of options are available. For your situation, a drug called gabapentin may be a good choice. Gabapentin can also cause drowsiness, so it is often recommended for women who have bothersome night sweats.

Other medications that can be effective include certain drugs that are approved to treat depression, but also reduce hot flashes in women without depression. Venlafaxine, escitalopram and paroxetine are examples of these medications. But be aware that you should not take paroxetine if you take tamoxifen for breast cancer.

Some people tout nonprescription medications as being useful for reducing hot flashes. Be careful with these. In many cases, their effectiveness has not been confirmed. Some of them are associated with an increased risk of other health problems. The herbal supplement black cohosh, for instance, is sometimes cited as being useful for minimizing hot flashes. But it has not been shown to be effective, and it may cause liver damage.

If you are interested in taking medication for your hot flashes, talk to your doctor about which one is right for you. It may also be useful to talk with a physician who specializes in women’s health issues. At Mayo Clinic, specialists in the Women’s Health Clinic are available for this purpose. Many other health care organizations offer this type of service, as well.

Herb to Know: Black Cohosh

By Betsy Strauch
• Cimicifuga racemosa
• (Sim-ih-SIFF-you-guh rass-eh-MOE-suh)
• Family Ranunculaceae
• Hardy perennial

The genus Cimicifuga comprises twelve species of erect her­baceous perennial plants that are native to north temperate regions. Black cohosh (C. racemosa), the species probably most familiar to herb gardeners, is a wildflower of moist or dry woods in eastern North America and is also cultivated as an ornamental.

Black cohosh produces clumps of strong stems 3 to 8 feet tall. Large, alternate green leaves are pinnately compound with toothed leaflets. Long, graceful wands of small, starry white flowers held above the foliage bloom from June through September. The flowers have no petals, and the greenish white sepals fall off soon after a flower opens, leaving a tuft of showy stamens surrounding a single pistil. The flowers are thought to be pollinated by green flesh flies.

The generic name Cimicifuga comes from the Latin cimex, a kind of bug, and fugare, “to put to flight”. Bugbane is the English equivalent. Both names refer to the belief that the plants’ strong odor repels insects. Indeed, tops of the “unpleasantly elder-scented” Eurasian species C. foetida used to be dried and stuffed into pillows and mattresses for this purpose. Racemosa means “in the form of a raceme” and refers to the arrangement of individual flowers on an elongated stalk.

The word cohosh comes from an Algonquian word meaning “rough” and refers to the plant’s lumpy blackish rhizomes. An alternate common name, rattletop, refers to the sound of the dry seeds in their pods atop the flower stalks.

Medicinal Uses

Native Americans used the rhizome to relieve menstrual cramps and to ease childbirth, hence another common name—squawroot. Blue cohosh (Caulophyllum thalictroides), a wildflower in the barberry family (Berberidaceae), is known as squawroot for the same reason. Black cohosh was an ingredient of Lydia Pinkham’s Vegetable Compound, a patent remedy for “female complaints” that was popular in the nineteenth and early twentieth centuries. It has also been used to treat arthritis, coughs, diabetes, tinnitus, dropsy, neuralgia, malaria, yellow fever, and so forth. The alternate common name black snakeroot (C. racemosa is only one of many herbs known as snakeroot) refers to the rhizomes’ use in poultices to treat snakebite.

Black cohosh has been considered both a relaxant and a mild tonic. Studies have shown extracts of the rhizome to be anti-inflammatory and to lower blood pressure in laboratory animals. Nevertheless, the U.S. Food and Drug Administration finds “no pharmacologic evidence of any therapeutic value.”

Large doses can cause nausea, dizziness, or miscarriage.

Other Uses For Black Cohosh

Black cohosh is not commonly used for food. However, the leaves of the Asiatic species C. simplex are eaten boiled, and the fragrant root is used as a spice. The flowers and seed heads of both species make good cut flowers.

Black cohosh is beautiful at the back of a shady border or woodland wildflower garden. It combines well with ferns and coarse-leaved plants such as hostas. C. simplex, similar to black cohosh but shorter, blooms in late fall. Fall-blooming anemones and heleniums are attractive companions.

Growing Black Cohosh

Black cohosh is hardy in zones 3 through 10. Ideal conditions are light shade and rich, moist, humusy soil; however, plants will tolerate full sun or full shade and can withstand summer drought when established. Amend lean soils with peat moss or compost. Set plants 2 feet apart. They need no staking. Mulch with compost or aged manure in the fall. Plants can remain where they are indefinitely, but to increase your stock, divide established plants in early spring. If you have none to divide, consider buying one and dividing it in a year or two. Propagating plants from seed is possible but not for the impatient: germination can take as long as a year. Holding seeds planted in moist potting mix for three months at 70°F followed by three months at 40° is reported to result in high germination.

Finding a Cure for Hot Flashes

(The Sequitur)

Most women in menopause are looking for a cure for hot flashes. Although a cure in the true sense of the word is still not available, there are some safe and effective methods to help you with your symptoms.

The cause for hot flashes is rather complex and still not completely understood. We know that estrogen is playing a role but it is not the only reason. For some women it is actually the opposite – estrogen dominance (too much estrogen) – that can cause the symptoms. Estrogen dominance can happen during the earlier stages of the menopause transition.

So if you add estrogen in hormone form to your body, your symptoms might even get worse. And that is about the last thing you want if you are suffering from “power surges”.

The best method to control hot flashes depends not only on the stage of your menopausal transition but also on some genetic differences and individual preferences.

