Evidence supporting the use of: Cohosh
For the health condition: Hot Flashes

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Synopsis

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

Black cohosh (Actaea racemosa, formerly Cimicifuga racemosa) has a long history of traditional use, especially among Native American populations and in European herbal medicine, for relieving menopausal symptoms such as hot flashes. Its use became widespread in the 19th and 20th centuries as an alternative to hormone replacement therapy. The proposed mechanism is thought to involve estrogenic or serotonergic pathways, though this remains unclear.

Scientific validation for black cohosh’s effectiveness in treating hot flashes is mixed and generally weak. Some clinical studies and meta-analyses have shown modest benefit compared to placebo, but others have found no significant difference. The American College of Obstetricians and Gynecologists (ACOG) and other medical bodies note that evidence is insufficient to recommend black cohosh as a reliable treatment for hot flashes. Additionally, the active constituents and exact mechanism of action remain uncertain, and concerns about liver toxicity have been raised, though causality is not definitively established.

In summary, black cohosh’s use for hot flashes is primarily based on traditional practice rather than robust scientific evidence. While some women report benefit, well-conducted studies have not consistently confirmed efficacy, and its safety profile is not fully established.

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Products containing Cohosh

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