Black Cohosh Uses, Benefits, Side Effects and Dosage

Black Cohosh is also known as Black snakeroot, Bugbane, Cimicifuga, Macrotys Actaea, Rattleroot, Rattleweed, and Squawroot. It is native to America, and now cultivated in Europe. The straight, strong, dark brownish rootstock of the plant are used for medicinal purpose. The rootstock is the underground portion of the stem producing leaves from its upper surface, and roots from its lower surface.

Black cohosh roots or rhizomes are used for a variety of ailments such as arthritis, menopausal symptoms, and respiratory symptoms, and also to induce labor.  Black cohosh has a variety of actions such as selective estrogen-receptor modulator activity, anti-inflammatory, and dopaminergic effects.

Traditionally it is avoided during early pregnancy, but could be used to assist birth under professional supervision.


Black cohosh is a perennial plant belonging to the family Ranunculaceae, with the scientific name of Actaea racemosa L, a common synonym for which is Cimicifuga racemosa (L), Nutt. In 1998, the genus Actaea was revised to subsumeor include the genera Cimicifuga, and Souliea; thus, the genus now contains 28 species.1,2 Of these, 8 are found in North America, 19 in Asia, and 1 in Europe.

  • Latin Name: Cimicifuga racemosa (L.) Nutt. (Ranunculaceae)
  • Synonym(s), and related species: Actaea monogyna Walter, Actaea racemosa L., Macrotrys actaeoides Rafin
  • Native: North America
  • Medicinal Parts: The medicinal part is the fresh, and dried root.


Triterpene glycosides including actein, and several series of related compounds such as the cimicifugosides, the cimiracemosides, cimigenol, and its derivatives, 26-deoxyactein, and many others.

Phenylpropanoid esters such as the cimiracemates A–D, isoferulic, and ferulic acids, and methylcaffeate are present.

Quinolizidine alkaloids including cytisine, and N-methylcytosine.


  • Antispasmodic: Used to relieve spasm of involuntary muscle.
  • Astringents: Constrict tissues; styptic.
  • Diaphoretic: Promote sweating.
  • Diuretic: Promoting excretion of urine/agent that increases the amount of urine excreted.
  • Emmenagogue: Stimulates or increases menstrual flow.
  • Expectorant: Promotes the secretion of sputum by the air passages, used to treat coughs.
  • Narcotic: Affecting mood or behavior.
  • Sedative: Promoting calm or inducing sleep


Black cohosh has estrogenic Action, and is widely used as an alternative to estrogen therapy in menopausal women to treat peri-, and postmenopausal symptoms. It is also used in the treatment of dysmenorrhea, and premenstrual disorders. It has expectorant, antitussive, and sedative activities, and indicated in lungs congestion, Bronchitis, Flu or Common Cold.

The World Health Organization (WHO, 2002), and the European Scientific Cooperative on Phytotherapy (2003) have also listed black cohosh for menopausal symptoms.

The German Commission E (1989) has approved extracts from the rootstock of black cohosh for use in premenstrual discomfort, and dysmenorrhea or climacteric (menopausal) neurovegetative symptoms.

  • Bronchitis
  • Cold cough
  • Female tonic
  • Fever
  • Flu
  • Lumbago (pain in the lumbar region)
  • Menstrual irregularities
  • Musculoskeletal pain
  • Pneumonia
  • Premenstrual syndrome (PMS)
  • Rheumatism
  • Rheumatoid arthritis
  • Sedative
  • Sluggish labor
  • Snakebite
  • Sore throats

Benefits of Black cohosh

Black cohosh contains natural estrogen, and helps in hot flashes, contracts the uterus, and increases sluggish menstrual flow.

Increases estrogen effect

Various studies support the use of black cohosh as an alternative to estrogen therapy in menopausal women. Black cohosh roots contain triterpene glycosides which bind to the estrogen receptor where it selectively suppresses LH secretion. Unlike estrogens, black cohosh does not affect the secretion of prolactin, follicle-stimulating hormone, luteinizing hormone. The result is an estrogenic effect, which will decrease symptoms such as hot flashes, diaphoresis, and psychological disturbances.

Prevents osteoporosis

Black cohosh has bone resorption action, and prevents osteoporosis in postmenopausal women.

Gives relief in PMS

Black Cohosh gives relief in premenstrual symptoms, dysmenorrhea, and menopause.

Neutralizes poisons

Black Cohosh helps the body to get rid of toxins by stimulating the secretions of the kidneys, the liver, lymphatic system, and bladder.

Helps in Cold, and flu

Black Cohosh is expectorant, and antitussive. It supports better circulation, and expels mucus from the bronchial tubes.

Daily Dosage

  • Capsules: 40-80 mg twice a day standardized to 1 mg triterpenes.
  • Liquid extract: 0.3–2 ml liquid root extract
  • Powdered rhizome: 0.3 – 2 g
  • Solid dry powdered extract: 250-500 mg (4:1)

Tincture: 2-4 ml root tincture.

40 mg herb in 40–60% ethanol.

The herb is not recommended for treatment longer than 6 months unless advised by a physician.


It may produce mild toxicity in some cases with nausea, vomiting, and nervousness exhibited.

Safety Profile | Contraindications


  • Classification: Unsafe (first, and second trimester).
  • Caution: Do not use during pregnancy as it can increase the risk of spontaneous abortion.


Not to be used while nursing.


Black cohosh should not be given to children.

Breathing problems, Measles

Contraindicated in cases of fully erupted measles, and in patients with breathing difficulties.

Side Effects

No health hazards are known in conjunction with the proper administration of designated therapeutic dosages, although some side effects are the possible. It will produce adverse reactions in those with low blood pressure or low blood sugar since it is hypotensive, and hypoglycemic.


  • It can slow the heart rate.
  • It contains glycosides which may potentiate the effect of antihypertensive medications, and result in hypotension.

Reproductive organs

  • It can stimulate uterine.
  • It can cause miscarriage.


It can cause Nausea, vomiting, and anorexia.

Rare but possible Side effects

Spontaneous hepatotoxicity has been reported in at least 42 case reports world-wide with treatment by Cimicifuga racemosa rhizomes.


Excess dose (5 g) or an extract (12 g) leads to dizziness, tremors, gastroenteritis, pathologic erections, vomiting, headache, dizziness, limb pains, and lowered blood pressure.

Drug interactions

Avoid concurrent use with other medicines.

Blood pressure medicines

Black cohosh increases the action of antihypertensive.

Hormonal contraceptives

Black cohosh may increase the effects.

Hormone replacement therapy

Black cohosh may change the effects of other hormone replacement therapies.

Oestrogens or Oestrogen antagonists

Black cohosh contains oestrogenic compounds which can add to the effects of oestrogens or may oppose the effects of oestrogens.

Docetaxel, doxorubicin

Black cohosh may increase the toxicity of docetaxel, and doxorubicin.


Black cohosh may increase hypotension.


A case was reported about transplant rejection in a patient taking a supplement containing alfalfa, and black cohosh.

One Comment

  1. Thanks for bringing out this informative article. This could be a good reference for everyone. Thumbs up!

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