Abstract
Black cohosh, Actaea racemosa L (syn. Cimicifuga racemosa [L] Nutt), has enjoyed a rapid rise in popular use for the amelioration or alleviation of menopausal symptoms. At the same time, the last decade has witnessed a significant expansion of research on the chemistry, pharmacology, and clinical efficacy and safety of this botanical species. As a consequence of the growing body of data on black cohosh, together with the appearance of reports implicating this botanical in cases of liver damage, the Office of Dietary Supplements (National Institutes of Health) convened a workshop on the current state of knowledge for black cohosh (Gaithersburg, Maryland; June 2007); this review is based on that workshop. Based on the information presented and the ensuing discussions, several recommendations are proposed to facilitate better understanding and management of the safety of this botanical in the context of clinical trials