Cimicifuga racemosa

Common Names: Black Cohosh, Black Snake Root, Rattleweed

Clinical Names: Cimicifuga racemosa

Summary

botanical name: Cimicifuga racemosa

common name: Black Cohosh.

overview of interactions:
None known. For relevant notes on phytoestrogenic herbs:
In Herb Groups: Ob/Gyn: Gynecological

AHPA Botanical Safety Rating: 2b, 2c.



Clinical

botanical name: Cimicifuga racemosa

common names: Black Cohosh, Black Snake Root, Rattleweed.

parts used: Rhizome, roots.

qualities: Bitter, pungent, warm, dry.

affinities: Hypothalamic-pituitary-gonadal axis, lungs, reproductive tract, smooth and striated muscle.

actions: Emmenagogue, hormonal and utero-ovarian tonic (estrogen mimetic, LH suppressive), antirheumatic, antitussive, sedating nervine, antispasmodic.

dosage:
• tincture: (Fresh 1:2, Dry 1:5) 0.5-2 ml. twice or thrice daily.
• Standardized Extract: Standardized to triterpenes as 27-desoxyactein. 20 mg. Twice daily.
(Manufacturers preparations may vary)

therapy:
• Menopausal symptoms, PMS symptoms, dysmenorrhea hypertension, spasmodic rheumatic conditions, bronchitis, pertussis, hypertension.
• Depression, deep gloom, associated with menstrual cycle.
• Spastic parametropathy; conditions based on estrogen deficiency; puberty; pregnancy, menopause; menopausal depression.
• Intercostal myalgia; chorea; tinnitus aurium.
(Boericke W. 1927; Bradley P, et al.(eds.) 1992, 34-36; Weiss R. 1988, 316.)

specific indications:
• Menopausal symptoms, dysmennorrhea.
• Eclectic Specific indications: see footnote below.

AHPA Botanical Safety Rating: 2b, 2c.


toxicity: Cimicifuga has minimal to mild toxicity. Occasional side effects of gastro-intestinal disturbance, and frontal headache are reported. Since long term studies are lacking, Commission E recommends duration of treatment not to exceed six months, but support for this statement is lacking.
(Blumenthal M, et al. 1998, 90.)

contraindications:
• pregnancy: Contraindicated until end of the third trimester when it is considered partus preparator by midwife herbalists. It may also be used to prevent threatened miscarriage, however this is only recommended for herbalists trained in obstetrics or midwives experienced in herbal medicine.
• lactation
(Brinker F. 1998, 37.)

constituents:
• Triterpene glycosides (including Actein, cimicifugoside, 27-desoxyactein).
• Isoflavones (including formononetin).
• Aromatic acids (including isoferulic, salicylic).

pharmacology:
Cimicifuga extracts have been shown to reduce LH levels in vivo (animal studies). They also bind competitively to estrogen receptors in rat uteri.
(Jarry H, et al. Planta Medica 1985 4:316-319)

clinical trials:
In a clinical trial of 110 menopausal women, standardized Cimicifuga (Remifemin) after two months at 8 mg. daily reduced LH but did not change FSH levels. In another group of hysterectomized women, Cimicifuga extract gave similar climacteric symptom relief as estriol, conjugated estrogen, and estrogen-progestagen combinations.
(Duker EM, et al. Planta Med 1991, 57(5):420-4; Lehmann WE, Zentralbatt fuer Gynakologie 1988, 110:610-618 [Quoted in Snow J, 1996].)

