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Black Cohosh (Cimicifuga racemosa)

Although baby boomers may regard black cohosh as the new 'in' herb, its healing abilities were recognized more than a century ago.  Native American and American pioneer women alike found the root of this plant to be one of the most useful natural medicines for women.

What it is?

'Black' describes the dark colour of the root, and 'cohosh' is derived from an Algonquian word for 'rough'.  Long used to treat 'women's problems', black cohosh grows to a height of about 2.5 metres and is distinguished by its tall stalks of fluffy, white flowers.  This member of the buttercup family is also known as bugbane, squawroot, rattle root or Cimicifuga cacemosa, its botanical name.  However, its most common nickname, black snakeroot, describes its gnarled root, the part of the plant that is used medicinally.  Contained in the root is a complex network of natural chemicals, some of which are as powerful as the most modern pharmaceuticals.

What it does?

Traditionally, black cohosh has been prescribed to treat menstrual problems, pain after childbirth, nervous disorders and joint pain.  Today, the herb is recommended primarily for relief of the hot flushes that some women experience during menopause.

Major Benefits

In Europe, and increasingly in Australia and New Zealand, black cohosh is a popular remedy for hot flushes, vaginal dryness and other menopausal symptoms.  Scientific study has shown that black cohosh can reduce levels of LH (luteinizing hormone), which is produced by the brain's pituitary gland.  The rise in LH that occurs during menopause is thought to be one cause of hot flushes.

In addition, black cohosh contains phyto-oestrogens, plant compounds that have an effect similar to that of oestrogen produced by the body.  Phytoestrogens bind to hormone receptors in the breast, uterus and elsewhere in the body, easing menopausal symptoms without increasing the risk of breast cancer (which is a possible side effect of hormone replacement therapy).  In fact, some experts think that phyto-oestrogens may even help to prevent breast cancer by keeping the body's own oestrogen from locking onto breast cells.

Additional Benefits

Owing to its antispasmodic properties, black cohosh can alleviate menstrual cramps by increasing blood flow to the uterus and reducing the intensity of uterine contractions.  This action also makes it useful during labour and after childbirth.  Because it evens out hormone levels, it may benefit women with premenstrual syndrome (PMS), though chaste tree is probably better for this condition.

Although these effects are less frequently noted, black cohosh has demonstrated some mildly sedating and anti-inflammatory capabilities, which may be particularly valuable in treating muscle aches, as well as nerve-related pain such as sciatica or neuralgia.  Because it has the ability to help clear mucus from the body, black cohosh has been recommended for coughs.  This herb has also been shown to be effective as a treatment for ringing in the ears (tinnitus).  As well, it has been used successfully to improve vaginal dryness in menopausal women.

Common Uses

  • Reduces menopausal symptoms, particularly hot flushes.
  • Eases menstrual pain and other difficulties, such as PMS.
  • Works as an anti-inflammatory; relieves muscle pain.
  • Helps to clear mucous membranes and relieve coughs.


  • Capsule.
  • Tablet.
  • Tincture.
  • Dried herb/tea.
  • Ointment.


  • Never use black cohosh while pregnant or breast-feeding.
  • This herb may interfere with hormonal medications (birth control pills or oestrogen), so check with your doctor.
  • Be careful if you're on a hypertension medication; black cohosh may intensify the drug's blood-pressure-lowering effect.
  • Reminder:  If you have a medical condition, talk to your doctor before taking supplements.

How to take it?


Look for capsules or tablets containing extracts standardized to contain 2.5% of triterpenes, the active components in black cohosh.

For menopausal or PMS syndrome:  Take 40 mg of black cohosh twice a day.  For PMS, begin treatment a week to 10 days before your period.
For menstrual cramps:  Take 40 mg three or four times a day as needed.

Guidelines for use:

Black cohosh can be taken at any time, but to reduce the chance of stomach upset you may prefer to take it with meals.  Allow four to eight weeks to see its benefits.  Many experts recommend a six-month limit on taking black cohosh, though recent studies show that longer use seems to be safe and free of significant side effects.

Possible side effects

Though it has virtually no toxic effects, black cohosh may cause stomach upset in certain people.  One study suggested that it may induce slight weight gain and dizziness in some women.  It may also lower blood pressure.  A very high dose can cause nausea, vomiting, reduced pulse rate, heavy perspiration and headache.

Facts and Tips

  • Compresses soaked in a black cohosh tea can be used to soothe sore muscles and aching joints.  Boil the dried root in water for 20-30 minutes, then let the liquid cool a bit.  (It should still be hot, but not hot enough to burn your skin.)  Then apply the warm compresses to the affected area for about 20 minutes.
  • Though some experts think that black cohosh helps to reduce hot flushes and vaginal dryness as effectively as hormone replacement therapy (HRT), there's no evidence that this herb offers the protection against heart disease or osteoporosis that HRT is believed to provide.

Did you know?

Black cohosh was the principal ingredient in one of the most popular American folk medicines of all time – Lydia Pinkham's Vegetable Compound.  Popular in the early 1900s, this 'women's tonic' is still available in the US today.  Ironically, the current formula no longer contains any of this helpful native herb.