Black cohosh (Actaea racemosa or Cimicifuga racemosa, snakeroot, black bugbane, rattleweed, macrotys, and rheumatism weed), a member of the buttercup family, is a perennial plant native to North America. Black cohosh is most likely used for menopausal symptoms, including hot flashes (also called hot flushes) and night sweats, vaginal dryness, heart palpitations, tinnitus, vertigo, sleep disturbances, nervousness, and irritability[1].
RECENT RESEARCH
There is a report that a 76-year-old postmenopausal woman who has been taking Black Cohosh for years has had syncopal attacks multiple times during the past years associated with bradycardia with the heart rate dropping to 30 beats/minute. Discontinuation of Black Cohosh resulted in a gradual resolution of bradycardia, suggesting a plausible association.(2)
Ryoichi Sadahiro and colleagues conducted a meta-analysis of randomized controlled trials conducted to investigate the treatment effect on menopausal symptoms by Black Cohosh extract both alone or combined with other related active ingredients. They reviewed 22 articles of 2,310 menopausal women, and concluded that "black cohosh extracts were associated with significant improvements in overall menopausal symptoms." However, black cohosh did not improve anxiety significantly. (3)
REFERENCE
1. Black Cohosh, Dietary Supplement Fact Sheets, NIH website, May 04, 2024.
2. Ahmad W Haddad et al, Black Cohosh: An Uncommon Culprit of Bradycardia in Postmenopausal Women, Cureus. 2024 Mar 11;16(3):e55984.
3. Ryoichi Sadahiro et al, Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis, Menopause. 2023 Jul 1;30(7):766-773.