Black cohosh (Cimicifuga racemosa) may be used as an herbal remedy, especially for postmenopausal symptoms, dysmenorrhea and uterine colic. Unfortunately it can have serious adverse effects.
Mechanism of action: estrogenic effect
Adverse effects are infrequent may include:
(1) toxic hepatitis, which can lead to acute hepatic failure
(2) cutaneous vasculitis
(3) myopathy
(4) seizures
(5) allergic reactions
(6) pseudolymphoma
Theoretically black cohosh might affect an estrogen-sensitive tumor but limited studies in breast cancer have not demonstrated this.
It is important to specifically ask about what herbal medicines a patient is taking since the patient may not mention it.
Some of the adverse side effects occurred in patients taking a high dose for a period of time, sometimes together with other herbal products. Improvement after the black cohosh has been discontinued supports the diagnosis.
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