Black cohosh (Actaea racemosa or Cimicifuga racemosa) is an herbal supplement commonly used to treat hot flashes, night sweats, vaginal dryness, and other symptoms of menopause. While it has a long history of use in traditional medicine, research on its safety and efficacy has had mixed results.
Some key points on the safety of black cohosh:
- Multiple clinical trials have found black cohosh effective for relieving menopausal symptoms, compared to placebo. Symptom relief is generally similar to low-dose hormone therapy.
- Short-term use for up to 6 months appears relatively safe for most women, based on clinical studies. Side effects are usually mild, like stomach upset, headache, or rash.
- Long-term safety is less clear. There have been some concerns that long-term use could potentially damage the liver in susceptible individuals. However, the evidence is inconclusive. Monitoring liver function is recommended.
- Black cohosh should be avoided in women with liver disease, or who use alcohol heavily or take medications that are metabolized by the liver. Use caution if combining black cohosh with other herbs or supplements as well.
- There have been occasional case reports linking black cohosh to liver toxicity. However, a causal relationship has not been definitively established. Many experts feel the risk is small when black cohosh is used appropriately.
- It does not appear that black cohosh increases the risk for hormone-sensitive cancers like breast and uterine cancer. If you have had cancer in the past, discuss using black cohosh with your oncologist first.
- Black cohosh should not be used by pregnant or breastfeeding women due to insufficient safety data.
In summary, short-term use of black cohosh for menopausal symptoms may be reasonably safe for otherwise healthy women under medical supervision. However, due to outstanding questions about liver toxicity risk with sustained use, long-term safety cannot be assured based on currently available research. Monitoring liver blood tests and avoiding risk factors like alcohol use, preexisting liver disease are prudent precautions if using black cohosh to manage menopausal symptoms. As always, consult your healthcare provider before starting any new supplement regimen.
For personalized guidance on managing menopause with bioidentical hormones, nutrition and lifestyle changes - schedule a consultation at
Balanced Hormones Center. Our compassionate, women-centered approach focuses on your unique needs so you can thrive during this transition and beyond. Mention this article for 10% off your initial visit!