Black Cohosh vs The Menopause
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
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!
Read: Reclassification of Actaea to include Cimicifuga and Souliea (Ranunculaceae)
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)❞
~ Dr. Ryochi Sadahiro et al., 2023
Source: Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis
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.❞
~ Dr. Castelo-Branco et al., 2020
(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❞
Source: Is Black Cohosh Estrogenic?
(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:
- Black cohosh efficacy and safety for menopausal symptoms: the Spanish Menopause Society statement
- Black cohosh (Cimicifuga racemosa): safety and efficacy for cancer patients
- The safety of black cohosh (Actaea racemosa, Cimicifuga racemosa)
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Constipation increases your risk of a heart attack, new study finds – and not just on the toilet
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and it’s believed he was straining very hard to poo, which then led to a fatal heart attack.
We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many.
But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack.
This includes a recent study led by Australian researchers involving data from thousands of people.
Elvis Presley was said to have died of a heart attack while straining on the toilet. But is that true? Kraft74/Shutterstock Are constipation and heart attacks linked?
Large population studies show constipation is linked to an increased risk of heart attacks.
For example, an Australian study involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age.
A Danish study of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes.
It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital.
These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated.
Researchers have studied thousands of people to see if there’s a link between constipation and heart attacks. fongbeerredhot/Shutterstock How about this new study?
The recent international study led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population.
The researchers analysed data from the UK Biobank, a database of health-related information from about half a million people in the United Kingdom.
The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation.
People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation.
The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension.
The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations.
A Japanese study looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day.
How might constipation cause a heart attack?
Chronic constipation can lead to straining when passing a stool. This can result in laboured breathing and can lead to a rise in blood pressure.
In one Japanese study including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people.
One theory is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels.
As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease doubles when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure).
The systolic blood pressure rise with straining in passing a stool has been reported to be as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks.
High blood pressure from straining on the toilet can last after pooing, especially in older people. Andrey_Popov/Shutterstock Some people with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing.
This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure.
Another intriguing avenue of research examines the imbalance in gut bacteria in people with constipation.
This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack.
This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease.
What can we do about this?
Constipation affects around 19% of the global population aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health.
Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Share This Post
-
Fitness In Our Fifties
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
Q: What’s a worthwhile fitness goal for people in their 50s?
A: At 10almonds, we think that goals are great but habits are better.
If your goal is to run a marathon, that’s a fine goal, and can be very motivating, but then after the marathon, then what? You’ll look back on it as a great achievement, but what will it do for your future health?
PS, yes, marathon-running in one’s middle age is a fine and good activity for most people. Maybe skip it if you have osteoporosis or some other relevant problem (check with your doctor), but…
Marathons in Mid- and Later-Life ← we wrote about the science of it here
PS, we also explored some science that may be applicable to your other question, on the same page as that about marathons!
The thing about habits vs goals is that habits give ongoing cumulative (often even: compounding) benefits:
How To Really Pick Up (And Keep!) Those Habits
If you pressingly want advice on goals though, our advice is this:
Make it your goal to be prepared for the health challenges of later life. It may seem gloomy to say that old age is coming for us all if something else doesn’t get us first, but the fact is, old age does not have to come with age-related decline, and the very least, we can increase our healthspan (so we’re hitting 90 with most of the good health we enjoyed in our 70s, for example, or hitting 80 with most of the good health we enjoyed in our 60s).
If that goal seems a little wishy-washy, here are some very specific and practical ideas to get you started:
Train For The Event Of Your Life!
As for the limits and/or extents of how much we can do in that regard? Here are what two aging experts have to say:
And here’s what we at 10almonds had to say:
Age & Aging: What Can (And Can’t) We Do About It?
Take care!
Share This Post
-
Gravitas – by Caroline Goyder
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
A no-nonsense guide to (more than!) public speaking that isn’t just “tell jokes in your speech and imagine the audience naked”.
Because this isn’t just about speech-writing or speech delivery, so much as giving you important life skills. The kind that weren’t taught in school, but that nevertheless make a huge impact on success… whether you’re giving a presentation or hosting a party or negotiating a deal or just attending a social event. Or making a phonecall, even.
Whereas a lot of books of this kind treat “the audience” as a nebulous and purely responsive passive crowd of extras, Goyder does better. People are individuals, even if they’re all facing the same way for a moment. She works with that! She also teaches how to deal with not just hecklers, but also simply those people who sap your confidence and find fault with you and anything you do or say.b
Bottom line is: if you for whatever reason communicate with people, and would like them to think better of you, this is the book for you.
Share This Post
Related Posts
-
Tasty Tabbouleh with Tahini
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Tabbouleh is a salad, but it’s not “just a salad”. It’s a special kind of salad that’s as exciting for the tastebuds as it is healthy for the body and brain. Its core ingredients have been traditional for about a dozen generations, and seasonings are always a personal matter (not to mention that Lebanese tabbouleh-makers centuries ago might not have used miso and nooch, as we will today), but the overall feel of the Gestalt of tabbouleh seasonings remains the same, and this recipe is true to that.
