Evidence supporting the use of: Black cohosh
For the health condition: Fibroids (uterine)

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Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Black cohosh (Actaea racemosa) has been used in traditional herbal medicine, particularly in Native American and early European herbal practices, primarily for women’s health concerns such as menopausal symptoms, menstrual irregularities, and occasionally for uterine conditions like fibroids. The reasoning behind its use for uterine fibroids is based on its reputed ability to modulate hormone levels and relieve symptoms like pelvic pain and heavy menstrual bleeding, both of which are common in women with fibroids. Traditionally, black cohosh was believed to act as a “female tonic” and to help balance the menstrual cycle.

However, scientific evidence supporting the efficacy of black cohosh specifically for uterine fibroids is limited. Most modern clinical research focuses on its role in alleviating menopausal symptoms, with few well-designed studies examining its direct impact on fibroid size or associated symptoms. Some in vitro studies suggest that black cohosh extracts may have weak estrogenic or selective estrogen receptor modulator (SERM)-like effects, which could theoretically influence hormone-dependent conditions like fibroids. A few small clinical trials and observational studies from China have explored black cohosh in combination with other herbs for fibroid management, showing some symptom relief, but these studies lack rigorous controls and are not widely replicated.

In summary, the use of black cohosh for fibroids is based largely on traditional practice rather than robust scientific validation. Its role in fibroid management remains speculative, and more research is needed to establish its efficacy and safety for this specific condition.

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