During pre-menopause, your hormones go on a roller coaster: one day your estrogen is too high, the next day it is too low. Whereas in post-menopause, you will have low estrogen and progesterone levels in conjunction with some other hormones that are not in balance.

All these factors affect which remedy will work best for you. So in a nutshell, hot flashes are a complex problem and hot flash remedies must fit your individual hormone level and your body.

Unfortunately, there is no “one size fits all” solution for hot flash relief. Which method works best depends very much on YOU – your genetics, your cultural background, your life-long eating habits, your weight and the severity of your symptoms.

In essence there are three main ways to get relief:

Lifestyle changes are the least risky but also the most difficult to implement. It takes a lot of will power to give up those things that function as your hot flash triggers, or to loose weight and exercise regularly.

This is a large category that includes herbs, holistic remedies, home remedies for hot flashes, Chinese herbs, acupuncture and numerous other methods.

Which of the remedies work best for you is probably a matter of some trial and error. People react differently to the various herbs and remedies because of their genetic make up, lifestyle and preferences.

You may also find that over the course of your menopause transition you have to switch to a different remedy to effectively stop hot flashes. Early peri menopause has different problems than the later stages.

By far the most popular herbal remedy for hot flashes is Black Cohosh. It has a good safety record and has been widely researched. But Red Clover and Dong Quai are also well known hot flash remedies. All these herbs contain estrogen like substances called phytoestrogens.

Acupuncture is also a great natural treatment for hot flashes. Several trial have shown that it not only helps with hot flashes but it also helps with some of the other menopause symptoms.

Hormones and Medications are certainly an option for women with severe symptoms.

You have probably heard about the new “bioidenticals”? Bioidenticals are plant based hormones, which promise to bring your hormones back into balance and to provide a total menopause solution. Unfortunately it is also very expensive and there is a lot of unfounded claims being made by unscrupulous practitioners.

But hormone therapy has come a long way since Premarin and Prempro where the only medications out there. Even the science that warned women in menopause against the use of hormones is changing as more and more research is completed.

In some cases, doctors prescribe drugs as hot flash remedies that were developed for other illnesses. There is some active research about anti depressants for hot flashes that are promising. However, the side effects of prescription drugs should be taken into consideration.

So it stands to reason to start with the most natural cure for hot flashes before going for hormones or prescription drugs.

What Is Black Cohosh Used for?

By Joanne Marie (Demand Media)

The black cohosh plant, also called bugbane or black snakeroot, is native to North American forests. A member of the buttercup family, black cohosh roots and underground stems have medicinal properties that were recognized centuries ago by Native Americans. Supplements containing black cohosh root may be useful in treating menopausal symptoms and for several other health problems.

Traditional Uses

Traditionally, Native Americans used black cohosh root to relieve menstrual cramps, menopausal hot flashes and sleep problems. During the 19th century, herbal practitioners in the U.S. recommended the herb for colds, coughs, backache, to improve lactation and as a remedy for rheumatism and fever. In Germany today, black cohosh is approved by the government's regulatory agency as a remedy for menstrual discomfort and menopausal problems. Roots and rhizomes of black cohosh plants contain a number of different natural compounds. According to the American Academy of Family Physicians, the primary components with biological activity are chemicals in a class called terpenes; two of these terpenes are called actein and cimifugoside.

Menopausal Benefits

According to several research studies, consuming black cohosh supplements may help relieve menopausal symptoms, including hot flashes and night sweats. For example, in a clinical trial published in "Advances in Therapy," 120 female subjects with menopausal symptoms took either black cohosh or an anti-depressant for a total of six months. Both groups experienced improved symptoms, but the herb-treated group had greater improvement than the group that took the drug alone. While these are promising results, larger, double-blind studies that include an untreated, placebo group are needed to confirm the usefulness of black cohosh as a relief for menopause-related problems. Other Uses

Black cohosh root may also have anti-inflammatory properties, making it potentially useful in relieving discomfort from osteoarthritis and rheumatoid arthritis. In a review published in "Clinical Reviews in Allergy and Immunology," researchers evaluated several herbal remedies for arthritis and concluded that black cohosh is among those with strong anti-inflammatory activity. According to Memorial Sloan-Kettering Cancer Center, compounds in black cohosh may also have anti-cancer properties, possibly suppressing growth of prostate cancer cells and causing liver cancer cells to die. However, the positive evidence comes from laboratory research studies with cultured cells. The Cancer Center says that, while such studies are suggestive, clinical trials with human subjects are necessary to confirm the herb's potential as a cancer treatment or preventive.


Black cohosh is available in capsules or tablets from health food stores. The recommended dose of the herb is 40 to 80 milligrams daily; choose a preparation standardized for its content of actein, one of the root's active ingredients. Although black cohosh is considered safe, high doses may cause abdominal pain, diarrhea or other gastrointestinal problems, headache or tremors. Do not take black cohosh if you have a hormone-sensitive disorder such as cancer of the breast, uterus or ovary, or if you have a family history of breast cancer. Discuss black cohosh in detail with your physician to decide if it is a good choice for your situation.

Black Cohosh for Perimenopause Symptoms

(Magnolia, The Perimenopause Blog)

Black cohosh has become a very popular alternative remedy for relief of perimenopause symptoms. So popular in fact, that the medical community is taking notice and conducting clinical trials and studies on the effectiveness of the herb.

In 2001, the American College of Obstetricians and Gynecologists stated that black cohosh may actually be helpful for women experiencing hot flashes and night sweats associated with perimenopause.

