Black Cohosh: Uses and Side Effects

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Black cohosh was used by Native Americans as a remedy for several different illnesses. Today, it is most commonly used for its effects on menopause and other gynecological issues. But, the herb can also help with back pain, and muscle tension. This articl

Black Cohosh, also known as Actaea racemosa or Cimicifuga racemosa and part of the buttercup family, is a perennial and herbaceous plant native to eastern North America. It is typically found on the floors of forests. The herb has also been called black snake root (because of its use in the treatment of snake bites) and Squaw Root due to its emmenagogue properties and its use in stimulating uterine contractions. The word cohosh is of Algonquin origin and is thought to imply that the herb was used as a remedy for problems associated with the female reproductive system.

The plant can grow to about 9.8 to 24 inches tall and the leaves are broad with serrated edges. The flowers bloom in late spring and early summer. Black cohosh was used by Native Americans to treat many different illnesses. Most well-known are its effects on menopausal symptoms. However, it was also used for analgesia (pain relief), kidney disorders, sore throat and back pain and inflammation.

The remedy is made from the roots and rhizomes, or underground stems, of the plant and can be taken in the form of a tincture (alcoholic extract), capsule or tea. The capsule form is available over-the-counter in most pharmacies. The exact mechanism of action of the herb is unknown, but it is thought that it contains phytoestrogens that mimic the actions of estrogen in women decreasing the symptoms of menopause, and stabilizing hormone levels that cause dysmenorrhea (painful menstruation) and amenorrhea (irregular or absent menstruation). While research is inconclusive, there is some evidence to support black cohosh as a serotonin agonist (it binds to and activates serotonin receptors), which may explain its mild sedative properties.

Some of the lesser known uses of Black Cohosh include depression, muscle spasm, congestion of the cerebrospinal fluid, rheumatism and general malaise. Matthew Wood states it alleviates “tightness of the attachments of the trapezius muscles to the scapula” because of its antispasmodic properties (119). Black cohosh also contains triterpene glycosides which have been shown to prevent osteoclastogenesis reducing the likelihood of osteoporosis in post-menopausal women.

Many women use black cohosh for a number of gynecological issues including endometriosis and menopause. The herb is well-known for alleviating hot flashes, night sweats and cramps associated hormone fluctuations during menses or menopause. A recent study published in Alternative Therapies in Health and Medicine stated black cohosh alleviated symptoms of menopause by 26 percent.  It may also be helpful for those women who suffer from hormonal migraines and vaginal dryness because of its balancing effects on estrogen and progesterone.

Side Effects

As with any medication or supplement, black cohosh can have side effects. It can cause hypotension (low blood pressure), headaches, indigestion, nausea, hyperhidrosis (excess perspiration), weight gain and vomiting.  High dosages of the herb can cause seizures, heart arrhythmia, or disturbances in vision. There have been some cases that site alleged liver damage by black cohosh. However, most of these cases involved patients on several different medications and suffering from several different medical diagnoses. The evidence remains inconclusive.

Drug Interactions

Because of the herb’s mechanism of action, black cohosh may interact with hormone replacement therapies (such as Premarin) and oral contraceptives (like Loestrin). It may also interfere with Cisplatin, a chemotherapy drug. The herb also contains small amounts of salicylic acid causing mild thinning of the blood.

There have been very few short-term and long-term scientific studies on the effects black cohosh. The remedy works for some women, and not others. Black cohosh should only be taken under the supervision of a qualified physician. Those who take blood pressure medications or blood thinners, or who have allergies to plants in the buttercup family, should avoid using the herb and check with their physician prior to starting black cohosh.


Wood, Matthew The Earthwise Herbal: A Complete Guide to New World Medicinal Plants Berkley, CA: North Atlantic Books, 2009

“Actaea racemosa.” Wikipedia. Wikimedia Foundation, 2012. Web. 2 May 2012

Wong, Cathy. “Black Cohosh.” A New York Times Company, 2011. Web. 7 May 2012

Photo by H. Zell CC BY SA 3.0, via Wikimedia Commons

© Copyright 2012 by Daughter of Maat ALL RIGHTS RESERVED


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