Comment Reply

Hi, Missy,

Welcome to EmpowHer, and thanks for your question!

So am I correct in assuming that you are concerned about the amount of black cohosh already in your EstroNatural Extra Strength? Or are you thinking of taking another supplement of black cohosh in addition?

The Walgreens label for your product, which you can find here:

http://www.healthline.com/natstandardcontent/estronatural-extra-strength

says that it has 40 mg of black cohosh in a 2-capsule dose. What I found about taking black cohosh was that it has been studied in people who have used it for up to six months without many adverse conditions, but that it hasn't been studied longer than that. And since the FDA doesn't strictly regulate herbs and supplements, there's not a guarantee of consistency or product safety.

Here's what the Mayo Clinic site says:

"Black cohosh is popular as an alternative to hormonal therapy in the treatment of menopausal (climacteric) symptoms such as hot flashes, mood disturbances, diaphoresis, palpitations, and vaginal dryness. Several studies have reported black cohosh to improve menopausal symptoms for up to six months, although the current evidence is mixed.

"The mechanism of action of black cohosh remains unclear and the effects on estrogen receptors or hormonal levels (if any) are not definitively known. Recent publications suggest that there may be no direct effects on estrogen receptors, although this is an area of active controversy. Safety and efficacy beyond six months have not been proven, although recent reports suggest safety of short-term use, including in women experiencing menopausal symptoms for whom estrogen replacement therapy is contraindicated. Nonetheless, caution is advisable until better-quality safety data are available. Use of black cohosh in high-risk populations (such as in women with a history of breast cancer) should be under the supervision of a licensed healthcare professional."

And here's a link to the Mayo's page about dosing:

http://www.mayoclinic.com/health/black-cohosh/NS_patient-blackcohosh/DSECTION=dosing

And to its page on safety:

http://www.mayoclinic.com/health/black-cohosh/NS_patient-blackcohosh/DSECTION=safety

I am wondering why you had a hysterectomy? Because women who have hormone-sensitive conditions, such as cancer of the breast, ovaries or uterus, endometriosis or uterine fibroids, should avoid black cohosh until more is known about how it works and whether it has a hormonal effect. Here's a page with information on the latest study:

http://altmedicine.about.com/od/blackcohosh/a/blackcohosh.htm

And here's a very thorough page on black cohosh from the National Institutes of Health's Office of Dietary Supplements:

http://ods.od.nih.gov/factsheets/BlackCohosh.asp

So overall, I couldn't find any recommendations for black cohosh being used for more than six months. Does your doctor know that you're taking this supplement? It's always a good idea to take a bottle to your doctor's office so they can look at the ingredients and be sure, even if it's even just to check that it doesn't interact with anything else you might be taking.

Did you lose your insurance, Missy? Some pharmaceutical companies now help people with their prescription medicines who can't afford them. Or you may be able to get a prescription through your county health department. Do you think either of these is an option?