Further, some studies show that black cohosh relieves menopausal symptoms while others do not. These inconsistencies have placed seeds of doubt in physicians, consumers and the public in general. To remedy some of the inconsistent results, a 12 month random and placebo controlled study is currently in progress at Columbia University of New York.

Further, the long term effects of taking this supplement have not yet been studied. Some cases have actually been tied to liver disease, prompting Britain and Australia to require its manufacturers to put a warning on the label of their brand of supplements.

The extract of this plant is sold in great quantities in the US and Europe under the trade name Remifemin. Results of tests comparing Remifemin to combination treatment with estrogens and diazepam have shown treatment with Remifemin to be superior as measured by the Kupperman Menopausal Index.

Other tests such as the Self-evaluation For Depression Scale, the Hamilton Anxiety Inventory, and the Clinical Global Impression Scale–all recognized and trusted measures of clinical efficacy–have been used in studies evaluating the performance of Black Cohosh extract.

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As this root is grown mainly in North America, black cohosh was initially identified for its helpful effects by the Native Americans. Cohosh actually is a Native American word that means “knobby rough roots”. The Native Americans used it for multiple treatments, including what they referred to as “female symptoms” as well as depression, snake bites and kidney problems. This herb was also used as an abortifacient which is a substance that induces abortion.

Over the 19th century use lessened, but has risen again in popularity, especially in Europe. Around the 1950s testing began to try to understand the effects of black cohosh, but to no avail. Initially it was thought that it contained phytoestrogen, or estrogen-like compounds (and some still do believe this theory). Further research has shown that it is more likely that the biological effects (less depression, better sleeping) are contributed to binding with serotonin receptors.

Although the studies are still being conducted to scientifically prove that this supplement alleviates all of these symptoms, many alternative medicinal physicians and patients still place their faith in black cohosh. This is certainly not to say this is only a path for those that choose alternative and herbal medicines; it simply implies that until it is conclusively proven to work, it will not be endorsed by some physicians.