What is black cohosh?
Black cohosh is a plant in the buttercup family that grows in eastern and midwestern North America. Its scientific name is Actaea racemosa (also called Cimicifuga racemosa). Black cohosh is also called black snakeroot, bugbane, rattleroot, squawroot, and macrotrys or macrotys. The underground stems and roots of the black cohosh plant are used in herbal supplements.
Black cohosh was first used by American Indian or Alaska Native people. Extracts from black cohosh have been used as medicine to treat menopausal symptoms in Europe for over 50 years. In Germany, black cohosh has been approved to treat menstrual period pain, menopausal symptoms, fast heartbeat, nervousness, irritability, sleep problems, noise or ringing in the ears, dizziness, sweating, and depression.
How is black cohosh taken or given?
Black cohosh is taken or given by mouth as a dietary supplement. It is sold as a powdered herb, whole herb, liquid, or dried extract in pill form.
What laboratory or animal studies have been done using black cohosh?
In laboratory studies, tumor cells are used to test a substance to find out if it is likely to have any anticancer effects. In animal studies, tests are done to see if a drug, procedure, or treatment is safe and effective in animals. Laboratory and animal studies are done before a substance is tested in people.
Laboratory and animal studies have tested the effects of black cohosh. For information on laboratory and animal studies done using black cohosh, see the Laboratory/Animal/Preclinical Studies section of the health professional version of Black Cohosh.
Have any studies of black cohosh been done in people?
Observational studies of postmenopausal women without a history of breast cancer have not shown a link between black cohosh and breast cancer prevention. However, one case-control trial found that postmenopausal women who took black cohosh had a 53% decrease in risk of breast cancer compared to postmenopausal women who did not take black cohosh. A retrospective cohort study of patients with breast cancer and survivors of breast cancer who took black cohosh extract also showed lower risk of recurrence.
Observational and open-label studies have shown some benefits of black cohosh on menopausal symptoms in cancer and noncancer populations. However, clinical trials have not confirmed these effects.
A review of observational studies of patients with breast cancer and survivors of breast cancer looked at the effects of taking an herbal supplement with black cohosh extract with or without hormone therapy on menopausal symptoms. Patients who took black cohosh reported fewer and less severe hot flashes and other menopausal symptoms. An open label study in Germany showed similar results in breast cancer survivors who took black cohosh and a hormone therapy.
Have any side effects or risks been reported from black cohosh?
Few side effects have been reported from the use of black cohosh. The most common side effects were nausea, joint pain, and rashes. Side effects are likely related to problems with product quality rather than black cohosh itself.
A few studies have reported that the risk of interactions between black cohosh and other medicines is small. One study found that black cohosh may lower the effect of medicines that reduce cholesterol levels, such as statins.
Is black cohosh approved by the U.S. Food and Drug Administration (FDA) for use as a cancer treatment in the United States?
The FDA has not approved the use of black cohosh as a treatment for cancer or any other medical condition.
The FDA regulates dietary supplements separately from foods, cosmetics, and drugs. The FDA's Good Manufacturing Practices require that every finished batch of supplements is safe and that the claims on the label are true and do not mislead the consumer. However, the FDA does not regularly review the way that supplements are made, so all batches and brands of black cohosh supplements may not be the same.