How much black cohosh should i take to start my period

Additionally, black cohosh is often sold in blends containing other herbal supplements, including:. According to existing evidence, there do not appear to be any complications associated with stopping black cohosh suddenly, nor are there any known withdrawal symptoms. Because black cohosh may potentially affect your hormones , you may experience changes to your menstrual cycle when you stop taking it. To ensure your safety and minimize your risk of liver damage, take no more than the recommended daily dose of the black cohosh supplement you choose.

If you can, purchase a supplement that has been tested by a third-party organization like ConsumerLab or USP to ensure that the ingredients in the supplement align with the claims on the label.

Black cohosh has the potential to interact with other medications and therapies. Here are its known interactions:. Black cohosh may have additional drug interactions that have not yet been identified. Additionally, because one of the most severe side effects of black cohosh is liver damage, you should be cautious of taking black cohosh in combination with any other supplements or medications that may damage your liver.

Consult your healthcare provider for guidance. Black cohosh should be kept sealed and stored at room temperature. In traditional Native American medicine, black cohosh was often used to increase breastmilk production Although most side effects are mild, little is known about the effects of black cohosh on pregnant women, breastfeeding women, and infants. Still, the supplement has been used to induce labor and miscarriage, and although evidence is lacking to support its use for this, some people online report success.

Regardless, labor should be induced only at the direction of a qualified healthcare provider. Because it may affect hormone levels, it should only be given to adolescents at the direction of a qualified healthcare provider. Additionally, given that one of the most severe potential side effects is liver damage, you should avoid black cohosh supplements if you have liver disease. Some potential alternatives to black cohosh include blue cohosh, rhapontic rhubarb, and evening primrose oil.

It may also have some severe side effects It appears to have some benefits for the treatment of menopause symptoms Finally, evening primrose oil has effects similar to those of black cohosh on hot flashes , so it may be a promising alternative 4. Many women reject the risks associated with hormone replacement therapy to treat their menopause symptoms and instead seek relief from alternative…. Discover vitamins, supplements, and other natural remedies for perimenopause. These teas for menopause may be a natural way to ease your symptoms.

Hot flashes are one of the most common symptoms of menopause. What are the most effective remedies? Research shows you can prevent, halt, and even reverse type 2 diabetes with proper diet and lifestyle. Fresh foods and nutritional supplements are key. We explain what to expect during menopause, including when it begins, how long it lasts, and why it occurs. Substances in black cohosh that may account for its activity include triterpene glycosides such as actein, epideoxyactein, and cimicifugoside; resins, such as cimicifugin; and aromatic acid derivatives such as caffeic, isoferulic, and fukinolic acids [ 8 , 9 ].

Products containing black cohosh extract are frequently standardized to provide at least 1 mg triterpene glycosides per daily dose [ 10 ]. The product has been on the market for years and has been reformulated over time [ 10 ]. Studies using various designs since the s have attempted to determine whether black cohosh affects menopausal symptoms [ 12 ]. Complicating efforts to understand the efficacy of black cohosh for treating menopausal symptoms is the wide variation in the chemical compositions of formulations.

Black cohosh's active ingredients and potential mechanism s of action are unknown. Studies have found varying results for the plant's effects on human physiology as to whether, for example, it raises the body's levels of estrogen which is present in lower levels in menopausal women than in premenopausal women, or whether it affect levels of luteinizing hormone or follicle-stimulating hormone [ 13 , 14 ]. It is not clear whether black cohosh affects the structure and activity of vaginal and uterine tissues [ 5 , 15 ].

Some researchers believe that black cohosh might exert its effects through a brain-related action, such as moduation of serotonergic pathways, or through its potential ability to act as an antioxidant, anti-inflammatory, or selective estrogen receptor modulator [ 5 , ].

Two high-quality randomized controlled trials investigating black cohosh for menopausal symptoms are described here. One, published in , assigned women aged 45—55 years experiencing daytime hot flashes and night sweats into one of five groups to take one of the following [ 18 ]:. After 3, 6, and 12 months of supplementation or placebo, the number and intensity of hot flashes and night sweats did not differ between the herbal-intervention groups and the placebo group, with one exception.

At 12 months, participants consuming the multibotanical preparation plus soy foods had significantly worse symptom intensity than those consuming the placebo. After 3, 6, 9, and 12 months of supplementation or placebo, the number of vasomotor symptoms declined significantly in all groups. However, there were no statistically significant differences between the black cohosh and red clover groups compared to placebo, with one exception.

The black cohosh group showed worse symptom intensity at 6 and 9 months. This study also investigated secondary endpoints such as somatic symptoms e. For most of these outcomes, no significant differences were observed between any of the treatment groups at any time. A Cochrane review evaluated 16 randomized clinical trials on the effectiveness of black cohosh in reducing menopausal symptoms, including hot flushes, night sweats, vaginal dryness, and combinations of symptoms measured by validated rating scales [ 5 ].

