By skyforbes 
Much of the research into the effects of Black Cohosh have been focused on the treatment of menopausal symptoms and whether or not it works via an oestrogenic pathways or indirectly via the CNS (central nervous system).
However, the importance of this plant in treatment of other conditions such as those in the nervous system should not be overlooked. This is certainly a plant with a great value for many other health problems which requires more research.
Menopause
In a randomised, double-blind, placebo-controlled clinical trial 84 early or post-menopausal participants with a moderate to high Greene Climacteric Scale (GCS) score (a scale used to measure of menopausal symptoms) were randomly allocated into treatment using either 6.5 mg of dried extract of Black cohosh roots daily or a control (placebo). The participants took one tablet per day for 8 weeks (4).
The GCS total score in the treatment group was significantly lower than that in the control group at both week 4 and week 8. The results clearly displayed a significant improvement of menopausal symptoms than that of the control group in all GCS subscale scores (vasomotor, psychiatric, physical, and sexual symptoms (4).
In another double-blind, CE- and placebo-controlled study an extract of black cohosh demonstrated a clear reduction in oestrogen deficiency symptoms to the same degree as conjugated oestrogens. Improvements were measured on all climacteric complaints, somatic complaints, mental and emotional state, sweating episodes with a significant improvement in sleep quality among the test group (10).
The literature to date does not fully confirm a direct oestrogenic mechanism to explain the effects of black cohosh, though it is not ruled out entirely. It is however thought that black cohosh may instead act on the neural pathways via its effects on neurotransmitters in the CNS (central nervous system) that modulate the thermoregulation system (6).
Black Cohosh has been the subject of a huge amount of scientific research, both through clinical trials and studies on its active compounds. In both, there seems to be conflicting outcomes in terms of the directly oestrogenic effects of Black Cohosh.
This is often the way with the scientific research carried out to assess the effectiveness of a chemically complex herbal medicine, whose efficacy is difficult to measure within the reductionist nature of modern research.
It is generally agreed however among the herbal community that black cohosh is a hormonal amphoteric (herb that can balance, according to the body’s needs). This is an action often seen in medicinal plants due to the dynamic and synergistic actions of their chemistry (6,7).
Research has been unable to conclude whether Black Cohosh exerts these effects by acting as an oestrogen in the brain. It is most likely however that it may alleviate hot flashes by acting on neurotransmitter systems (specifically serotonergic neurons) in the thermoregulatory hypothalamus via selective serotonin reuptake. It is also considered that compounds in Black Cohosh, by this same mechanism may indirectly interact with the oestrogenic systems (6, 7, 8).