The American Botanical Council (ABC), a US body which addresses research on herbs and botanical extracts, is producing a scientific review of the health benefits of black cohosh, used by many women to treat menopause symptoms.
The review, which comes after increasing evidence which has highlighted the risks of HRT, will be published on the organisation's website and targets the consumer as well as doctors and scientists, who are not always aware of research on alternative therapies.
The black cohosh herb, also known as Actaea racemosa and Cimicifuga racemosa, is native to America. It was used by Native American Indians for "female problems", and was a major ingredient in Lydia Pinkham's famous women's tonic, sold for more than 50 years in the 19th century.
A special formulation of black cohosh was developed in the early 1940s in Germany as a natural agent for treating menstrual and menopausal symptoms. This herbal preparation has been used in the majority of the clinical trials that have been conducted, according to the ABC, most of which support its safety and efficacy for treating the physical and emotional symptoms of menopause, including hot flushes, night sweats, mood swings, irritability and occasional sleeplessness associated with menopause.
The product studied in most of the trials has been used in Germany since the mid 1950s and is currently marketed in the US under the name RemiFemin Menopause. The German government's Commission E, a special committee of doctors, pharmacists and other scientific experts set up to evaluate and approve herbs, has approved black cohosh as a non-prescription medicine for treatment of various symptoms associated with menopause.
"As researchers, healthcare providers and menopausal women consider the implications of the recent reports by the National Institutes of Health and the National Cancer Institute that question the safety and long-term health benefits of hormone replacement therapy, the ABC monograph provides important information on the clinical data supporting black cohosh as a natural treatment option for menopause symptoms," said Mark Blumenthal, founder and executive director of the ABC.
"Now, more than ever, it is critically important for menopausal women to discuss treatment options - including reliable alternatives - with their healthcare providers," said Dr Mary Hardy, director of the Integrative Medicine Medical Group at Cedars-Sinai Medical Center in Los Angeles. "The ABC monograph provides an excellent overview for clinicians as well as patients who want to better understand the science behind black cohosh," she added.
The ABC's website contains a referenced profile of black cohosh for health professionals with a discussion of clinical data and a table summarising clinical trials. For consumers the site has a one-page Patient Information Sheet that is based on information condensed from the larger scientific monograph. Both the scientific information and the patient information sheet are part of a new reference book, The ABC Clinical Guide to Herbs, being published by ABC early next year. The book is accredited for continuing education for physicians, pharmacists, nurses, dietitians, and other healthcare professionals.
Hardy added that she does not recommend that women on HRT discontinue their hormone pills without consulting their doctors. She also discussed the importance of choosing herbs based on individual symptoms and needs. "There is an increasing amount of evidence supporting the use of black cohosh as well as soy, red clover and some other dietary supplements in treating menopausal symptoms. Women should discuss with their doctors or other healthcare professionals who are knowledgeable about herbals which options may be appropriate for them," she noted.
Hardy added that part of the problem is that many physicians have not been exposed to the scientific research on clinically researched alternatives. "We as health professionals have a responsibility to evaluate the science on herbal dietary supplements in order to guide our patients appropriately. Reliable resources like the ABC Clinical Guide are an excellent way to review the existing research on various herbs, " she said.