black cohosh

Other common names: Black bugbane, black snakeroot,
rheumatism weed
Latin name: Actaea racemosa L. [Ranunculaceae]
Latin synonyms: Cimifuga racemosa (L.) Nutt.
Plant parts: Root, rhizome



Black cohosh is native to North America. Native Americans used
the rhizomes and roots as a gynecological remedy as well as for treatment
of rheumatic conditions and hives. Black cohosh was also used
for its sedative and pain-relieving properties. Dried plant material,
hydroalcoholic liquid, and dried extracts are available commercially.
The underground parts contain cycloartane-type triterpene glycosides,
which are measured for quality control purposes (Flannery et al.,
2002).

Clinical research has been conducted on a commercial preparation
called Remifemin®, which is manufactured by Schaper & Brümmer
in Germany and distributed in the United States by GlaxoSmithKline.
Remifemin is available in tablet form, and each tablet contains black
cohosh root extract equivalent to 20 mg root/rhizome. Over time, the
formulation has changed from a solution to tablets, and the medium
of extraction has changed from ethanolic alcohol (60 percent by volume)
to isopropyl alcohol (40 percent by volume). The preparations
are standardized to contain 1 mg total triterpene saponins (expressed
as 27-deoxyactein) in each dose, equivalent to 20 mg root/rhizome.
Recent analysis of the structure of 27-deoxyactein has determined
that it is actually 26-deoxyactein (Chen et al., 2001).

Black cohosh root extracts have been used for treating menopausal
symptoms. Menopause is the cessation of menstruation, which generally
occurs when women reach age 50. The physical symptoms of
menopause include hot flashes, sweating, cardiovascular complaints,
fatigue, vertigo, muscle and joint pain, urinary incontinence, vaginal
dryness, and atrophy of the vaginal epithelium. Psychological symptoms
include irritability, forgetfulness, anxiety, depression, sleep disturbances,
and reduced libido. Menopause is thought to occur when
no eggs are left in a woman’s ovaries. The resulting decline in ovarian
function causes a reduced production of estrogen and progesterone
and a corresponding increase in follicle-stimulating hormone (FSH)
and luteinizing hormone (LH) (Murray and Pizzorno, 1999).