The rhizome and the roots of this nice North American forest plant - botanical name Cimicifuga racemosa (L.), which belongs to the plant family Ranunculaceae is known by the collective term - black cohosh. Common names which are attributed to the herb are numerous and some of the more well known are black snakeroot, the rattle weed or rattle root, the bugbane, the bugwort, and the squaw root - which must not be confused with the blue cohosh. As a genus, Cimicifuga includes twenty three temperate climate plant species, six of these are found in North America, one species is common in Europe, and the remaining species are found in the temperate regions of eastern Asia and the Far East. Several Asian plant species of this genus have properties similar to the black cohosh, and these are traditionally used in treating gynecological conditions in affected women.
The use of the black cohosh as an herbal medicine was initially practiced by Native Americans, who place great value on this particular herbal remedy to this day. Native American preparation of the herbal remedy typically involved initially boiling the root in some water, the beverage produced was drunk directly as a treatment for numerous disorders and conditions, including problems such as rheumatism, all kinds of diseases affecting women, and all debilitation such as sore throat and related respiratory tract infections. As the common knowledge about the remedial action of the black cohosh began to spread, the remedy also began to be used by the more discerning and eclectic physicians. They prescribed this herb for all the treatment of all the conditions mentioned before and particularly for the treatment of so called problems with the uterine region and especially, to stimulate menstrual flow in women affected by menstruation related disorders. All of the afore-mentioned disorders can be treated using the herbal remedy, and herbalists also suggest its use as an astringent, it has been used as a diuretic, as an alterative, in the anti-diarrhea role, as a cough suppressant, as a diaphoretic, among other known uses.
There has been very little scientific research conducted on the herb, especially studies which are designed to specifically identify the physiological activities induced by the medication-such studies have been few. The majority of such studies have also been conducted abroad and data is yet to come out. Comprehensive experiments were conducted out on mice in the 1960's and even then, the long suspected estrogenic like effects, carried out to check the herbs ability to stimulate menstruation, was not verified during the course of the study. However, following experiments began to show that a compound or a methanol like extract found in the black cohosh bears substances which can bind to the estrogen receptors in the uterine tissues of rats. Rats given this extract were observed to have a selective reduction in levels of the luteinizing hormone - these experiments were conducted on ovariectomized rats. What is inferred from these results is that the black cohosh definitely displays some degree of estrogenic activity and there is some validity to the traditional use of this herbal remedy in the treatment of gynecological disorders.
Black cohosh contains a steroidal triterpene derivative, which was isolated chemically and is known as actein, doses of this compound were found to lower the blood pressure in rabbits and in cats; however, the same results could not be obtained when administered to dogs. While some peripheral vasodilatation was observed in human subjects, the compound elicited no substantial hypotensive effects in normal persons or in hypertensive individuals.
The mid 50's were the time that the modern experience with the extracts black cohosh can be said to have started following tests using the extracts. The experimental use of the black cohosh extract was carried out in Germany, during various tests, German gynecologists trying to discover an alternative compound to be used in hormone replacement therapy - a method which at that time was displaying unwanted side effects in many patients - these scientist reported successful clinical experiences with the extracts, that is the black cohosh was found to capable of limiting the menopausal symptoms affecting the women under the experiment. While not controlled clinical tests, at least 14 clinical reports on the black cohosh, involving more than 1,500 patients was published in German by 1962. The successful use of black cohosh was reported by the study groups in the treatment of pre-menopausal and menopausal symptoms - some of the claims were a reduction in the appearance of hot flashes and significant improvement of the depressive moods, which often affects menopause women.
Native Americans have traditionally used remedies made from the black cohosh for treating problems faced exclusively by women, since most of these were gynecological symptoms, and hence the black cohosh was aptly called "squawroot" by most Native Americans. The treatment of gynecological symptoms such as menstrual pain and other female problems which results in the excess progesterone production, and other menopausal symptoms, particularly the hot flashes, symptoms of debility, and depression are all treated using the herbal remedies made from the black cohosh.
In Europe, the herbal remedies made from the black cohosh are normally prescribed in the treatment of various conditions related to women. These problems can include the physical symptoms which come along with premenstrual syndrome (PMS), the symptoms associated with dysmenorrheal, and those coming along with menopause in the women. The affects of the black cohosh and its abilities include an action similar to the female hormone estrogen, the ability to bind to the estrogenic receptors within the body, and the full suppression of luteinizing hormones in the female body. Patients have also reported the occasional successful treatment of stomach pain or the treatment of intestinal discomfort through the use of the black cohosh. Black cohosh has not been successful in the treatment of mutagenicity, teratogenicity, and carcinogenicity in all studies conducted to prove this potential, for example, a six month long study on the chronic toxicity in rats treated using black cohosh, at almost ninety times the human dose - failed to prove any effective remedial action. At this time, the need for further studies on the black cohosh as a potential cure for the mentioned illness will not be helpful and are unnecessary.
Some disorders such as inflammatory arthritis are treatable using the black cohosh and this have been confirmed again and again, the positive treatment and cure from such problems is true particularly when the disorder is associated with menopause and its related conditions. The black cohosh is also a proven and very effective remedy against all rheumatic problems, including such severe disorders such as rheumatoid arthritis - especially when it is used for long periods of time and on a regular basis.