The Office of Dietary Supplements with The National Institute of Health also cites several randomized, double-blind studies which have been done on black cohosh, showing that it does appear to have some effect in decreasing excessive sweating, hot flashes, and night sweats in perimenopausal and menopausal women.

While researchers remain careful to refrain from definitive conclusions about the effectiveness and safety of black cohosh; the good news is that according to the research they has been done, black cohosh does seem to be beneficial for some women in treating symptoms of perimenopause.

What is Black Cohosh?

Black cohosh is a native North American perennial plant of the buttercup family, found in both the United States and Canada. The botanical names are Actaea racemosa and Cimicifuga racemosa for those of you who are interested in such things. Other common names are black snakeroot, bugbane, bugwort, rattleroot, rattletop, rattleweed, and macrotys. Apparently, insects are not too fond of black cohosh, hence some of the names.

Historical Uses of Black Cohosh

North American Indians used black cohosh for a variety of physical conditions such as hives, constipation, kidney disorders, and even gynecological disorders.

19th Century America also used it as a home remedy for ailments like rheumatism and fevers, as a diuretic, and to promote menstrual cycles. Physicians used it enthusiastically for other reproductive maladies such as inflammation of the uterus or ovaries, infertility, and even for relief of labor pains.

Modern Uses of Black Cohosh

In addition to hot flashes and night sweats, according to WebMD, black cohosh is also used to treat headaches, mood changes, insomnia, vaginal dryness, and heart palpitations. There are even some preliminary studies which are looking at black cohosh as a preventative treatment for prostate cancer – again, according to WebMD.

How Should You Take Black Cohosh?

Black cohosh is the main ingredient in the popular over-the-counter dietary supplement Remifemin. On a personal note, I took Remifemin night formula for insomnia. It definitely helped me. (you can read the post wrote about it here.) Black cohosh can also be taken in capsules, solutions, tablets, tinctures, powders, and even teas.

How Much Should You Take?

There is no standardized treatment plan for the use of black cohosh. But, the typical dose suggested is 20 to 200 milligrams daily. For menopause symptoms, studies suggest 20 to 40 milligrams twice daily.

If you choose to take Remifemin, directions for dosage will be found on the box. However, it should be noted that more than 900 milligrams per day is considered an overdose. But, seriously, who is going to take that much?

Risks & Side Effects of Black Cohosh

In high doses, side effects of black cohosh can include headaches and upset stomach. Some people have developed liver problems, complained of gastric problems, and heaviness in the legs.

Black cohosh is not recommended for women who are pregnant, who have a history of breast or uterine cancer, or who have endometriosis. If you take birth control pills, use hormone replacement therapy, sedatives, or blood pressure medications, consult your physician before taking black cohosh.

Is Black Cohosh FDA Approved?

Black cohosh is sold as a dietary supplement in the United States and is therefore regulated as a food and not a drug. Because manufacturers do not have to provide evidence to the FDA that dietary supplements are effective or even safe before marketing, the composition of black cohosh may vary from product to product.

But, if you want my opinion ladies, there are plenty of drugs that are FDA approved that have been found to be dangerous to our health every, single day. So, as with any medication or supplements, exercise good judgment before you take it, making sure you have as much information as possible to make an informed decision.

How to Grow Black Snakeroot From Seed

By Bridget Kelly (Demand Media)

Black snakeroot (Sanicula marilandica) is a carrot relative and a perennial herb. Although it produces scented flowers in the summer, it is typically grown for its dark, almost black foliage. Black snakeroot provides a stunning focal point to a shady spot in the garden. Growing from 1 to 4 feet tall, it thrives in U.S. Department of Agriculture plant hardiness zones 3 through 8. The seed germination process differs, depending on whether the black snakeroot seed is fresh or if it has been stored, such as purchased packaged seed.

How to Grow Fresh Blacksnake Seed

1 Moisten a handful of peat moss and insert the black snakeroot seeds into it until they are completely enveloped. Place the bundle in a sandwich bag, seal it and leave it in the refrigerator for 90 days. Check the moisture content of the moss periodically. If it is drying out, drip water onto it until it’s slightly moist again. 2 Fill a germination container with soilless potting mix. The container can be anything, as long as it has holes in the bottom for drainage. Nursery flats work well if you’re planting lots of seeds; otherwise, a standard nursery pot will suffice. After filling the container with the mix, use your hands to press it down to firm it.

3 Sow the seeds on the surface of the mix and cover with a 1/8-inch layer of sand or perlite. Use water from a spray bottle to keep the top layer moist during germination.

4 Place the container in a polythene bag or cover it with plastic wrap. Place the container in a lightly shaded area on a heat mat set to 70 degrees Fahrenheit.

5 Remove the container from the bag when the seeds emerge. Keep the soil moist at all times and transplant the seedlings into individual pots filled with potting soil when they have their third set of leaves.

Grow Stored Black Snakeroot Seed

1 Sow the snakeroot seeds onto the surface of a germination container filled with moist, soilless planting mix. Cover them with a 1/8-inch layer of the mix. Enclose the container in a polythene bag or cover it with plastic wrap. Place the container on a heat mat set to 70 F. Allow it to remain for three months.

2 Move the covered container to the refrigerator and allow it to remain for an additional three months. Check the media periodically to ensure that it remains moist.

3 Place the covered germination container back on the 70-degree heat mat for another three months.

4 Remove the seedlings from the bag and transplant the seedlings into individual 3-inch pots filled with potting soil when they have their third set of leaves. Set the pots in a lightly shaded indoor area and keep the media slightly moist.

