The Practical Herbalist

Black Cohosh

According to a recent study, Black Cohosh had no effect in treating perimenopausal hot flashes. My concern is not that black cohosh is ineffective, but rather that the reports fail to understand and explain the dynamics of black cohosh in regards to hot flashes and other perimenopausal symptoms.

Black cohosh is not a standard herb historically in the Chinese herbal or European/Western styles of herbal medicine. Rather it is referred to as a "squaw root". One of many roots that were used by native American women for menstrual and pregnancy issues. It was adopted by early European herbalists who came to this country. They used it for regulating the uterus and for promoting labor which were the major uses of the herb. In one of the references that I have, the author lists the functions of the herb in order of strength and importance. The functions related to hot flashes were listed near the bottom as an incidental function. This means that any benefit black cohosh has in regards to hot flashes, could easily be negated by various foods in the diet (something that I am sure was not controlled for in the studies). So why is Black cohosh one of the top selling herbs for dealing with hot flashes when there are hundreds of foods and herbs that can do a better job?

The answer is the the ongoing application of western biomedical thought to the use of herbs. Black cohosh is very specific in its effects to the uterine system. Therefore since menopause is the shutting down of the uterine system, logically this must be a good herb to use to control the symptoms of that change. The problem with that logic, is that from an herbal perspective the symptoms you want to control are a response to the shutting down of the uterine system, not the symptoms related to the uterus itself. Basically black cohosh is a mild herb being used for the wrong reason. This is why many women that I have seen in my practice have found little relief in black cohosh supplements.

There are very effective herbal formulations that do control hot flashes, night sweats, dryness and mood swings. The process of getting these symptoms under control starts with talking to a herbalist who can determine the specific dynamics of your body and prescribe herbs and a diet that will help your body to bring these symptoms under control. For a further explanation on how to use foods and herbs properly to deal with perimenopausal symptoms, check out the article here on my website titled: The Herbal Approach to Menopause