The two trials discussed above were included in this Cochrane review. The 16 included trials randomized a total of 2, women mean age Study durations were 8 to 54 weeks, with a mean duration of The studies were highly heterogeneous with respect to such factors as design, duration, type and amount of black cohosh used, and main findings.

A systematic review and meta-analysis of randomized clinical trials examined four studies of herbal and plant-based therapies that included black cohosh three of which were examined in the Cochrane review described above to treat menopausal symptoms [ 20 ]. The trials randomized a total of women to a daily dose of various formulations of 6.

There were no significant associations between supplementation with black cohosh and reduction in the number of vasomotor symptoms, such as hot flashes. Furthermore, there were no beneficial associations between black cohosh use and relief of menopausal symptoms using self-reported rating scales. The American College of Obstetricians and Gynecologists, in its clinical guidelines for managing menopausal symptoms, concluded that "data do not show that" herbal dietary supplements like black cohosh "are efficacious for the treatment of vasomotor symptoms" [ 21 ].

The North American Menopause Society advises clinicians against recommending herbal therapies such as black cohosh because "they are unlikely to be beneficial" italics in original in alleviating vasomotor symptoms [ 15 ]. Its authors recommended that researchers conduct higher-quality trials with larger samples and provide more details about their experimental protocols.

Others have recommended that researchers should completely and comprehensively describe the black cohosh preparation they used so that other researchers could use the same or similar products [ 22 ]. Clinical trials using various black cohosh preparations to treat menopausal symptoms have shown that its use is associated with a low incidence of adverse effects.

The most commonly reported side effects are gastrointestinal upset and rashes, both of which are mild and transient [ 1 , 24 ]. Most studies have examined black cohosh use for short periods, typically 6 months or less, so no published studies have assessed the long-term safety of black cohosh in humans. Across the world, reports have described at least 83 cases of liver damage—including hepatitis, liver failure, elevated liver enzymes, and assorted other liver injuries—associated with black cohosh use [ 1 , 25 ].

However, there is no evidence of a causal relationship. It is possible that at least some reported cases of hepatotoxicity were due to impurities, adulterants, or incorrect Acteae species in the black cohosh products used.

However, no one independently analyzed these products to confirm the existence of these problems [ 3 , ]. In , the Australian Department of Health began requiring that products containing black cohosh carry the following label statement: "Warning: Black cohosh may harm the liver in some individuals. Use under the supervision of a healthcare professional" [ 29 ]. However, some homeopathic practitioners recommend the use of black cohosh to induce labor in pregnant women who are at or past term.

Even then, pregnant women should never use black cohosh unless under the strict supervision of a knowledgeable physician. There are no known scientific reports of interactions between black cohosh and conventional medications. There is some concern about taking black cohosh along with medications that are toxic to the liver. Since so many medications affect the liver, it is possible that combining black cohosh with prescription medications could potentially be harmful to the liver.

It is also possible that taking black cohosh could alter the effects of drugs that are metabolized by the liver. Speak with your physician and see the Precautions section. Taking black cohosh can interact with other medicines, vitamins, and certain foods. Talk to your health care provider about possible interactions. Yale researchers also report that herbal medicines such as black cohosh may interfere with common breast cancer treatments, such as radiation and chemotherapy drugs.

Randomized, double-blind, placebo-controlled trial of Cimicifuga racemosa black cohosh in women with anxiety disorder due to menopause. J Clin Psychopharmacol.

Borrelli F, Ernst E. Black cohosh Cimicifuga racemosa for menopausal symptoms: a systematic review of its efficacy. Pharmacology Res. Black cohosh and St. Yonsei Med J. Growth inhibitory activity of extracts and purified components of black cohosh on human breast cancer cells.

Breast Cancer Research and Treatment. Ernst E, Chrubasik S. Phyto -- anti-inflammatories. A systematic review of randomized, placebo-controlled, double-blind trials. Rheum Dis Clin North Am. Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial. Black cohosh and breast cancer: a systematic review. Integr Cancer Ther. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial.

Effects of herbal preparations on symptom clusters during the menopausal transition. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol. Black cohosh improves objective sleep in postmenopausal women with sleep disturbance.

Leach MJ, Moore V. Black Cohosh Cimicifuga supp. Cochrane Database Syst Rev. Black cohosh: efficacy, safety, and use in clinical and preclinical applications. Altern Ther Health Med. United Sates Pharmacopeia review of the black cohosh case reports of hepatotoxicity. Mahady GB. Treat Endocrinol. Annals of Internal Medicine. Niederhuber: Abeloff's Clinical Oncology. Philadelphia, PA: Elsevier Saunders;