Address menopausal symptoms with black cohosh

Traditional Values

Women have traditionally used the herbal treatment black cohosh to address menopausal symptoms , according to a study that appears in the February 2006 issue of Obstetrics & Gynecology.

In the U.S., black cohosh is considered an “alternative” treatment. But in Germany (where this study was conducted) the use of herbal supplements is far more common. So when a team of researchers from several different research institutions in Berlin designed a study to examine the effects of herbals on menopausal symptoms and associated depression, they chose two traditional treatments that are considered “mainstream” in their country: black cohosh and St. John’s wort.

Good and very good

The Berlin team recruited 301 women who had been experiencing a combination of menopausal symptoms and “pronounced psychological component” (read: depression) for at least six months.

For eight weeks, half the women received two tablets per day of the combined herbs while half received placebo tablets. For an additional eight weeks the dosage was cut to just one tablet per day. Each tablet contained one milligram of triterpene glycosides (the active ingredients of black cohosh), and 0.25 milligrams of hypericine (the active ingredient of St. John’s wort).

Results were dramatic. Using the Menopause Rating Scale, researchers found that scores decreased by half in the treatment group, but less than 20 percent in the placebo group. And using the Hamilton Depression Rating Scale, scores dropped by more than 40 percent in the treatment group and about 13 percent in the placebo group.

Calling the treatment “significantly superior” to placebo, researchers also noted that when symptom results were isolated, hot flashes decreased by more than 50 percent in the treatment group. In a post-study poll of the subjects, more than 60 percent rated the black cohosh/St. John’s wort combination as “good” or “very good.”

A warning

In 2002 I told you about a joint study from Columbia University and George Washington University in which researchers examined the results of 29 independent studies on alternative treatments for symptoms of menopause. The Columbia/GWU team concluded that, overall, only one alternative therapy was shown to be effective in treating menopausal symptoms, and especially hot flashes: black cohosh.

As with all supplements, it’s a good idea to consult with your doctor or health care provider before using black cohosh. In some cases, black cohosh has been associated with mild side effects such as headaches, stomach upset and weight problems. In the Berlin study, researchers stated there were “no relevant group differences regarding adverse events.”

But there’s one important caution that women and their doctors need to be aware of. Black cohosh contains natural phytoestrogens, which may act much like the hormone estrogen. A 2003 study using mice found that the herb might make breast cancer more aggressive and more likely to spread to other organs.

At this time there’s no evidence that black cohosh will produce the same effect in women, and no evidence that the herb prompts the development of breast cancer. This is an issue I’ll watch closely as further research emerges.

Sources:
“Black Cohosh and St. John’s Wort for Climacteric Complaints” Obstetrics & Gynecology, Vol. 107, No. 2, February 2006, greenjournal.org
“Black Cohosh/St. John’s Wort Could Ease Menopause Symptoms” Clarisse Douaud, NutraIngredients, 3/2/06, nutraingredients.com
“Herbal Combo Eases Menopause Complaints” Reuters Health, 2/28/06, reutershealth.com