Saw Palmetto and Black Cohosh for Female Health

Saw Palmetto and Black Cohosh for Female Health
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Black Cohosh

Black cohosh (Actaea racemosa) is a member of the buttercup family and can be found growing in eastern parts of North America. The roots and rhizomes from this tall, flowering plant have been used in Native American medicine for more than two centuries to treat female problems. Today, it is widely used in Europe to treat menopausal symptoms. In fact, it has become quite popular since the risks of hormone therapy were publicized in 2002.

Menopausal Symptoms

Quite a few clinical studies have found evidence that black cohosh is effective in relieving menopausal symptoms, such as hot flashes, mood changes, night sweats and vaginal dryness. However, some studies failed to show any benefits, so many experts agree that more research is needed.

According to one study involving 80 menopausal women, those in the black cohosh group had better results than those in the placebo and conjugated estrogen groups. After 12 weeks, the participants in the treated groups had significantly lower scores on the *Kupperman index and the Hamilton anxiety scale than those in the placebo group. Actually, those who took black cohosh had somewhat better scores than those who took estrogen. Daily hot flashes, which were scored separately from other symptoms, decreased more in those in the black cohosh group (4.9 to 0.7) than those in the estrogen group (5.2 to 3.2) and placebo group (5.1 to 3.1).

*The Kupperman index grades (severe = 3, moderate = 2, mild = 1, not present = 0) the following symptoms: hot flashes, nervousness, weakness, dizziness, difficulty sleeping, muscle or joint pain, tingling or crawling skin, headache, melancholy and abnormal heart beat.

After menopause, the vaginal lining can become thin and dry due to decreased levels of estrogen. In one study, black cohosh showed estrogenic changes in vaginal epithelium, but another study showed no changes.

Other Uses

Black cohosh is also used to ease premenstrual syndrome (PMS) symptoms, regulate the menstrual cycle, relieve painful periods, treat infertility, induce labor and prevent bone loss. These conditions have less scientific support. More research is needed.


Available forms include tablets, capsules and liquid extracts. To prepare a cup of tea, pour 1 cup of boiling water over 1 teaspoon of dried root, cover and steep for 20 minutes.

Side Effects

Side effects, which usually occur with high doses, include stomach pain, nausea, vomiting, diarrhea, headaches, dizziness, tremors, slow heart rate, visual dimness, joint pains and weight gain.


Women allergic to aspirin should not take black cohosh.

Pregnant women should avoid because it may stimulate contractions. If using to induce labor, consult your health care provider before taking.

Women with hormone-sensitive conditions, such as endometriosis, fibroid tumors and cancer of the breast, uterus or ovaries, should not use. Those with a history of breast cancer or at a high risk for developing it should consult their doctor before taking.

Women with liver damage or who drink alcohol in excess should also avoid this herb.

Safety of long-term use is unknown, so black cohosh should not be taken for more than six moths at a time.

Saw Palmetto

Saw Palmetto Berries

Saw palmetto (Serenoa repens) is a low-growing palm tree native to the eastern United States. The berries were used by Native Americans as a tonic, as an expectorant and antiseptic, to stimulate appetite, to promote weight gain and to treat urinary tract and genital system problems. Today, it is best known for its use in treating symptoms of benign prostatic hypertrophy (BPH - an enlarged prostate).

Female Problems

Much research and studies have been done on the treatment of BPH, with positive results, but little is known about the effects of saw palmetto on other conditions. However, it is suggested that it may help women by enhancing sexual drive, stopping unwanted facial and body hair growth, treating thinning hair, normalizing irregular menstrual cycles, relieving some menstrual symptoms, treating hormonal acne and promoting breast enlargement.


Available forms include tablets, capsules and liquid extracts. To prepare a cup of tea, pour 1 cup of boiling water over 1 tablespoon of dried berries, cover and steep for 15 minutes.

Side Effects

Reported side effects, which are rare and normally mild, include nausea, vomiting, diarrhea, constipation and dizziness.


Because saw palmetto may have possible hormonal activity, women who are pregnant, breastfeeding, have had hormone-related cancers or are at risk for these cancers should not use.

This herb may decrease the effects of birth control pills and estrogen pills.

If you have a medical condition or are taking medications, consult your health care provider before taking saw palmetto and black cohosh.


Web MD: Black Cohosh -

National Institutes of Health: Black Cohosh -

Medline Plus: Saw palmetto -

Herbs 2000: Saw Palmetto -

Photo Credit:

H. Zell / Wikimedia

bob in swamp / Flickr


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