5 Harden off the black snakeroot seedlings before planting them outside. Choose a shady area outdoors and leave the potted seedlings there for four hours the first day. Gradually increase the amount of time they spend outdoors and the amount of sunlight they receive over two weeks.

6 Choose a partly shady area in which to plant the black snakeroot seedlings. Loosen the soil in the planting area to a depth of 6 inches. Improve heavy soil by digging in a 3-inch layer of compost. Moisten the area to a depth of 4 inches.

7 Plant the black snakeroot seedlings to the depth that they are growing in the pot and 24 inches apart.

Things You Will Need

• Peat moss
• Sealable polythene bag
• Germination container
• Soilless potting mix
• Heat mat
• Compost
• Shovel

If germination does not occur three months after the second warm stratification period, repeat the entire stratification process.

Getting to the root of black cohosh's uses

DOES IT WORK? Black cohosh is often used in place of HRT, but does it have much impact?

MENOPAUSE IS a natural part of ageing, and begins as production of female hormones (particularly oestrogen) decreases. When it occurs varies, but it signals the end of a woman's child-bearing years. For some, the transition is relatively smooth, but for others it is a difficult time emotionally or physically.

Hot flushes, depression, vaginal dryness and irritation are the most common symptoms. Hormone replacement therapy (HRT) became very popular until long-term studies published in 2002 found that some women were at risk of serious side effects.

Many women then turned to natural approaches to treat their menopausal symptoms, with black cohosh being one of the most popular.

Black cohosh is made from the underground parts of a North American plant that Native Americans called squawroot.

Evidence from studies

Recent interest in black cohosh began in the 1980s when several clinical studies were conducted with a German product called Remifemin. This product is of a type called a standardised extract.

Herbs naturally produce varying amounts of different ingredients, some of which can have medicinal properties. The amounts of these active ingredients vary with growing and production conditions.

When the active ingredients are known, manufacturers can ensure each batch contains a specific quantity. This is called a standardised product.

Remifemin is standardised to contain specific amounts of triterpene glycosides (although whether these are the active ingredients is unclear). All the German studies in the 1980s found that women improved with the herb and reported no adverse effects.

However, seven of these studies were not double-blinded. In other words, the women knew what they were receiving. Many studies have found that this tends to lead to more positive results than when studies are double-blinded.

Since those early studies, a small number of double-blind studies have been carried out and the results have varied widely. Most of these were conducted for three months or less. Only one found black cohosh of more benefit than placebo.

The largest and longest randomised, double-blind trial to date was published in 2006. Women were randomly put into groups taking black cohosh, a multiherb product, a placebo, soy products, or HRT. Only the group taking HRT had significantly better results compared to placebo. This study lasted one year, and during that time the menopausal symptoms in the placebo group decreased by almost one-third in both frequency and severity.

Thus, many women can expect their symptoms to improve over a year without taking anything.

Problematic aspects

Most women have no side effects from black cohosh, although intestinal problems and rashes can develop. These are usually rare, mild and reversible. On very rare occasions, liver problems have been reported.

Herbalists have traditionally used black cohosh to induce labour, leading many to urge that it not be used during early pregnancy or breast-feeding.

Blue cohosh and white cohosh are completely unrelated plants and should not be used in place of black cohosh.


Black cohosh appears to bring relief from some menopausal symptoms and is generally safe to take. However, much of the herb's reputation is based on traditional use and older trials that were not designed as well as possible.

More recent, better-designed studies have not had similarly positive results. Most producers recommend taking two to four milligrams of triterpenes daily.

Products vary in how much active ingredient they contain per tablet. Given the herb's good safety profile, it may provide some benefit for those who do not want to use hormonal therapies.

Black Cohosh Herbal Remedy

(Good News Naturally)

Let’s talk about some new studies, a couple of new studies that I’m going to focus on right now, but the first one is on some new benefits that have been discovered with an herbal remedy referred to as black cohosh.

Now, many of you ladies listening may have heard of black cohosh because it has a long, long, history of benefit in research in the area of both perimenopausal and menopausal symptoms in general. Things like hot flashes and night sweats, and interrupted sleep, and things like that. Again, been around for a long, long time, but now there’s a new study that is found that it can be useful in helping to reduce fibroid tumors among postmenopausal women.

The study, which was published in the “Evidence-Based Complimentary and Alternative Medicine Journal”, looked at the progression of fibroid tumors in 62 women who would either take in black cohosh … And this was a very specific form of black cohosh standardized to its active ingredients and I’ll try to talk about that more in this segment.

They took that, either took black cohosh or a prescription drug for menopausal symptoms which you can guess was a thing like Premarin, for example, typically the synthetic drug used, and so, they had taken it 10 years earlier to treat menopausal symptoms. Now, what they ended up finding out was that the fibroids were smaller amongst those who had taken the herbal remedy and were definitely bigger among those who had taken the medication. Okay?

This is an important point because this kind of focuses on something that I’ve talked about a number of times here on Good News Naturally, and if you want to go digging around the in the podcasts, you can find an interview that I did with Dr. Marita Schauch. She is from Vancouver, Canada. She’s a naturopath. We did a segment there on Healthy Hormones, and one of the topics that we got into discussing was the topic of estrogen dominance in a woman’s body.

Part of the driver with fibroids is that the women are experiencing something called estrogen dominance. You can even refer to it as simply a hormone imbalance. Why did the black cohosh herbal remedy show better results in this fibroid situation than the synthetic form of estrogen that was used in these women? The answer is pretty simple. What we’re looking at here is natural versus synthetic. Let me explain to you how this works.

