Black cohosh, also known as both Actaea racemosa and Cimicifuga racemosa, is a member of the buttercup family that is used to alleviate the symptoms of menopause, such as hot flashes. Preparations of black cohosh are made from its roots and underground stems, called rhizomes.

Black cohosh was widely used by Native Americans, and it became a popular cure-all in 19th-century America—especially among a group of alternative practitioners who called the herb macrotys. This group often prescribed black cohosh for conditions of women’s reproductive organs, including menstrual problems, inflammation of the uterus or ovaries, infertility, and labor pains or complications.

Scientists aren’t sure how black cohosh might work. It’s possible that its active compounds, such as fukinolic acid, work like the female hormone estrogen—although studies in this area have been contradictory. Women who have reached menopause generally have lower levels of estrogen in their bodies, and this can contribute to symptoms such as hot flashes, mood swings, weight gain, and vaginal dryness. Most reports on the benefits of black cohosh emphasize relief from hot flashes and mood swings.

In 2001, the American College of Obstetrics and Gynecology issued a statement that black cohosh, when taken for 6 months or less, may be helpful for women with menopause symptoms. Although preliminary research is encouraging, few studies have been placebo controlled and dosage has been inconsistent, so no official recommendation has been made by any government health organization.

Black cohosh appears to be safe when taken as directed, although it can cause headaches, stomach discomfort, and a feeling of heaviness in the legs. (A very small percentage of people have reported liver damage, as well.) The herb usually is not used for long periods of time, however, and studies have followed women for only 6 months or less. Women who are pregnant or who have breast cancer or liver disorders should not take black cohosh without talking to a doctor.

ADDITIONAL FACTS

  1. Other common names for black cohosh include black snakeroot, bugbane, bugwort, rattleroot, rattle-top, and rattleweed. Insects tend to avoid it, which accounts for some of these names.
  2. One widely used commercial brand of black cohosh is a tablet called Remifemin. Other preparations, such as solutions that mix black cohosh extract with alcohol, have been less well studied.
  3. Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides), a nicotine-like herb also used to treat menstrual and gynecological problems that also has not been thoroughly tested for effectiveness and safety.