Harvard Women's Health Watch

No evidence black cohosh helps with hot flashes

Black cohosh is a popular ingredient in herbal menopause remedies, but a recent Cochrane review finds that it does little to relieve at least one common menopause symptom—hot flashes. The review's authors evaluated 16 studies, involving a total of 2,027 menopausal women, that compared black cohosh against placebo or various other treatments, including hormone therapy, red clover, and the antidepressant fluoxetine (Prozac). The women took an average 40-mg dose of black cohosh for an average of 23 weeks. Black cohosh didn't do any better than placebo at relieving hot flashes, and it was far less effective at alleviating this symptom than hormone therapy. Comparisons of black cohosh with other treatments were either inconclusive or not statistically significant. There wasn't enough solid evidence to evaluate its effect on measurements such as quality of life, sexuality, or bone health. Because there is such limited evidence on the safety and effectiveness of black cohosh, the authors say more studies are needed before they can either confirm or dismiss black cohosh as a menopause remedy.

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