There are receptor sites. As our body produces hormones, there are receptor sites that uptake those hormones. They’re also referred to as parking spaces if you will. They park into those sites so that they do the job the hormone was created to do. Alright?

If you use black cohosh, this is a plant-based form or what they would refer to as a phyto or plant-based estrogenic-type substance. What happens here is that because it is not synthetic, as it parks into that receptor site for that hormone, it does a couple of things.

Number one, it helps the woman’s body feel satisfied that it’s produced this hormone and it’s up-taken into this receptor site. That’s a good thing. That’s why it benefits the menopausal symptoms of hot flashes and night sweats, and things like that, but here’s what else it does.

When a woman has estrogen dominance, you have bad estrogen circulating in your body that should have been excreted, okay? It should have been excreted and there is a process of the phase one and phase two detoxification that goes on in the human body that is responsible for getting rid of that excess estrogen.

Many times, there’s either an abundance of estrogen which is what happens when you take synthetic estrogen, plus, we get estrogenic effect from other environmental toxicities like pesticides, herbicides, and even things like common health and beauty care products and cleaners, and things like that.

The black cohosh is doing two things. It’s parking in that receptor site, helping the body feel satisfied, but by also parking in that receptor site, guess what else it does. It prevents that bad estrogen from getting into that receptor site, thereby, protecting the woman from things like uterine fibroids, and worse, some of the estrogen-driven cancers that women deal with.

You see how that works? I hope you guys stayed with me through that explanation. I know that’s a lot to try to grasp and understand. Hopefully, you’re sitting somewhere where you can comprehend what I just said. Alright?

The natural is parking in that receptor site giving benefit and giving protection. The synthetic estrogen is giving the woman more estrogen which she really does not need and that creates a problem with driving fibroids and other forms of cancer. That’s why so many doctors and so many women have now turned away from using synthetic estrogen such as Premarin as a form of menopausal treatment, period. Okay?

It’s something I want you to understand and this is just one of the many benefits that I think black cohosh can bring to women with this benefit of both parking and the feel-good side of it along with the protective side of it. Again, this is a classic form of medicine versus synthetic or allopathic medicine. Okay?

Now, here’s my recommendation for you. If you’re concerned about this at all, if you’ve got hormone imbalances you need help with, you’re perimenopausal, menopausal, or postmenopausal and you still need some hormone balancing, here’s a great combination for you to look at.

The company is called Natural Factors and they have a product called MenoSense. MenoSense, just like it sounds. There’s also a companion product known as EstroSense.

I love recommending these two products together because the MenoSense contains that black cohosh along with other historical herbal remedies for women’s hormonal health balance in one formula called MenoSense, so you can utilize that. Then, you use the EstroSense along with it and what this does is this helps you to detoxify and disarm the harmful excess estrogens that you may have in your body via estrogen dominance.

Primarily, that’s going to be coming from environment and things like that, this estrogenic activity, plastic, for example. We don’t even think about some of this common household stuff, but they are now making lots of connection between things like plastics. As I mentioned, these cleaners that are being used in the homes and even health and beauty care products, the things we refer to as parabens for example, these all bring this estrogenic influence into the human body.

Even some of the foods that people are consuming are doing that. If you are consuming high, high levels of soy, then, you are getting excess estrogen coming into you from that. This EstroSense has the herbs and nutrient contents such as the active ingredients in cruciferous vegetables. They help to disarm and help the body to excrete these out of the system. Better to break that estrogen-dominance cycle that so many women have got in this country, so take that into consideration.

Black cohosh may cut breast cancer risk


(Reuters Health) - A new study provides preliminary evidence that an herbal medicine used to help women cope with menopausal symptoms may reduce breast cancer risk.

However, much more research is needed before the herb, black cohosh, can be recommended to prevent the disease, Dr. Timothy R. Rebbeck of the University of Pennsylvania School of Medicine in Philadelphia and colleagues caution.

Many women use hormone-related supplements such as black cohosh, dong quai, red clover, ginseng and yam to deal with hot flashes and other symptoms of menopause, Rebbeck and his team note in the International Journal of Cancer.

To examine how the use of these herbs might relate to breast cancer risk, the researchers compared 949 women with breast cancer to 1,524 healthy controls.

African-American women were more somewhat likely than European Americans to use the herbs. Women who reported taking black cohosh (5 percent of blacks and 2 percent of whites) were at 61 percent lower risk of breast cancer, the researchers found.

Also, those who took an herbal preparation derived from black cohosh called Remifemin had a 53 percent lower risk of the disease.

Previous studies have shown that black cohosh can block cell growth, Rebbeck and colleagues note. The herb is also an antioxidant, and has been shown to have anti-estrogen effects as well. On the negative side, the herb can have side effects, and animal studies have suggested it may affect breast cancer severity.

"Substantial additional research must be undertaken before it can be established that black cohosh, or some compound found in black cohosh, is a breast cancer chemopreventive agent," the researchers write.

"Furthermore," they stress, "women may wish to seek guidance from their physician before using these compounds."

Study finds no evidence black cohosh damages liver

By Amy Norton

(Reuters Health) - Despite reports of liver damage in some women using black cohosh to ease menopause symptoms, clinical trials testing one major brand of this herb have so far found no evidence that it is to blame, according to a research review.

