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Black Cohosh for Menopause: Safety and Efficacy Issues and Future Perspectives

Title
Black Cohosh for Menopause: Safety and Efficacy Issues and Future Perspectives

Abstract
Black cohosh [Actaea racemosa L., formerly Cimicifuga racemosa (L.) Nutt.] is an herbal medicine that has been used in the United States for over 100 years for the treatment of many conditions, including menopausal symptoms. To date the clinical data remain controversial. While there are over 20 positive clinical trials, all of the recent NIH-funded studies are negative, casting doubt on its efficacy. In addition, the cases of hepatoxicity are replete, although direct causality to the ingestion of black cohosh has not been demonstrated. In vitro studies have suggested possible chemopreventative effects; however, the in vivo studies to date do not support this hypothesis and suggest enhanced metastases. Unresolved issues of quality, safety, and efficacy remain and until these issues are resolved, the use of black cohosh products cannot be recommended.