commentary - Eclectic Medicine and Cimifuga:
Cimicifuga was an important Eclectic medication and played a key role in the history of eclectic therapeutics as Macrotys, which at one time was prepared, like Podophyllum, as a solid extract by the "resinoid" faction of the Eclectics. Later it became an important Specific Medication.
Specific Indications: Heavy, tensive, aching pain (Scudder); pain characterized as rheumatic: dull, tensive, intermittent, drawing, and seeming as if dependent upon a contracted state of the muscular fibers; soreness of muscular tissues, as if one had been pounded or bruised; stiff neck; aching of whole body from colds; the onset of fevers, or from muscular exertion; lumbago; bruised feeling of muscles of the forehead, with stiffness of the ocular muscles; soreness and stiffness of the throat with sense of muscular drawing in the pharynx and fauces; muscular pains in the loins, thigh, or back, of a drawing character; deep-seated boring and tensive pains; rheumatoid dyspepsia: dull, aching pain and tenderness in stomach and bowels, with tendency to metastasis, and aggravated by food and drink, the stomach feeling as if painfully contracting upon a hard body or lump; the soreness and aching pains of abdominal gripe, when of rheumatoid type; sore, bruised sensation in the respiratory tract; chronic muscular rheumatism; ovarian pains of a dull aching character; dragging pains in the womb, with sense of soreness; the dull tensive pains incident to reproductive disorders of the female; false pains; after-pains; weak, irregular uterine contractions during labor; irregular, scanty, or delayed menstruation, with dull pain and muscular soreness; chorea, with amenorrhea; rheumatism of the uterus
(Felter HW, 466.)
• muscular aching and pains of la grippe; rheumatic endocarditis; diaphragmatic rheumatism, pleurodynia, intercostal neuralgia; gastralgia, enteralgia, mediastinal pain, pain in the orbits and ears, when acute and rheumatoid in nature; acute muscular pain; headache; eye-strain; atony of the reproductive tract; amenorrhea; dysmenorrhea; uterine subinvolution; leukorrhea; reflex mammary pains during gestation; ovaralgia; ovarian neuralgia; hysteria; spasmodic asthma; pertussis.
(Felter HW. 1922.)



Interactions

None known.
For discussion of phytoestrogenic herbs see Herb Groups - Ob/Gyn: Gynecological


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Do not rely solely on the information in this article.

The information presented in Interactions is for informational and educational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, case reports, and/or traditional usage with sources as cited in each topic. The results reported may not necessarily occur in all individuals and different individuals with the same medical conditions with the same symptoms will often require differing treatments. For many of the conditions discussed, treatment with conventional medical therapies, including prescription drugs or over-the-counter medications, is also available. Consult your physician, an appropriately trained healthcare practitioner, and/or pharmacist for any health concern or medical problem before using any herbal products or nutritional supplements or before making any changes in prescribed medications and/or before attempting to independently treat a medical condition using supplements, herbs, remedies, or other forms of self-care.


References

Boericke W. Pocket Manual of Homeopathic Materia Medica and Repertory. B. Jain Publishers Pvt. Ltd., New Delhi, 1927.

Bradley PR, ed. British Herbal Compendium, vol 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992, 34-36.

Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998.

Brinker F. Herb Contraindications and Drug Interactions. Second edition. Sandy, OR: Eclectic Institute Inc,1998.

Duker EM, et al. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Med 1991, 57(5):420-424.
Abstract: Remifemin is an ethanolic extract of the rhizome of Cimicifuga racemosa (C.r.) and is used to relieve climacteric hot flushes. In the present study the effects of this preparation on LH and FSH secretion of menopausal women were investigated. After an 8 weeks treatment, LH but not FSH levels were significantly reduced in patients receiving the Cimicifuga extract. To further characterize the endocrinologically active principles of this plant extract, a lipophilic extract of C.r. was prepared and subjected to Sephadex chromatography. Fractions obtained were tested for their ability to reduce LH secretion in ovariectomized (ovx) rats and to compete in vitro with 17 beta-estradiol for estrogen receptor binding sites. Three types of endocrinologically active compounds were obtained: (1) Constituents which were not ligands for the estrogen receptor but suppress LH release after chronic treatment, (2) constituents binding to the estrogen receptor and also suppressing LH release, and (3) compounds which are ligands for the estrogen receptor but without an effect of LH release. It is concluded that the LH suppressive effect of C.r. extracts observed in menopausal women and ovx rats is caused by at least three different synergistically acting compounds.

Felter HW. 1922. The Eclectic Materia Medica, Pharmacology and Therapeutics Reprinted, Sandy, OR: Eclectic Institute, 1983.

Jarry H, et al. Studies of the endocrine effects of the contents of Cimicifuga racemosa 2. In vitro binding of the compounds to Estrogen receptors. Planta Medica 1985 4:316-319.

Lehmann WE, Reidel HH, Zentralbatt fuer Gynakologie 1988, 110:610-618. (Quoted in Snow, 1996)

Snow J. Cimicifuga racemosa Monograph. Protocol Journal of Botanical Medicine. 1996,1(4):17-19.

Weiss R . Herbal Medicine.Beaconsfield, England: Beaconsfield Publishers Ltd., 1988.