You will need
For the tabbouleh:
- 1 cup bulgur wheat
- 1 cup plum tomatoes, chopped
- 1 cucumber, peeled and chopped (add the peel to a jug of water and put it in the fridge; this will be refreshing cucumber water later!)
- 1 cup chickpeas, cooked without salt
- 1/2 cup parsley, chopped
- 1/2 cup mint, chopped
- 2 spring onions, finely chopped
- 2oz fresh lemon juice
- 1 tsp white miso paste
- 1 tsp garlic powder
- 1 tsp ground cumin
- 1 tsp ground celery seeds
- 1 tsp ground nigella seeds
- 1 tsp ground black pepper
- 1 tsp MSG, or 1/2 tsp low sodium salt (you can find it in supermarkets, the sodium chloride is cut with potassium chloride to make it have less sodium and more potassium)
- 1 tbsp nutritional yeast (nooch), ground (it comes in flakes; you will have to grind it in a spice grinder or with a pestle and mortar)
For the tahini sauce:
- 3 garlic cloves, crushed
- 3 tbsp tahini
- 1 tbsp fresh lemon juice
- 1 tbsp white miso paste
- 1 tsp ground cumin
To serve:
- A generous helping of leafy greens; we recommend collard greens, but whatever works for you is good; just remember that dark green is best. Consider cavolo nero, or even kale if that’s your thing, but to be honest this writer doesn’t love kale
- 1 tsp coarsely ground nigella seeds
- Balsamic vinegar, ideally aged balsamic vinegar (this is thicker and sweeter, but unlike most balsamic vinegar reductions, doesn’t have added sugar).
Method
(we suggest you read everything at least once before doing anything)
1) Rinse the bulgur wheat and then soak it in warm water. There is no need to boil it; the warm water is enough to soften it and you don’t need to cook it (bulgur wheat has already been parboiled before it got to you).
2) While you wait, take a small bowl and mix the rest of the ingredients from the tabbouleh section (so, the lemon juice, miso paste, and all those ground spices and MSG/salt and ground nutritional yeast); you’re making a dressing out of all the ingredients here.
3) When the bulgur wheat is soft (expect it to take under 15 minutes), drain it and put it in a big bowl. Add the tomatoes, cucumber, chickpeas, parsley, mint, and spring onions. This now technically qualifies as tabbouleh already, but we’re not done.
4) Add the dressing to the tabbouleh and mix thoroughly but gently (you don’t want to squash the tomatoes, cucumber, etc). Leave it be for at least 15 minutes while the flavors blend.
5) Take the “For the tahini sauce” ingredients (all of them) and blend them with 4 oz water, until smooth. You’re going to want to drizzle this sauce, so if the consistency is too thick for drizzling, add a little more water and/or lemon juice (per your preference), 1 tbsp at a time.
6) Roughly chop the leafy greens and put them in a bowl big enough for the tabbouleh to join them there. The greens will serve as a bed for the tabbouleh itself.
7) Drizzle the tahini over the tabbouleh, and drizzle a little of the aged balsamic vinegar too.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Felt Time – by Dr. Marc Wittmann
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This book goes far beyond the obvious “time flies when you’re having fun / passes slowly when bored”, or “time seems quicker as we get older”. It does address those topics too, but even in doing so, unravels deeper intricacies within.
The author, a research psychologist, includes plenty of reference to actual hard science here, and even beyond subjective self-reports. For example, you know how time seems to slow down upon immediate apparent threat of violent death (e.g. while crashing, while falling, or other more “violent human” options)? We learn of an experiment conducted in an amusement park, where during a fear-inducing (but actually safe) plummet, subjective time slows down yes, but measures of objective perception and cognition remained the same. So much for adrenal superpowers when it comes to the brain!
We also learn about what we can change, to change our perception of time—in either direction, which is a neat collection of tricks to know.
The style is on the dryer end of pop-sci; we suspect that being translated from German didn’t help its levity. That said, it’s not scientifically dense either (i.e. not a lot of jargon), though it does have many references (which we like to see).
Bottom line: if you’ve ever wished time could go more quickly or more slowly, this book can help with that.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
In the Realm of Hungry Ghosts – by Dr. Gabor Maté
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We’ve reviewed books by Dr. Maté before, and this one’s about addiction. We’ve reviewed books about addiction before too, so what makes this one different?
Wow, is this one so different. Most books about addiction are about “beating” it. Stop drinking, quit sugar, etc. And, that’s all well and good. It is definitely good to do those things. But this one’s about understanding it, deeply. Because, as Dr. Maté makes very clear, “there, but for the grace of epigenetics and environmental factors, go we”.
Indeed, most of us will have addictions; they’re (happily) just not too problematic for most of us, being either substances that are not too harmful (e.g. coffee), or behavioral addictions that aren’t terribly impacting our lives (e.g. Dr. Maté’s compulsion to keep buying more classical music, which he then tries to hide from his wife).
The book does also cover a lot of much more serious addictions, the kind that have ruined lives, and the kind that definitely didn’t need to, if people had been given the right kind of help—instead of, all too often, they got the opposite.
Perhaps the greatest value of this book is that; understanding what creates addiction in the first place, what maintains it, and what help people actually need.
Bottom line: if you’d like more insight into the human aspect of addiction without getting remotely wishy-washy, this book is probably the best one out there.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
