How Does It Work?:
Black Cohosh and Menopause



Black cohosh (Cimicifuga racemosa) is a perennial herb in the Ranunculaceae (buttercup) family. This herb has traditionally been used to support women's health. Its approved monograph in The Complete German Commission E Monographs discusses the well-documented use of Cimicifuga racemosa for the relief of menopausal complaints.

The primary constituents in Cimicifuga racemosa extract are glycosides, specifically triterpene glycosides which include cimicifugoside, actein and 27-deoxyactein. The Cimicifuga racemosa extract used in Black Cohosh is standardized to these triterpene glycosides measured as 27-deoxyactein.

The exact mechanism of action for the effects of black cohosh has not been fully elucidated. Early research hypothesized that black cohosh exerted estrogen-like effects. Recent animal research shows that black cohosh binds to the estrogen receptor; however, it does not affect the luteinizing hormone level and does not exhibit estrogen-like effects. Thus, there is currently no consensus as to the biological effect of this binding.Research indicates that Cimicifuga racemosa does not alter estrogen levels and does not change the thickening of the lining of the uterus.

How black cohosh works at the cellular level is currently being studied in several ongoing research projects. To date, there is no definitive published data available to clearly describe the process; however, forty years of clinical studies on a standardized black cohosh extract have shown efficacy in the relief of hot flashes, profuse sweating, insomnia and depressive moods associated with menopause, with few adverse effects.

In a randomized, placebo-controlled, double-blind study, a researcher compared women who took standardized black cohosh extract with women taking a placebo. At the end of the study, the women taking the standardized black cohosh extract showed improvement relative to the placebo as measured by the Kupperman Menopausal Index, the Hamilton Anxiety Scale, and the Maturation Index of vaginal epithelium. No clear improvement of menopausal complaints was observed in the control (placebo) group. This study demonstrated clinical and statistical improvement of menopausal symptoms by the women taking the standardized black cohosh extract.

In a more recent 6-month randomized, open-label trial involving 53 women, significant decreases in unwanted menopause-related symptoms were reported following the administration of Cimicifuga racemosa.

The benefits of Black Cohosh may be first experienced in two to three weeks; however, the full benefits may not be realized until after four to eight weeks of administration.