Black cohosh is one of my favorite herbs to use with breast cancer survivors who are having symptoms of imbalanced hormones. While it is so common to have these symptoms it seems like something you “just need to get through”, black cohosh is one of our herbal allies that can really help! The hormone imbalances experienced by survivors can range from mildly annoying to life altering–but there are ways to minimize or eliminate those symptoms. This is one of the tools I use that can help you on your journey to becoming a Thriving Survivor.
Breast Cancer Survivors Need Support For Healthy Hormones!
Especially for women who have not gone through menopause prior to breast cancer, treatment can wreak havoc on hormone balance. Chemotherapy commonly has a profound impact on the ovaries, and can put women straight into menopause. This abrupt change in itself can cause many symptoms. Additionally, for women who have hormone receptor positive tumors, medication to decrease estrogen in the body is standard.
There are two primary types of medication that are used: selective estrogen receptor modulators, such as tamoxifen, and aromatase inhibitors, such as arimidex ( also known as anastrozole) or letrizole. No matter which type of medication you receive, it is extremely common to experience “menopausal symptoms” such as hot flashes and night sweats. Other common concerns I see in my patients include anxiety, depression, insomnia, and weight gain. The aromatase inhibitors also tend to cause muscle and joint pain.
Black Cohosh Helps Safely Manage Menopause Symptoms
I love black cohosh to help with these symptoms for a few reasons. First, it is so effective. Black cohosh has been seen to decrease hot flashes and night sweats, even in women who are taking anti-estrogen medication. One recent study shows it “improves hot flashes, night sweats, insomnia and anxiety in breast cancer survivors aged 35-52, even among women who are concurrently taking tamoxifen.” It can also ease the mental agitation and anxiety that can accompany hormone shifts. Finally, black cohosh has also historically been used for muscle cramping and pain. This can make it useful for a wide range of concerns.
Studies Show Black Cohosh Is Safe And Beneficial For Breast Cancer Survivors
Black cohosh has a stand out safety record. There are very few side effects associated with this herb. It does not actually impact your hormone production, so there is no concern with adding extra estrogen to your system; it simply helps the body behave as if the hormones are in balance. There have been quite a few studies done on black cohosh on breast cancer survivors. Not only does it show no added risk of recurrence, it has actually been found to be protective against breast cancers. A 2023 study actually showed the combination of black cohosh with the chemotherapeutic doxorubicin killed more breast cancer cells than doxorubicin alone, and extracts of black cohosh are being tested currently as breast cancer treatments.
What Is Black Cohosh?
Black cohosh (Actaea racemosa, or Cimicifuga racemosa) is a beautiful perennial herb native to North America, primarily in the Eastern part of the country. It is known for its large, white, spiky flowers and is commonly found in woodland areas. It was traditionally used in Native American medicine and is a popular herbal medicinal used in contemporary Western Herbalism.
Tribes such as the Cherokee, Iroquois, and Algonquin used the root of the plant to treat conditions related to women's health, including menstrual irregularities and menopausal symptoms, as well as to relieve rheumatism, sore throats, and kidney issues. Use of the herb was adopted by Western medical doctors and was prominent for many years; black cohosh was included in the United States Dispensatory well into the 20th century.
How Do I Take Black Cohosh?
There are a variety of ways that this herb can be prepared. I generally provide black cohosh to my patients in one of two ways:
Encapsulated in powdered form
In an alcohol-based liquid extract, otherwise known as a tincture
Both of these forms work well. Traditionally, tea was made from the roots, but I don’t regularly recommend that because the taste is somewhat strong. However, tincture form can be a nice balance because you get the flavor but it’s in one swallow instead of a whole cup! I often make a customized herbal formula for my patients with a variety of herbs, that includes black cohosh. However, it can also work very well on its own.
How Do I Get Black Cohosh?
Black cohosh is extremely popular in general commerce and is quite easy to find. However, there has been concern over the past few years because products labeled “black cohosh” have been adulterated with other plant material or may be something else entirely.
For this reason I strongly recommend that you obtain your black cohosh from a licensed provider with expertise in herbal medicines. I use plant extracts from companies that I know and trust, optimally with whom I have a personal relationship with the owner. Feel free to check out my “Supplements for Survivors” list on fullscript, where you can find a black cohosh supplement I recommend.
Want To Know More?
I am a research hound! I am always combing the available scientific literature to see what studies are showing in the field of holistic health for breast cancer survivors. Feel free to check out the studies below.
If you want to skip the research but still get the information, then you might want to check out our Breast Cancer Support Group. As a Thriving Survivor, you'll be privy to our private chats where we discuss natural remedies for common treatment side effects, access to exclusive resources, and receive genuine support from women with real empathy for your situation. We are eager to welcome you in!
Here’s to our good health!
Dr Kaycie
Sources:
1. Gerardo Hernández Muñoz 1, Salvatore Pluchino. Cimicifuga racemosa for the treatment of hot flushes in women surviving breast cancer. Maturitas. 2003 Mar 14;44 Suppl 1:S59-65.
2. Matthias Rostock 1, Julia Fischer, Andreas Mumm. Black cohosh (Cimicifuga racemosa) in tamoxifen-treated breast cancer patients with climacteric complaints - a prospective observational study.Gynecol Endocrinol.
2011 Oct;27(10):844-8.
3. X Ruan 1 2, A O Mueck 1 2, A-M Beer et al. Benefit-risk profile of black cohosh (isopropanolic Cimicifuga racemosa extract) with and without St John's wort in breast cancer patients. Climacteric. 2019
Aug;22(4):339-347.
4. Heidi Fritz 1, Dugald Seely, Jessie McGowan, et al. Black cohosh and breast cancer: a systematic review. Integrative cancer therapy. 2014 Jan;13(1):12-29.
5. Donovan A McGrowder 1, Fabian G Miller 2 3, Chukwuemeka R Nwokocha 4, Medicinal Herbs Used in Traditional Management of Breast Cancer: Mechanisms of Action. Medicines (Basel).2020 Aug 14;7(8):47.
6. Płoska A, Wozniak M, Hedhli J, Konopka CJ, Skondras A, Matatov S, Stawarz A, Schuh S, Czerwinski A, Dobrucki LW, Kalinowski L, Dobrucki IT. In Vitro and In Vivo Imaging-Based Evaluation of Doxorubicin Anticancer Treatment in Combination with the Herbal Medicine Black Cohosh. Int J Mol Sci. 2023 Dec 15;24(24):17506.
7. Zhang H, Chen Y, Huang S, Xiao WW, Qiu MH, Shao LD, Chen CH, Li D. Development of actein derivatives as potent anti-triple negative breast cancer agents. Bioorg Med Chem Lett. 2023 Jun 1;89:129307.
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