Happy Sunday! Today I would like to discuss black cohosh as a potential alternative to treat menopausal or perimenopausal symptoms.
During perimenopause, ovarian function starts to decrease, lowering inhibin B and anti-mullerian hormone, while increasing the secretion of follicle-stimulating hormone (FSH), resulting in irregular ovulatory cycles and oestrogen levels. These hormonal changes can result in hot-flashes, vaginal dryness and sleep disturbances. While many women will then consider hormone replacement therapy to address these symptoms, others interested in natural alternatives often turn to cimicifuga racemosa or Black Cohosh (BC).
Some studies describe the herb to have weak oestrogen-like effects on the body, mimicking oestradiol while suppressing luteinising hormone secretion. Other studies describe BC’s effect as a selective oestrogen receptor modulation (SERM). Other researchers are of the opinion that BC’s effects relate to the central nervous system, perhaps in relation to serotonergic pathways or due to its anti-inflammatory effects. More recent articles suggest that BC’s hormonal effect might have been misunderstood, and that the herb may actually contain antinociceptive agents, blocking the sensory results of painful stimulus.
So at the moment, there is not a clear view of how BC really works. However, the Committee on Herbal Medicinal Products (HMPC) considers black cohosh as an acceptable herbal treatment for menopausal symptoms, based on its well-established use, meaning that the active ingredient of BC has been used for +10 years with documented results in approximately 20 clinical studies involving over 6,000 patients.
BC does not seem to present any known food interactions, although there are reports of BC interacting with certain drugs: atorvastatin, cisplatin, drugs metabolised by P450 2D6 (CYP2D6) and hepatotoxic drugs – so if you are on any of these, consult with your doctor before you start taking BC.
Potential adverse effects of BC to take into account could include headaches, dizziness, breast tenderness, vaginal bleeding and/or irritability, amongst others. Furthermore, research indicates that BC could result in liver toxicity in some women. So if you are taking statins or drink alcohol regularly, you would need to be extra careful with your liver health. Also, BC should be taken only up to a year, as current research haven’t examined its effect for longer periods of time.
Hope this was useful! Let us know if you have any questions or would like further nutritional support. Stay healthy!
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