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June 2013

Black Cohosh Studied For Hot Flashes in Breast Cancer

Black cohosh may lack effectiveness for reducing hot flashes in women who have breast cancer, a study reports.

Black cohosh is popular as an alternative to hormonal therapy in the treatment of menopausal symptoms such as hot flashes, mood disturbances, excessive sweating, palpitations and vaginal dryness. Several studies have reported black cohosh may improve menopausal symptoms for up to one year, although the evidence is mixed. Safety and effectiveness beyond one year have not been proven. Reports suggest the safety of short-term use, including in women with menopausal symptoms for whom estrogen replacement therapy is not suggested. Nonetheless, caution is advised until better-quality safety data are available. There have been reports of liver damage and higher lead levels in the blood from black cohosh. Use of black cohosh in high-risk populations (such as in women with a history of breast cancer) should be under the supervision of a licensed healthcare professional.

In the current study, researchers looked at data on the use of black cohosh in women who had or were at risk of breast cancer. They included 26 trials that evaluated the effectiveness of black cohosh on hot flashes.

The research team found conflicting data in terms of the effectiveness of black cohosh for hot flashes. While some trials reported benefits compared to baseline, significant effects were lacking when black cohosh was compared to placebo. Two of the studies found a lack of association between cohosh and breast cancer risk, while two others reported significant risk reductions in postmenopausal women.

The researchers concluded that the current evidence lacks support for an association between black cohosh and breast cancer risk. Additionally, they found a lack of evidence to support the use of black cohosh in treating hot flashes in women who had breast cancer. Further study is needed before firm conclusions can be made.

Other integrative therapies such as calcium, phytoestrogens, rose hips, and vitamin B6 have also been studied for menopausal symptoms. These treatments are supported by good scientific evidence for this purpose.

For more information about black cohosh, please visit Natural Standard's Foods, Herbs & Supplements Database.


  1. Fritz H, Seely D, McGowan J, et al. Black Cohosh and Breast Cancer: A Systematic Review. Integr Cancer Ther. 2013 Mar 25.
  2. Natural Standard: The Authority on Integrative Medicine. 

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