Synopsis

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

Cohosh—referring to both black cohosh (Actaea racemosa) and blue cohosh (Caulophyllum thalictroides)—has a longstanding use in traditional herbal medicine, particularly among Native American groups and later in Western herbal traditions. Black cohosh is more commonly cited regarding female reproductive health, including symptoms associated with premenstrual syndrome (PMS). "PMS Type H" typically denotes the "Hyperhydration" subtype, characterized by bloating, breast tenderness, and water retention. Traditional herbalists have employed black cohosh as a remedy for various menstrual irregularities and discomforts, including those resembling PMS Type H symptoms.

However, while the traditional use is evident, scientific validation is limited. Most clinical research on black cohosh focuses on menopausal symptoms (especially hot flashes), with little direct evidence supporting its efficacy for PMS or specifically for PMS Type H. Some herbal texts and anecdotal reports claim that black cohosh may act as a mild diuretic and modulate hormonal balance, which could theoretically address hyperhydration symptoms, but robust clinical trials are lacking. Blue cohosh, meanwhile, is less commonly recommended for PMS due to safety concerns.

In summary, the use of cohosh for PMS Type H is grounded in traditional herbal practice rather than rigorous scientific study. Evidence quality is low (rated 2), with most support coming from historical use and practitioner anecdotes rather than controlled clinical trials.

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