Updated July 2022
Interest in using natural medicines for menopausal symptoms continues to grow. Some patients might ask about black cohosh and St. John’s wort. What should you tell them?
When it comes to black cohosh (Actaea racemosa), there’s evidence that using one specific product (Remifemin) might help with hot flashes, and it seems to be comparable to hormonal therapy. But it’s not clear if other black cohosh products help – the evidence is fairly mixed. This may be due to the way the black cohosh in these products is cultivated and processed. Remifemin is standardized to triterpene glycosides, whereas the contents of other products are not clearly defined. Additionally, some black cohosh products have been found to contain other species of Actaea, which may have different effects.
As for St. John’s wort (Hypericum perforatum), most research shows that it can reduce menopausal symptoms such as hot flashes. It might also improve quality of life and psychological symptoms. It’s likely safe when used for up to 12 weeks, but keep in mind that St. John’s wort interacts with many drugs. Make sure to review any drugs or supplements a patient is taking before use.
To learn more about other natural medicines for menopausal symptoms, check out our Comparative Effectiveness Chart.
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