Black Cohosh vs The Menopause

Plus: how to not damage your skin shaving

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The 10almonds Team
February 20, 2024

Today’s almonds have been activated by:

When you’re “eating the rainbow”, don’t forget the beetroot! It’s good in salads, soups, or as a side with many main dishes. As a general rule of thumb: if you are serving potatoes, beetroot will probably go great with them!

As to why include beetroot: it has a very good nutritional profile (including micronutrients) and has phytochemicals that improve various blood metrics (blood pressure, lipids, sugars, etc).

⏰ IN A RUSH?

Today’s 30-Second Summary

If you don’t have time to read the whole email today, here are some key takeaways:

  • Black cohosh is a herbal remedy taken to relieve menopausal (or postmenopausal) symptoms.

    • It has been found beneficial against physical symptoms, but not against emotional ones

    • It is not, by the way, estrogenic, and has a good safety profile, including for breast cancer patients. See today’s main feature to read all about it!

  • Being unable to easily participate in spoken conversations is not just an inconvenience; it’s also a [causal, fixable] risk factor for age-related cognitive decline.

    • Today’s sponsor, Hear.com, are offering the most cutting-edge dual-processing technology in hearing aids that isolate and separate speech from background noise, now with their latest most advanced device yet!

Read on to learn more about these things, or click here to visit our archive

🤫 A WORD TO THE WISE

ADHD Medication!

Can you take it long term? What are the risks? And do benefits continue? Dr. Alison Poulton answers these questions and more:

👀 WATCH AND LEARN

How To Not Damage Your Skin

Dr. Simi Adedeji’s incredibly friendly persona makes this video (below) on avoiding skin irritation, ingrown hairs, and razor burn after shaving a pleasure to watch.

To keep things simple, she breaks down her guide into 10 simple tips:

You’ll notice that we’re now hosting these videos on our website, so that we can have room to provide a bit more context. Watch and enjoy!

YOU MAY HAVE MISSED…

💊 MAIN FEATURE

Black Cohosh, By Any Other Name…

Black cohosh is a flowering plant whose extracts are popularly used to relieve menopausal (and postmenopausal) symptoms.

Note on terms: we’ll use “black cohosh” in this article, but if you see the botanical names in studies, the reason it sometimes appears as Actaea racemosa and sometimes as Cimicfuga racemosa, is because it got changed and changed back on account of some disagreements between botanists. It’s the same plant, in any case!

Does it work?

In few words: it works for physical symptoms, but not emotional ones, based on this large (n=2,310) meta-analysis of studies:

❝Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges' g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges' g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges' g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo.

However, black cohosh did not significantly improve anxiety (Hedges' g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges' g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131)❞

Here’s an even larger (n=43,759) one that found similarly, and also noted on safety:

❝Treatment with iCR/iCR+HP was well tolerated with few minor adverse events, with a frequency comparable to placebo. The clinical data did not reveal any evidence of hepatotoxicity.

Hormone levels remained unchanged and estrogen-sensitive tissues (e.g. breast, endometrium) were unaffected by iCR treatment.

As benefits clearly outweigh risks, iCR/iCR+HP should be recommended as an evidence-based treatment option for natural climacteric symptoms.

With its good safety profile in general and at estrogen-sensitive organs, iCR as a non-hormonal herbal therapy can also be used in patients with hormone-dependent diseases who suffer from iatrogenic climacteric symptoms.❞

(iCR = isopropanolic Cimicifuga racemosa)

So, is this estrogenic or not?

This is the question many scientists were asking, about 20 or so years ago. There are many papers from around 2000–2005, but here’s a good one that’s quite representative:

❝These new data dispute the estrogenic theory and demonstrate that extracts of black cohosh do not bind to the estrogen receptor in vitro, up-regulate estrogen-dependent genes, or stimulate the growth of estrogen-dependent tumors❞

(the abstract is a little vague, but if you click on the PDF icon, you can read the full paper, which is a lot clearer and more detailed)

The short answer: no, black cohosh is not estrogenic

Is it safe?

As ever, check with your doctor as everyone’s situation can vary, but broadly speaking, yes, it has a very good safety profile—including for breast cancer patients, at that. See for example:

Where can I get some?

We don’t sell it, but here for your convenience is an example product on Amazon 😎

Enjoy!

❤️ OUR SPONSORS MAKE THIS PUBLICATION POSSIBLE

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📖 ONE-MINUTE BOOK REVIEW

Just One Thing: How Simple Changes Can Transform Your Life – by Dr. Michael Mosley

This is a collection of easy-to-implement changes that have good science behind them to show how they can benefit us. Some things are obvious (e.g: drink water); others, less so (e.g: sing, to reduce inflammation).

The book is divided thematically into times of the day, though in many cases it’s not a hard rule that a thing needs to be done at a certain time. Others are, like a cold shower in the morning and hot bath before bed—you might not want to switch those around!

The style is very pop-science, and does not have in-line citations for claims, but it does have a bibliography in the bag organized by each “one thing”, e.g. it might say “get some houseplants” and then list a number of references supporting that, with links to the studies showing how that helps. For those with the paper version, don’t worry, you can copy the URL from the book into your browser and see it that way. In any case, there are 2–6 scientific references for each claim, which is very respectable for a pop-sci book.

Bottom line: if you’re looking for evidence-based “one little thing” changes that can make a big difference, this book has lots!

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Wishing you the very most well-informed start to the week,

The 10almonds Team