Black Cohosh for Menopause Relief
An extract of black cohosh (Cimicifuga racemosa) can relieve menopause symptoms as effectively as a low-dose estrogen patch, according to Gynecological Endocrinology (2005;20:30–5).
Menopause, the time when a woman’s menstrual cycles end, leads to a drop in estrogen and progesterone levels that contributes to many of the early symptoms of menopause, such as hot flashes, night sweats, and mood swings. Hormone replacement therapy (HRT) has been used for decades to relieve the symptoms of menopause, but its link with an increased risk of breast cancer and stroke has led women to search for safer approaches. Low-dose estrogen administered through the skin via a patch has been shown to be effective for reducing symptoms while not increasing the risks of estrogen-related problems. A low dose of progesterone is typically used with the estrogen patch to prevent the lining of the uterus from building up (a potentially precancerous change).
Black cohosh is an American herb that has been used traditionally to treat conditions related to both excessive and deficient levels of estrogen. In postmenopausal women, chemicals from this plant can bind to cells in the body that are affected by estrogen; these chemicals have a weak estrogen-like effect. Research has shown that extracts from black cohosh do not thicken the uterine lining, despite its similarity to estrogen; moreover, there is no evidence that the use of black cohosh contributes to the risk of breast cancer or stroke.
In the current study, 64 healthy women who had reached menopause at least six months previously, were experiencing at least five hot flashes per day, and had never used HRT were chosen to participate. They were randomly assigned to receive either 40 mg of an extract of black cohosh per day or weekly low-dose estrogen patches administering 25 mcg of estrogen per week for three months. The women receiving the estrogen patches also received a synthetic progesterone-like medication during the last 12 days of the study. Women recorded the number of hot flashes they experienced each day during the study. They also answered questionnaires monthly to evaluate their hot flashes and emotional symptoms, and had blood tests and an ultrasound exam of the uterus at the end of the study.
Both treatments significantly reduced hot flashes, anxiety, and depression within the first month and through the end of the study. The degree of improvement in these symptoms was the same in the women receiving the black cohosh and those receiving the estrogen patch. Only the women using the estrogen patch, however, had a reduction in vaginal dryness. Blood tests further revealed that black cohosh and the low-dose estrogen patch had positive effects on cardiac risk: the use of black cohosh led to an increase in levels of beneficial HDL cholesterol, the estrogen patch reduced levels of total cholesterol by the end of the study, and both treatments significantly reduced harmful LDL cholesterol levels.
These results add to the evidence that an extract of black cohosh can effectively relieve menopausal symptoms. Moreover, they demonstrate that black cohosh is as effective as the low-dose estrogen patch for relieving most symptoms, and can even have a positive impact on cardiac risk. Black cohosh is therefore a reasonable option for women who should not use hormones for medical reasons, and for women who prefer nonhormone approaches.
Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.
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