The value of the black cohosh is also apparent in its sleep inducing and sedative action, indeed the treatment of a variety of conditions, including high blood pressure and tinnitus - persistent ringing in the ears - is possible using the black cohosh. The herbal remedies of the black cohosh and its peculiar properties are also effective against whooping cough and asthma and their associated physical symptoms.
Other medical uses
Habitat and cultivation
The black cohosh grows wild and is native to parts of Canada and its areas along the eastern states of the US - native stocks of the plant extend as far south as the state of Florida in the contiguous US. Shrubby areas and shady spots in the woodlands form ideal growth zones for the black cohosh - though the herb may grow in other kinds of habitats including grasslands. Europe has been colonized by this herb and it can be seed in the wild, these herbs are the legacies of self-seeded forms arising from initial cultivated stocks. Harvesting of the herb normally occurs in the autumn, and the black cohosh is grown from the harvested seeds.
The estrogenic action of the black cohosh is confirmed and well established, in addition, the herb is believed to aid in reducing the levels of the pituitary luteinizing hormone within the body of the patient. This action is believed to lead to a decrease in the production of progesterone in the ovaries of women.
Extracts of the black cohosh have been compared in during five clinical studies undertaken since the 80's - none with a double-blind design. The comparison was on the action of the herbal extracts against the actions of a placebo and/or an estrogen replacement, subjects were being treated for menopausal symptoms and related conditions. Following six to eight weeks of treatment during the open, and multi center study, the data derived from 629 patients suggested very favorable results in at least eighty percent of the test patients. Some of the stated improvements the patients reported, included relief from many neuro-vegetative complaints such as sudden hot flashes, persistent sweating, headache, vertigo, heart palpitations, and alleviation from tinnitus - ringing in the ear. Though not specified, at least seven percent of the test patients reported side effects of one kind or the other - these however, did not result in the immediate discontinuation of the therapy or dosage - presumably because the side effects were not severe or life threatening.
The treatment of different menopausal disorders and sudden hot flashes had positive results during a German trial, this study which was published in 1995, involved the use of the black cohosh in combination with the St. John's wort herb, according to the researchers; at least 78% effective healing or relief was noticed in test subjects.
An inhibitory effect was seen in the LH secretion in both ovariectomized rats as well as in 110 menopausal women, during the course of a study conducted in 1991, these results demonstrate the selective suppression effect of the extract over the luteinizing hormone secretion in women experiencing menopause.
The positive effects of two Asian species of the herb, the C. heracleifolia and the C. foetida, was observed during a recent Japanese experiment - these herbs affected serum calcium and phosphate levels and also had some action over the bone mineral density in the test rats. The Japanese scientists concluded that black cohosh's rhizome has potential in the treatment of osteoporosis, mainly in menopausal women, and this herb could be potentially used in the treatment of such disorders.
The herbal remedies prepared from the black cohosh herb come in a variety of forms, the herb can be taken in a crude form, the dried root can be used, as the rhizome - about 300-2,000 mg every day, or it can be used in the form of a solid, in the dry powdered extract form - doses can be 250 mg taken thrice every day. 2 - 4 ml of herbal tinctures can also be taken at every day during the whole length of the treatment regimen. Many herbal stores also have the standardized extracts of the herb, these extracts contain one mg of the active compound deoxyacteine in each tablet - these can be taken as daily supplements. Normally, doses are of one 40 mg dose two times every day of the treatment regimen. It is best to discontinue supplementation of the black cohosh herb after continuous use of six months.
Side effects and cautions
Lactating and pregnant women are advised not to take the black cohosh, as the herb has very strong estrogen like effects, and the herbal remedy may act within the body as a dose of estrogen. Continual heavy doses of the herb can induce extreme abdominal pain, symptoms such as nausea, persistent headaches, and may even cause spells of dizziness to develop from time to time. A doctor must be consulted by all women already on estrogen therapy, if they want to also add supplements of the black cohosh as part of their treatment program.
How it works in the body
The black cohosh is believed to balance the estrogen levels in the body and gynecologically speaking, this is the view held by herbalist in North America. A strong estrogenic activity is attributed to the black cohosh by the European herbalists, herbalist there believe that the strong estrogenic action of the black cohosh once ingested may actively work in reducing the levels of the hormone progesterone in the body and at the same time promote estrogen levels within the woman's body. The herbal remedy is therefore suggested by herbalists to combat a lack of estrogen in the body and to bring down excessive levels of progesterone in women. The black cohosh also has other effects in the body, and herbalists believe that it affects the musculoskeletal system through its anti-inflammatory actions in people with arthritic conditions and disorders. The black cohosh is also known for its sedative qualities, this property is used in treating other parts of the body, for example, it is often used as an herbal measure in lowering the elevated blood pressure in people, and the herbal remedies made from the black cohosh are also used to reduce spasms and tensions in the muscles. The herb also has a positive effect over the respiratory system and it is extensively used in treating disorders of the respiratory system.