Extracts of black cohosh, a plant native to North America, are marketed as a "natural" form of hormone replacement therapy (HRT) and are most commonly used to treat hot flashes and other symptoms of menopause.

Studies so far have come to conflicting conclusions about whether black cohosh works.

There have also been concerns raised about its safety. Reports of liver inflammation and liver failure in a small number of black cohosh users prompted some countries, like Australia and the UK, to require warning labels on the products.

But it has never been clear that black cohosh was to blame for those cases of liver damage. In most cases, doctors were unable to account for the patients' drinking habits or use of medications that can harm the liver.

And many postmenopausal women who are plagued by hot flashes and night sweats prefer to try black cohosh instead of taking hormones. Hormone replacement therapy, or HRT, has been controversial since 2002, when the Women's Health Initiative, a massive government-sponsored clinical trial, found that women on HRT had higher rates of heart attack, stroke, breast cancer and blood clots than placebo users.

Experts now advise that while HRT is effective for menopausal symptoms, women should take the lowest possible dose for the shortest time possible.

For the new study, reported in the journal Menopause, researchers combined the results of five previously published clinical trials of the black cohosh product Remifemin. Together, the studies involved more than 1,100 women who used either this black cohosh product or a comparison substance -- either an inactive placebo or a hormonal medication called tibolone -- for three to six months.

Overall, the researchers found, 88 women dropped out of the studies, but none did so because of abnormal liver enzymes, a potential sign of liver damage.

And there was no evidence that black cohosh triggered harmful changes in liver enzymes. In both the black cohosh and comparison groups, about 5 percent of women developed abnormally high levels of a liver enzyme known as AST.

On the other hand, of 37 black cohosh users who had abnormally high AST levels before treatment, 62 percent saw those levels drop back into the normal range during therapy.

The study was led by Dr. Belal Naser of Salzgitter, Germany-based Schaper & Brummer GmbH & Co., which manufactures Remifemin.

But an expert not involved in the study said the findings are consistent with other evidence that black cohosh is safe for the liver.

Dr. Richard B. van Breemen, a professor at the University of Illinois College of Pharmacy in Chicago, was part of a 2009 clinical trial that tested black cohosh against a placebo, standard hormone replacement and red clover -- another alternative therapy for menopause symptoms.

They found that over one year, black cohosh was no better than the placebo for easing hot flashes and night sweats.

But there was also no evidence that the herb harmed women's liver function.

"Although black cohosh did not prevent hot flashes in menopausal women in our study, we found that black cohosh was safe," van Breemen told Reuters Health in an email. "In particular, we tested for liver damage in our study and found that black cohosh was not hepatotoxic (toxic to the liver)."

That trial, which was funded by the U.S. National Institutes of Health, was not included in the current analysis -- which focused only on trials of Remifemin.

That narrow focus, van Breemen noted, is a weakness of the study.

Still, he said, "the conclusion...that black cohosh does not cause liver damage is consistent with the results of our investigation and many other clinical trials."

In general, experts do advise that women stop using black cohosh and tell their doctor if they develop any potential signs of liver toxicity, including abdominal pain, dark urine or jaundice (yellowing of the skin and whites of the eyes).

Three months worth of Remifemin tablets costs about $30 in the U.S. -- roughly the same as Premarin, a widely used hormone replacement drug.

Exploring Black Cohosh, Hot Peppers, in Breast Cancer Treatment

By Jenifer Frank

Dr. Erin Hofstatter, a young research scientist and breast cancer specialist at Yale’s Smilow Cancer Hospital, often prescribes tamoxifen, raloxifene and similar drugs to her patients. The drugs “reduce your risk (of cancer recurring) by half … but they come with baggage,” she tells her patients, “hot flashes, night sweats, leg cramps, small risk of uterine cancer, small risk of blood clots, small risk of stroke, you have to get your liver tested.”

Hofstatter’s unease with standard treatments for breast cancer has spurred her to seek alternative, safer ways to treat breast cancer. To this end, she has begun a study of black cohosh, in the pill form of an herb from the buttercup family, used for thousands of years by Native Americans to treat menopausal symptoms.

Dr. Erin Hofstatter, a young research scientist and breast cancer specialist at Yale’s Smilow Cancer Hospital, often prescribes tamoxifen, raloxifene and similar drugs to her patients. The drugs “reduce your risk (of cancer recurring) by half … but they come with baggage,” she tells her patients, “hot flashes, night sweats, leg cramps, small risk of uterine cancer, small risk of blood clots, small risk of stroke, you have to get your liver tested.”

Hofstatter’s unease with standard treatments for breast cancer has spurred her to seek alternative, safer ways to treat breast cancer. To this end, she has begun a study of black cohosh, in the pill form of an herb from the buttercup family, used for thousands of years by Native Americans to treat menopausal symptoms.

Just as practices like acupuncture and meditation – once considered, at best, nontraditional are now widely used to help patients cope with the side effects of cancer treatments and other illnesses, natural products – foods (blueberries, walnuts, soy), herbs like black cohosh and plant-based anti-oxidants like capsaicin (which makes hot peppers hot) have become accepted subjects for research.

But far from simply embracing these practices or foods, scientists now apply rigorous scientific methods to what are considered non-traditional medications to determine just how effective – or ineffective -- they are. A similar scientific focus is being directed at exercise, diet, and meditation. Research is also going on into something called energy healing.

“I think that when we think about therapies, whether for breast cancer or anything else, we do need to think outside of the box and evaluate things that we may not have been open to evaluating in the past,” said Dr. Anees Chagpar, director of The Breast Center - Smilow Cancer Hospital at Yale-New Haven. “Because there are natural therapies that may be very useful and helpful.

