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Black Cohosh
Aka: Black Cohosh, Cimicifuga racemosa, Actaea racemosa, Remifemin
- Mechanism
- Native North American plant
- Plant root contains Estrogenic steroids
- Triterpene glycosides (acetin, cimicifugoside)
- Isoflavonoid formononetin
- Effects
- Weak Estrogenic effects
- Some studies suggest no effect on Uterus or vagina
- Anti-Estrogen effects
- Anti-proliferative effects on Breast Cancer cells
- Decreases leuteinizing Hormone (LH) levels
- Oxytocin-like effect in pregnancy (contractions)
- Indications: Current Use
- Menopausal symptoms
- Post-menopausal Hot Flushes
- Insomnia
- Mood disturbance
- Dysmenorrhea
- Contraindications
- Pregnancy (due to uterine contractions)
- Use caution if risk factors for Breast Cancer
- Black Cohosh has unclear effect on Breast Cancer risk
- Efficacy
- No rigorous RCT studies to show efficacy to date
- Adverse Effects
- Gastrointestinal intolerance (Nausea, discomfort)
- Headache
- Dizziness
- Weight gain
-
Drug Interactions
- No CYP enzyme or P-Glycoprotein interactions
- OATP2B1 Interactions that reduce efficacy of affected medications
- Amiodarone
- Fexofenadine
- Glyburide
- Statins
- Cost
- Monthly: $12 to $30
- Dosing
- Remifemin (Standardized 1 mg terpene per 20 mg tablet)
- Typical dose: Two 20 mg tablets bid
- Effects anticipated at 2-4 weeks after starting
- References
- Jarry (1985) Planta Medica 4:316-9
- Rand (2001) CMEA Medicine Lecture, San Diego
- Asher (2017) Am Fam Physician 96(2): 101-7 [PubMed]
- Kligler (2003) Am Fam Physician 68(1):114-6 [PubMed]
- Morelli (2002) Am Fam Physician 66(1):129-34 [PubMed]