Health Library Content

Black Cohosh

Botanical name(s):

Cimicifuga racemosa. Family: Ranunculaceae

Other name(s):

black snake root, bugbane, bugwort, rattleroot, rattleweed, squaw root

General description

Black cohosh is a tall perennial herb originally found in the northeastern United States. Native Americans boiled the root in water and drank the brewed beverage to treat women's problems, as well as fatigue, snakebite, and arthritis. The medicinal part consists of the dried rhizome and roots. Black cohosh is cultivated in Europe.

Black cohosh contains alkaloids, tannins, and terpenoids. The medicinal part has been used to control symptoms of menopause, especially hot flashes. No effect on estrogen-dependent cancers has been demonstrated.

Medically valid uses

Currently, there are no documented valid medical uses for black cohosh.

Unsubstantiated claims

Please note that this section reports on claims that have NOT yet been substantiated through scientific studies.

Black cohosh is most commonly used to treat menopausal symptoms (hot flashes, sweating, depressed mood) and premenstrual discomfort (cramping and muscle tension, for example). The plant has estrogenlike effects and binds estrogen receptors. A study reported in the December 2006 Annals of Internal Medicine found that the root was no better than a placebo. Most studies have not evaluated use of black cohosh for longer than six months, so there is no safety information regarding long-term use. 

Dosing format

Black cohosh can be found in capsule and powder form. Follow packaging instructions for correct dose. Remifemin (the brand name of the standardized extract) has been used in Germany for menopausal management since the mid-1950s.

Side effects, toxicity, and interactions

There is concern that black cohosh may cause hepatitis and liver failure based on several reports of this occurring in women using it. Stop using this supplement and see your doctor if you develop abdominal pain, jaundice (yellowing of the eyes or skin), or dark urine.  

Large doses of this herb can cause dizziness, nausea, headaches, stiffness, visual disturbances, reduced pulse rate, and increased perspiration.

Women who are pregnant or breastfeeding should not use black cohosh. Women who have had hormone-sensitive breast cancer should not use black cohosh.

Additional information

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