In the late 1800s, when many women were embarrassed to consult male doctors about "female problems," they found comfort in Lydia Pinkham’s Vegetable Compound, a patent medicine advertised to cure everything from nervous prostration to a prolapsed uterus. Pinkham, a grandmotherly type from Lynn, Massachusetts, first shared her mixture of ground herbs and alcohol with neighbor women. Her son urged her to market the formula with her picture on the bottle, and within a few years, the compound was the best-selling medicine of the era. Pinkham was exalted as the "savior of her sex."
One of her principal herbs was black cohosh, a native American plant with a long folk history of relieving menstrual cramps and easing childbirth. Whether women found relief from the herb or from the 18 percent alcohol content in the compound is a matter of debate.
Not for Women Only
Pinkham’s wasn’t all hooch and no medicine, however. Black cohosh is a powerful relaxant and antispasmodic for both nerves and muscles. It is especially good at relieving cramping in smooth muscles, which include the uterus. The herb also acts as a phytoestrogen, meaning that some of its chemicals have qualities similar to the female hormone estrogen.
All of these properties are helpful to women who have problems with their reproductive systems: excessive bleeding, irregular periods, delayed menstruation, severe menstrual cramps, and the hot flashes of menopause. Black cohosh works as a regulator or normalizer of the female reproductive system by helping to restore hormone balance, says Stanley W. Beyrle, N.D., a naturopathic doctor at the Kansas Clinic of Traditional Medicine in Wichita.
"When it comes to gynecological complaints, there isn’t a better herb than black cohosh," says Dr. Beyrle. "It’s always one of my base herbs in any herbal formula for females."
Although it has a reputation as a woman’s herb, black cohosh may have therapeutic benefits for both sexes. As an anti-inflammatory, it has been used to reduce pain and swelling in people who have rheumatoid arthritis, sciatica, osteoarthritis, neuralgia, or inflammation as a result of joint and muscle injuries.
"Anything that reduces inflammation, cramping, and swelling can reduce pain," says Dr. Beyrle. "That makes black cohosh useful for many conditions."
A Forest Herb
A member of the buttercup family, black cohosh is a native plant found in eastern deciduous forests from Ontario to Georgia. In North America, most black cohosh root is still harvested from the wild. In Europe, supplies come from herb farmers.
Native American women made a tea from the plant’s resinous roots and rhizome to soothe menstrual cramps and promote menstruation. Black cohosh was also important in folk medicine as a childbirth aid that eased delivery by stimulating the uterus. Native Americans and American colonists also valued it as a treatment for rheumatism and sore throats.
SUPPLEMENTSNAPSHOT
| Black Cohosh Botanical name: Cimicifuga racemosa. May help: Bronchial, stomach, and muscle spasms; rheumatoid arthritis, osteoarthritis; sciatica; neuralgia; muscle and joint injuries; breast cancer; premenstrual syndrome; leg cramps, endometriosis; menstrual cramps; heavy menstrual bleeding; irregular periods; and hot flashes and other menopausal discomforts. Origin: Found in eastern deciduous forests from Ontario to Georgia. Cautions and possible side effects: Do not take while pregnant. Do not take while breastfeeding or for longer than six consecutive months without a doctor’s supervision. May cause occasional stomach upset, diarrhea, abdominal pain, headache, and lowered heart rate and blood pressure. |
As early as 1787, the plant attracted the interest of Europeans. Eclectic physicians, a nineteenth-century branch of early American medicine, made black cohosh one of their central healing botanicals for women. From 1820 to 1926, the herb was listed as an official drug in the United States Pharmacopoeia.
Like many phytomedicines, however, it eventually fell out of favor with the American medical community. It continued to be used in Europe, and today, in Germany, it is a government-approved treatment for premenstrual syndrome, painful menstruation, and nervous conditions connected to menopause.
Hormone Harmony
The herb has many active ingredients, but an isoflavone called formononetin is the critical one for women. Formononetin and other compounds in the root and rhizome are able to bind to estrogen receptors in the uterus.
If you lack estrogen—as is the case in menopause—the herb acts like a hormone replacement. If you have too much estrogen, which is frequently the case when menstruation is painful and cramping is severe, the phyto- estrogens block estrogen from binding at those receptor sites, says Kathleen Head, N.D., a naturopathic doctor in Sandpoint, Idaho, and senior editor of Alternative Medicine Review.
"There’s a lot we don’t know about phytoestrogens, but we do know that they have a regulatory kind of effect. That fits with how black cohosh has been used traditionally by women," she says.
Besides replacing estrogen, black cohosh also eases the symptoms of menopause by inhibiting the production of luteinizing hormone (LH). LH levels tend to increase in the body at the same time that estrogen levels plummet. Hot flashes may be linked to high levels of this hormone.
The results of one clinical study seem to reinforce black cohosh’s effectiveness in menopause. Researchers studied 60 women under age 40, all of whom had had hysterectomies. Because their uteruses had been removed, these women experienced premature menopause-like symptoms. Some were given black cohosh extract, while others were treated with various estrogen replacements.
The study found no difference between the two treatments. The black cohosh appeared to be equally as effective as its pharmaceutical counterparts. As with most herbs, however, the beneficial effects took longer to appear—as much as four weeks. The pharmaceutical drugs tended to work much faster.
"It’s really a useful treatment during menopause," says Dr. Head, "but it’s mild, and it may take time before it starts to work."
Quash That Cramp
The antispasmodic effect of black cohosh is much more immediate. Dr. Beyrle recommends the herb for patients who’ve sprained their backs, strained muscles, or have cramping and pain from arthritis. Pain from an injury often comes from tightness and soreness in a muscle, he says.
"I routinely use black cohosh in an herbal pain formula," he says. "If you can get those muscles to loosen up and relax, you can give someone relief from pain."
The herb has also been used to relieve stomach cramps as well as to quell coughing and relax constricted blood vessels in cases of whooping cough, bronchitis, and asthma. Sometimes, herbalists combine black cohosh with valerian or other sedative herbs to create a botanical tranquilizer for the central nervous system.
As a single supplement, black cohosh is available in tablets, capsules, and tincture.
