Black Cohosh - Non-Timber Forest Products

Reviews black cohosh research; includes uses, pharmacology,
pharmokinetics, clinical studies, dosage, adverse effects, drug interactions,
contraindications, and references. The active constituents include triterpene
glycosides such as actein, cimicifugoside, and 27–deoxyactein. The most
popular commercial product, Remifemin ® , is standardized to contain 1
mg of 27–deoxyacetin per 20-mg tablet. Studies on the presence of the
isoflavone formononetin have yielded conflicting results. Several clinical
studies indicated estrogenic effects for black cohosh, such as decreased
luteinizing hormone levels in menopausal women and increased uterine
weight in rats. Other studies failed to show these results. Several clinical
studies that demonstrated significant improvement in psychological
and somatic symptoms of menopause as measured by the Kupperman
Menopausal Index and the Hamilton Anxiety Scale are summarized. All
studies utilized Remifemin ® at dosages from 40 to 80 mg twice daily.
Research conducted by the manufacturer resulted in a recommended
dose of one tablet twice daily. Effects were apparent after two weeks of
use, and maximum benefit seen after eight weeks. Side effects included
gastrointestinal upset in a small percentage of consumers. Recent studies
have concluded that black cohosh is safe for women with a history of
estrogen-related cancer. The author noted that no drug interactions were
known, and that black cohosh should not be used during pregnancy.
Keywords: Assessment scales, chemical constituents, dosage, medicinal
uses, physiological actions, Remifemin ® , research reviews, side effects.
Petho. 1987. Climacteric complaints are often helped with black cohosh.
Ärztliche Praxis. 47: 1551-1553.
Reviews the effectiveness of Remifemin ® for treating menopausal
symptoms in an open study involving 60 female patients who replaced
hormone injection therapy with black cohosh tablets (40 mg twice daily)
over a 6-month period. The Kupperman Menopausal Index, subjective
observations, and the number of hormone injections needed after initiation
of Remifemin ® therapy were used to measure efficacy. Eighty-two percent
of patients reported the black cohosh therapy as good or very good, and 58
percent did not need additional hormone injections. No side effects were
reported over the six-month period.
Keywords: Assessment scales, clinical studies, hormone replacement
therapy, medicinal uses, Remifemin ® , side effects.
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