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Does anyone use black cohosh for night sweats?

By Anonymous August 21, 2009 - 5:28am
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A friend of mine was telling me yesterday that she uses something called black cohosh (I think I'm spelling this right) to help treat her menopause. I get night sweats really badly and I'm almost 50 and I still get my cycle and everything but I think it won't be too long before I am in menopause too. She said the black cohosh should help me. I like the idea of a product made by Mother Nature instead of a lab, know what I mean? But I'm not sure about this one as I've never heard of it. I've been "lurking" on here for awhile reading other posts and I figured it was a good time to post something of my own. My friend said soy is good too and I have read some articles on that, but the black cohosh was new to me. Thank you for helping. Sally

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EmpowHER Guest

I am 39yrs old and have had a FULL hysterectomy due to Ovarian Cancer....I stopped the Premearin and wanted to go the natural route...the Black Cohosh stopped the wicked hot flashes I had even to the point where I was no longer soaking wet from sweat, AND I was able to sleep.

I currently have (temporarily) stopped taking Black cohosh because there is a question about it being a possible Estrogen receptor...but since then, the sweats and the hot flashes are back.

August 26, 2009 - 9:56pm
HERWriter Guide

Dear Sally-

Thanks for your post and welcome!

Yes, you are correct, it's "black cohosh" and it's part of the buttercup family. I agree that looking towards more natural methods is sometimes better than depending on a lab to crank out something synthetic!

There is not a whole not known about why it's used for "women's issues" like period pain and menopausal symptoms but it has been used for centuries. Some studies (see below) done on it's effectiveness seem very positive, others not so much but many women swear by it.

There are also serious side effects with over-dosage like liver disease and seizures that must be taken into consideration before taking it.

Here is Empowher's information regarding the studies conducted:

The best study was a 12-week, double-blind, placebo-controlled trial of 304 women with menopausal symptoms. 27 This study appeared to find that black cohosh was more effective than placebo. The best evidence was for a reduction in hot flashes. However, the statistical procedures used in the study were somewhat unusual and open to question.

Promising results were also seen in a 3-month, double-blind study of 120 menopausal women. 48 Participants were given either black cohosh or fluoxetine (Prozac). Over the course of the trial, black cohosh proved more effective than fluoxetine for hot flashes, but fluoxetine was more effective than black cohosh for menopause-related mood changes.

Previous smaller studies have found improvements not only in hot flashes but also in other symptoms of menopause. For example, in a double-blind, placebo-controlled study, 97 menopausal women received black cohosh, estrogen, or placebo for 3 months. 25 The results indicated that the herb reduced overall menopausal symptoms (such as hot flashes) to the same extent as the drug. In addition, microscopic analysis showed that black cohosh had an estrogen-like effect on the cells of the vagina. This is a positive result because it suggests that black cohosh might reduce vaginal thinning. However, black cohosh did not affect the cells of the uterus in an estrogen-like manner; this too is a positive result, as estrogen’s effects on the uterus are potentially harmful. Finally, the study found hints that black cohosh might help protect bone. However, a great many of the study participants dropped out, making the results less than reliable.

One study, too small to have reliable results from a statistical point of view, found black cohosh equally effective as 0.6 mg daily of conjugated estrogens. 45

A study reported in 2006 found that black cohosh has weak estrogen-like effects on vaginal cells and possible positive effects on bone (specifically, stimulating new bone formation). 32

An earlier study also found multiple benefits with black cohosh, but its results are difficult to trust. This trial followed 80 women for 12 weeks and compared the effects of black cohosh, estrogen, and placebo. 1 Again, black cohosh improved menopausal symptoms and vaginal cell health. However, in this study estrogen proved less effective than placebo. This result is so difficult to believe that it casts serious doubt on the meaningfulness of the results.

Several other studies are also often cited as evidence that black cohosh is useful for various symptoms of menopause, but in reality they prove nothing at all. 5-9,33 These trials lacked a placebo group. Although women reported improvements in symptoms, there is no way to know whether black cohosh was responsible. Women given placebo reliably report improvements in menopausal symptoms too; a 50% reduction in hot flashes is fairly typical. 10 Thus, it is possible that the benefits seen in these studies had nothing to do with black cohosh.

A substantial (244-participant) double-blind study published in 2007 compared black cohosh against the synthetic hormone tibolone, and found them equally effective for treating menopausal symptoms. 49 Though not approved as a drug in the US, tibolone does appear to be effective for menopausal symptoms, therefore these results are somewhat promising. 50 However, this study lacked a placebo group, and since the placebo effect is powerful for this condition, this omission significantly reduces the meaningfulness of the result.

One interesting double-blind study evaluated a combination therapy containing black cohosh and St. John's wort in 301 women with general menopausal symptoms as well as depression. 37 The results showed that use of the combination treatment was significantly more effective than placebo for both problems.

A smaller study using a combination of the same two herbs found improvements in overall menopausal symptoms as well as cholesterol profile. 47

In contrast, several other studies failed to find benefit. For example, in a 12-month, double-blind, placebo-controlled study of 350 women, participants were given either black cohosh, a multibotanical containing 10 herbs, the multibotanical plus soy, standard hormone replacement therapy, or placebo. 34,51 The results showed that hormone replacement therapy was more effective than placebo, but the other treatments were not. In addition, a double-blind study of 122 women failed to find statistically significant benefits with black cohosh as compared to placebo, 35 as did another study enrolling 132 women, 43 as well as one that involved 124 women using a black cohosh/soy isoflavone combination. 36 These negative outcomes were possibly due to the relatively small sizes of the black cohosh groups. In a condition such as menopausal symptoms, where the placebo effect is strong, and when the treatment is relatively weak, large numbers of participants are necessary to show benefit above and beyond the placebo effect. Nonetheless, this is an impressive number of negative studies, and some question must remain about the efficacy of this herb.

The bottom line: Black cohosh may be modestly effective for reducing hot flashes and other symptoms of menopause, but doubts remain.

Sally, check out our Black Cohosh page here for even more information : http://www.empowher.com/media/reference/black-cohosh

and we also have a short video from one of our medical experts (Dr. Tori Hudson) on the subject: http://www.empowher.com/media/video/video-dr-hudson-what-black-cohosh-and-it-effective-treating-menopause

Please take a look at the video, I think it's very interesting - it's just a few minutes long.

We also have a short news article on the debate of black cohosh, you can read it here: http://www.empowher.com/media/article/ongoing-debate-value-black-cohosh-hot-flashes

I hope other women who use, or have used it, will read your question and add their experiences.

Sally, what do you think of all this information? Is black cohosh something you think you would like to try?

August 22, 2009 - 6:09am
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