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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. It was first found in the northeastern U.S. Native Americans boiled the root in water. Then they drank the brewed beverage. They used it to treat women's hormonal problems. They also used it to treat fatigue, snakebite, and arthritis.

The medicinal part is made up 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. It hasn’t been shown to help any estrogen-dependent cancers.

Medically valid uses

There are no proven medical uses for black cohosh.

Unsubstantiated claims

There may be benefits that have not yet been proven through research.

Black cohosh is most often used to treat symptoms of menopause. These include hot flashes, sweating, and depressed mood. It’s also used to treat discomfort before your menstrual period. These symptoms include cramping and muscle tension.

The plant has estrogen-like effects, binding to estrogen receptors. Most studies haven’t looked at using black cohosh for longer than 6 months. So, there is no safety information on long-term use. 

Dosing format

Black cohosh comes in dried root, tablet, capsule, and extract form. Follow the instructions on the package for the correct dose.

Side effects, toxicity, and interactions

Some reports link black cohosh with hepatitis and liver failure. You should stop using the supplement and call your healthcare provider if you have signs of liver issues. Symptoms can include stomach pain, yellowing of your skin or the white part of your eyes (jaundice), or dark-colored urine.  

Large doses of this herb may cause side effects. These can include dizziness, nausea, headaches, and stiffness. They can also include vision problems, slow pulse rate, and heavy sweating.

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

Online Medical Reviewer: Bianca Garilli MD
Online Medical Reviewer: Chris Southard RN
Online Medical Reviewer: Jessica Gotwals RN BSN MPH
Date Last Reviewed: 8/1/2023
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