“[T]here is a paucity of scientific evidence and research to back up these complementary and alternative approaches. And so I think that anything that we can do to help shore up the knowledge that we have about their utility is a good thing,” she said.

Alternative Medicine’s Integration

Once marginalized by the medical establishment, alternative medicine has now become part of the establishment. The National Center for Complementary and Alternative Medicine (NCCAM) is one of the 27 institutes and centers that comprise the country’s premier research institution, the National Institutes of Health (NIH).

NIH data show that funding for NCCAM research projects has climbed from $54.3 million in 2000, to $97.6 million in 2014 – an 80 percent increase. Among the grantees in 2014 is Yale University, which received nearly $1 million for four research projects into complementary and alternative medicine – including one study, with the Dana-Farber Cancer Institute and the Susan G. Komen Breast Cancer Foundation – that is testing “mindfulness meditation” for children suffering from fibromyalgia or chronic pain.

In addition, the American Board of Integrative Medicine plans to give its first accreditation test in November. The exam will include questions on “Mind-Body Medicine and Spirituality” and “Whole Medical Systems” (such as homeopathy, Traditional Chinese Medicine and the ancient Indian system, Ayurveda), as well as on nutrition, dietary supplements and “Lifestyle, Prevention and Health Promotion.”

The Consortium of Academic Health Centers for Integrative Medicine, which began in 1999 as a small group trying to draw attention to and expand the use of integrative medicine, has grown into an organization of 57 medical centers, many connected to some of the country’s most prestigious medical schools and health organizations. The consortium includes the integrative medicine programs at Yale and UConn’s schools of medicine, and the Integrative Medicine Center at Griffin Hospital in Derby, which collaborates with Yale.

Alternative medicine’s evolution is at least partially fueled by public enthusiasm. A widely quoted 2007 survey, by the National Center for Health Statistics, shows that in 2006, Americans spent $33.9 billion out-of-pocket on alternative medicine. Some health professionals say this shows the widespread dissatisfaction with the traditional health system.

“Our current health care system is not sustainable. It’s not working, it’s too expensive, and people are really not that healthy,” said Dr. Mary P. Guerrera, a family practice physician at St. Francis Hospital and Medical Center in Hartford who also directs the integrative medicine program in the Department of Family Medicine at the University of Connecticut School of Medicine.

Given the popularity of alternative treatments, “It’s important for future physicians and health professionals to learn about [them],” she said. Guerrera said she’s seen “a huge bump” in the number of fourth-year medical students taking the elective course she teaches, “Integrative/Complementary and Alternative Medicine.”

Deborah Pacik, a second year UConn medical student and a longtime licensed acupuncturist, has treated cancer patients for pain, nausea and depression. “Patients have felt more energy, less nausea, more appetite, less dry mouth, and calmer and clearer with acupuncture,” she said. Deborah Pacik, a licensed acupuncturist, treats cancer patients. Credit Tony Bacewicz / C-HIT

But alternative medicine continues to have its critics. They can be found on such websites as and The Skeptic’s Dictionary. Dr. Steven Novella, a researcher and assistant professor of neurology at Yale School of Medicine, founded the take-no-prisoners website Science-Based Medicine, of which he is editor. On September 29, the site’s managing editor, Dr. David Gorski, a surgical oncologist, posted his latest attack on alternative medicine: “Quackademia Update: The Cleveland Clinic, George Washington University, and the continued infiltration of quackery into medical academia.”

Rigorous Investigations

A growing number of researchers are ignoring that skepticism by using scientific methods to measure and quantify the efficacy of unconventional treatments.

The NCCAM’s website is packed with warnings about not replacing traditional medical care with an alternative measure, and with understated dismissals of some claims from the marketplace. (On the acai berry, sold in fruit juice and as supplement: “There is no definitive evidence that acai has any special health benefits.”)

Chagpar, at Yale, summarized the attitude and motivation of many researchers: “There really needs to be further rigor to look at [complementary and alternative] therapies with the degree of scientific inquiry that we put routine drugs through.”

Hot peppers

In his 27 years as a surgeon and researcher at the Yale School of Medicine, Dr. John Geibel’s research has focused on the lower digestive system. But these days, he’s also excited about the anti-carcinogenic power of capsaicin on breast cancers. Capsaicin – capsicum is any plant from the nightshade family -- is the substance that gives hot peppers their heat, and, perhaps counter-intuitively, it has been identified as having some value as a pain reliever.

Geibel, vice chairman of the Department of Surgery at Yale, noted that genetic screening has been effective in determining whether some women will get breast cancer. “But even if you come in and perform the mastectomy, it’s difficult to impossible to remove every single [cancer] cell,” he said.

Earlier studies have shown capsaicin’s ability “to slow down or even stop the machinery of [cell] division,” he said, pointing to one in which capsaicin stopped the growth of prostate colonic tumors in a dish. What if, he posited, after a surgeon has removed a malignant tumor from a breast, the doctor can “coat the underlying tissue area with a capsaicin-based preparation to prevent any residual cells” from reproducing?

Geibel said he initially tested capsaicin on breast cancer cells in a culture to determine the dose and the best way to deliver it. “The next phase is to now take some tissue from an individual,” he said.

“It’s a relatively simple natural product,” he said. The goal of using products like capsaicin is “to have a destructive effect on the tumor, rather than a destructive effect on the individual.”

