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Blog: MenoPause ~ take time to think about it

Supplement safety: black cohosh & menopausal symptoms

by Margery Gass | Oct 31, 2012
Many women use botanical supplements like black cohosh during menopause. In this post, I'm going to briefly summarize research, possible risks, and how to be a smart consumer regarding this herb. Black cohosh (Actaea racemosa, also called Cimicifuga racemosa) is a popular non-drug treatment for menopause symptoms. Evidence about the effectiveness and safety of black cohosh for treatment of hot flashes is mixed: some studies show improvement of menopause symptoms and some show no benefit. There are no long-term safety studies yet, and most are shorter than 6 months. Future black cohosh studies should give us more information about the proper and safe use of this herb.

Meanwhile, there have been over 50 reports of liver damage such as hepatitis and liver failure with use of black cohosh-containing products. Cause and effect is difficult to prove in these situations, but the number of similar reports is concerning. Because black cohosh is harvested from plants grown in the wild, there is a risk of use of the wrong plant species and adulteration with harmful materials from other wild plants. The US Pharmacopeia states that any product containing black cohosh should carry the following statement: "In rare cases, black cohosh has been reported to affect the liver. Discontinue use and consult a healthcare practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice."

Here at NAMS, we recommend that you buy black cohosh from a reputable company and use it for a short time if it lessens your menopause symptoms. If it is not effective for you, do not use it. The most common side effects of black cohosh are stomach upset and headache.

How can you find the safest source of black cohosh? The US Food and Drug Administration (FDA) is unfortunately not required to inspect supplements. It is up to all of us to look out for our safety when using them. Can seals of approval help? For an interesting discussion of the potential value of seals of approval for supplements, read Kaiser Permanente's message to its members. Additionally, the National Center for Complementary and Alternative Medicine is a wonderful source of accurate information about alternative therapies. I encourage you to check it out. Note that there is an entire section on herbal products entitled "Herbs at a Glance," including specific information about black cohosh. Other excellent resources for consumers are the Office of Dietary Supplements and the FDA's overview of supplements and safety.


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4 Comments

  1. 1 Donna D. 30 Jul
    Could I have information about products to treat menopausal symptoms like Menoquil or MacaFem?
    Thank you.
  2. 2 Patsy Silk 10 May
    I DO TAKE ESTRADIOL,BUT I STILL HAVE REAL BAD HOT FLASHES.HELP.IM 59.
  3. 3 lindy obrien 15 Jan
    i am desperate to find something i  can take to re leave hot flashes im getting them mainly night i have to change pjs three times a night im so exhausted im finding it difficult to sleep .
    i get them a few times in the day aswell please can you recommend the best relief for this i can not take hrt im a x model and ive dieted all my life i can not bare to put weight on i swim 3 times a week i do 210 lengths a week to keep fit . ive been told about a cream you can use and then the black ghosh,   im unemployed i can not waist money what can i get for the best relief ? please can you give me some advice i was 50 in December ive not had a period for 12 months i also suffer with my thyroid . i sometimes think it could be this as my mother did not stop her periods till she was 58 please help thankyou . 
  4. 4 Sara Biston 17 Jul
    Every woman hit menopause. Women must know each and every thing about menopause.  Thank you for sharing such a useful information with us. I'll surely share this article with my mom and aunt who are soon to hit menopause.  I got some more information about menopause here also - 
    http://www.thebeautyinsiders.com/menopausal-guide-for-women-when-it-begins-causes-treatments-and-more.html

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MenoPause: the blog!

Posts to our Blog are written by NAMS staff members and Dr. Margery Gass. All posts are reviewed and edited by Dr. Gass. We strive to bring you the most recent and interesting information about various aspect of menopause and midlife health. We accept no advertising for our website. We want you to have accurate, unbiased, evidence-based information. 

Margery L.S. Gass, MD, NCMP
NAMS Executive Director

An internationally recognized leader in the field of menopause, Dr. Gass became Executive Director of The North American Menopause Society in 2010. Dr. Gass has been an investigator on numerous research projects, including serving as a principal investigator for the Women’s Health Initiative, and has published and presented on a wide range of topics related to menopause, including osteoporosis, sexual dysfunction, and hormone therapy.

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