Evidence supporting the use of: Black cohosh
For the health condition: Hot Flashes

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Synopsis

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

Black cohosh (Actaea racemosa, formerly Cimicifuga racemosa) is an herb traditionally used by Native Americans and later in Western herbal medicine, particularly for women's health issues such as menopausal symptoms, including hot flashes. Its use for hot flashes is partly rooted in tradition, but there is also a significant body of scientific research investigating its efficacy for this purpose.

Clinical studies evaluating black cohosh’s effects on hot flashes have produced mixed results. Some randomized controlled trials and meta-analyses report modest reductions in the frequency and severity of hot flashes among menopausal women using standardized black cohosh extracts, especially in comparison to placebo. However, other studies find no significant benefit. The variability in study outcomes may relate to differences in extract preparations, dosing, and study duration.

The proposed mechanisms of black cohosh’s action do not involve estrogenic activity, as once believed; instead, it may modulate serotonin receptors or exert effects on the hypothalamus, though this remains under investigation. Major medical organizations, such as the North American Menopause Society, consider the evidence for black cohosh’s efficacy to be limited and inconsistent, and recommend it be used with caution. Safety concerns, particularly regarding liver health, have also been raised, though serious adverse events are rare.

In summary, while black cohosh is widely used and has some scientific backing for the relief of hot flashes, the overall quality and consistency of evidence is moderate to low, supporting a rating of 2 out of 5 for this use.

More about black cohosh
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