Menopause Health Center
This article is from the WebMD News Archive
Black Cohosh Not Always What It Seems
April 26, 2006 -- Women who take black cohosh supplements to treat hot flashes and other symptoms related to menopause may not be getting what they pay for, new research shows.
A chemical analysis of 11 commercially available products marketed as black cohosh found that three did not even contain the herb, which is grown in North America. Instead, researchers say, these products contained a related Asian species of the plant that differs not only chemically but also in its clinical uses compared with the North American species. Importantly, the imposter is also cheaper to produce.
One other product contained both the genuine black cohosh and the Asian imitator. And the seven products that contained only black cohosh had widely varying amounts of the compounds thought to be the active agents for the relief of menopause symptoms.
The findings are published in the May 17 issue of the Journal of Agricultural and Food Chemistry.
"The variability between products with black cohosh wasn't too surprising, but the fact that some of these products did not even contain black cohosh was both surprising and worrisome," says researcher Edward J. Kennelly, PhD, of Lehman College and the City University of New York.
Kennelly tells WebMD that the tested products were found in stores in New York City between 2002 and 2004 and were thought to be representative of what was available in the area at the time.
Industry Reaction
The researchers used a sophisticated testing technique to determine if the products contained black cohosh or the related Asian species.
Although the Asian plant has been used in Chinese medicine for centuries, Kennelly says it is not used for the same indications as black cohosh.
The researchers did not identify the 11 products they tested by brand, but they did notify the FDA of their findings, Kennelly says.
A spokesman for a leading trade group for the botanical products industry tells WebMD that the group was made aware a little over a year ago that some extracts used in the manufacture of black cohosh supplements did not contain genuine black cohosh.
Steven Dentali, PhD, says a manufacturer warned the American Herbal Products Association (AHPA), and the group quickly took action to make sure other manufacturers knew that the extracts were out there.
It has also identified an inexpensive method that can be used by the industry to identify the cheaper Asian extracts.
Dentali is vice president of scientific and technical affairs for the AHPA.
How Can Consumers Tell?
While it isn't always easy for consumers to know what they are getting when they buy botanical products like black cohosh, Dentali says herbal products that seem too cheap may be suspect.
"It is true that sometimes you do get what you pay for," he says. "Most of the better-known brands have invested in making sure that their supply chain is secure. They would not dream of buying extracts from questionable sources to manufacture their products."
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.