Energy Healing

With training in molecular and cellular biology, Dr. Gloria Gronowicz, a professor at the UConn Health Center, has long been looking into the effects of energy healing on tumor growth and metastasis, working most recently with a breast cancer model in mice. Energy healing on tumor growth is an area of study for Dr. Gloria Gronowicz.

Energy medicine, which includes Reiki, qigong and a practice named “Therapeutic Touch,” actually involves no direct touching of a patient or an object being studied. Rather, practitioners work with what they say is the energy emitted from their hands, which they call biofields.

A paper published in May by Gronowicz and others, in the Journal of Complementary and Alternative Medicine, said that Therapeutic Touch had prevented cancer cells in a breast cancer model from spreading, though it had not shrunk the size of the primary tumor.

“Let us use everything to help patients,” Gronowicz said of the growth in research into alternative treatments.

Black Cohosh

Hofstatter, the Yale researcher, first heard of black cohosh from the gynecologic oncologist who runs Yale’s Sexuality, Intimacy and Menopause Clinic. The oncologist asked if Hofstatter would approve of giving Remifemin – a pill form of black cohosh – to one of the young doctor’s patients.

“I was actually fearful of black cohosh to begin with,” Hofstatter said. “It basically is a plant-based estrogen, and so many times, breast cancers can be fed by estrogen.” But she found ofstattetwo 2007 clinical trials that showed black cohosh acting as a protective agent in breast cancer development.

The more she researched, “the more I realized, ‘Oh my gosh, I may have just struck a pot of gold!’ ” she said. “Not only does it not appear to significantly increase the risk of breast cancer, but actually there’s data to suggest it’s protective, both in breast cancer survivors and potentially preventive in women who’ve never had breast cancer.”

Her study, funded by Yale through the American Cancer Association, focuses on women diagnosed with DCIS, ductal carcinoma in situ -- a common, noninvasive cancer that can develop into an invasive disease.

The trial takes advantage of the time between a diagnosis of DCIS and the surgery, generally two to four weeks. Right after diagnosis, the patient will take Remifemin twice daily until her surgery. Hofstatter thenH will compare the pre-surgery DCIS cells and those in the tissue removed during surgery to see if the number of DCIS cells has dropped.

“What I liked about the study is that I felt the risk to the patient was minimal” -- because she was going to have surgery anyway – “and that it would provide good information regardless of what we showed.”

Hofstatter, who received her grant in 2011, is still recruiting subjects for the study, and hopes to have her roster filled by 2015.

And she is clear-eyed about her hopes for black cohosh. “I have no idea if it works,” she said.

“The reason we’re doing the trial is because I do not know if it helps. For all I know, it could be bad -- that’s the thing about research.”

Join C-HIT on Tuesday October 21, starting at 5:30 pm, at Gateway Community College in New Haven, for a community forum on the latest inroads and challenges in breast cancer detection, research and treatment, while showing your support for in-depth journalism. For information and to register click here.

This story was reported under a partnership with the Connecticut Health I-Team (

Black Cohosh: An Herb for Hot Flashes?

By Diane Hoffmaster

For some women, menopause symptoms are mild and can be controlled with simple lifestyle changes. For others, menopause symptoms make it difficult just to survive the day with their sanity intact. Hot flashes, moodiness, and irregular periods may be so bad you need more than a fan and a 30-minute workout session to relieve stress. When menopause symptoms get to be too much to handle, many women start looking for alternative remedies to help bring them relief. One option that has been studied for its possible menopause symptom relief characteristics is black cohosh.

Black cohosh is an herb whose roots have been used for medicinal purposes for hundreds of years. According to, it grows from Ontario, Canada south to Tennessee and west to Missouri at forest edges. Over the years, it has been used to treat joint pain, influenza, smallpox, rheumatism, headache, cough, and some nervous system disorders. Recently, it seems to be gaining popularity as a method to treat menopause symptoms.

The parts of the black cohosh plant that are used medicinally are the fresh or dried roots and rhizomes (underground stems). They can be found in health food stores, some drugstores, and online. There are many forms to choose from, including teas, capsules, tablets or liquid extract forms. How black cohosh works in relieving menopause symptoms is not yet known. There is a possibility that black cohosh exhibits some estrogen-like activity, but the evidence is contradictory.

The National Institutes of Health (NIH) has funded and analyzed numerous studies regarding the effectiveness of black cohosh as a remedy for menopause symptoms. Some study results indicate black cohosh may help relieve menopausal symptoms, but other study results do not. Studies of black cohosh have yielded conflicting data, mainly because of the short time frame studied and differences in the quantity of black cohosh taken by study participants.

While studies on black cohosh show conflicting results, many women are taking this herb as a possible solution for their menopause symptoms. If you choose to try this for yourself, what is the appropriate dose? According to WebMD, the dose of black cohosh used in studies for menopausal symptoms has been 20-40 milligram tablets of a standardized extract taken twice a day. More than 900 milligrams a day of black cohosh is considered an overdose. Directions for other forms of black cohosh will vary. Six months is the maximum amount of time anyone should take black cohosh according to some experts.

Black cohosh is not without side effects. Some people may experience headaches and upset stomach after taking this herb. People with aspirin allergies or liver problems or who are pregnant or nursing should not take this supplement. If you are taking prescription medications, talk to your doctor before starting black cohosh.

Black cohosh may provide relief of common menopause symptoms for some women. While studies on this alternative therapy are inconclusive, if you are suffering from menopause symptoms and need relief, black cohosh may be a possible solution.

Photos of Black Cohosh flowers and Plants