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Infertility and Black Cohosh

Effect of Black Cohosh on Infertility

The exact mechanism of black cohosh in fertilty is unclear. Its therapeutic activity was originally believed to result from an activation of estrogen receptors which may address causes of infertility; however, because of conflicting research conclusions, the effects of black cohosh on the estrogen remains controversial.

Fukinolic acid, a recently identified active compound of black cohosh has been found to have estrogenic properties in vitro. Other components of black cohosh include: triterpene glycosides, resins, caffeic and isoferulic acids. The rhizomes of black cohosh contain other compounds with biological activity such as:

  • alkaloids- naturally occurring chemical compounds that produce pharmacological effects.
  • flavonoids- water-soluble plant pigments that have known health benefits including antioxidant properties
  • tannins- compounds that have shown potential antiviral, antibacterial, and antiparasitic effects.

Read more details about Black Cohosh.

Research Evidence on Black Cohosh

There are several studies on the effects of black cohosh for menopausal symptoms. Many of these studies used an estrogen product in the control group. Almost all of these studies suggest that the efficacy of black cohosh extract is similar to that of estrogen in the treatment of menopausal symptoms. However, drawing definitive conclusions from the results of these studies is difficult because most of them are open trials and lack long-term follow up.

The estrogen-like action of black cohosh is thought to stimulate the ovaries and could help boost fertility in women's hormonal imbalances. However, there is too little research to give a solid recommendation for black cohosh in the treatment of infertility.

How to Use Black Cohosh

Black cohosh extract is available in capsule, tablet and tincture form. The recommended dose of black cohosh ranges from 40 - 80 mg per day. Commercially available supplements usually contain 1 mg of 26-deoxyactein in each 20-mg dose of black cohosh extract. The proper dosage for black cohosh tincture is 2 ml twice daily. Therapeutic effects of black cohosh usually begin after 2 weeks of treatment.

Safety Issues

Black cohosh seldom produces any side effects other than occasional mild gastrointestinal distress. One rigorous study looked for possible deleterious effects on cholesterol levels, blood sugar, and blood coagulability, and did not find any.

Studies in rats have found no significant toxicity when black cohosh was given at 90 times the therapeutic dosage for a period of 6 months. Since 6 months in a rat corresponds to decades in a human, this study appears to make a strong statement about the long-term safety of black cohosh.

Unlike estrogen, black cohosh does not stimulate breast cancer cells growing in a test tube. However, black cohosh has not yet been subjected to large-scale studies similar to those conducted for estrogen. For this reason, safety for those with previous breast cancer is not known. Also, because of potential hormonal activity, black cohosh is not recommended for adolescents or pregnant or nursing women.

There are a growing number of case reports in which it appeared that use of a black cohosh led to severe liver injury. However, it is not clear whether the cause was black cohosh itself, or a contaminant present in the product.

One highly preliminary study found that black cohosh might reduce the effectiveness of the chemotherapy drug cisplatin.

Safety in young children or those with severe liver or kidney disease is not known.

Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides), which has different properties, treatment uses, and side effects. Black cohosh is sometimes used with blue cohosh to stimulate labor, but this therapy has caused adverse effects in newborns, which appear to be due to blue cohosh.

Interactions You Should Know About

Black cohosh might reduce the effectiveness of cisplatin.


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  2. Kruse SO, et al.Fukiic and piscidic acid esters from the rhizome of Cimicifuga racemosa and the in vitro estrogenic activity of fukinolic acid. Planta Med. 1999 Dec;65(8):763-4.

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