HCRC FAQ Sheet

Black Cohosh

By Maida Taylor, MD, MPH, FACOG
and Ellen Coleman, RD, MA, MPH

Black Cohosh (cimicifuga racemosa L. Nutt, family, Ranunculaceae) goes by many names including black snakeroot and bugbane. Not all plants called snakeroot in folk medicine are synonymous with black cohosh.

First introduced into western medicine by the American Indians, black cohosh has been used for a variety of ailments ranging from diahrea to sore throat to weakness in general. However, it is best know for its reputed ability to regulate menstruation. Black cohosh is promoted for menstrual discomfort, dysmenorrhea, and menopausal ailments.

Black Cohosh was one of the main constituents in Lydia Pinkham's Vegetable Compound and is used in an over-the-counter German menopausal preparation called "Remifemin." It binds to estrogen receptors and reduces luteinizing hormone levels in ovariectomized rats. These findings have been interpreted to mean that black cohosh has estrogenic activity. However, scientific investigations into this effect have not been numerous, with most studies carried out in other countries where they may or may not have been conducted properly.

Clinical trials are underway using a combination of herbals, including black cohosh, to determine efficacy for alleviation of menopause symptoms.

The internal dose is extracts (with alcohol) equivalent to 40 milligrams of drug per day, for no loner than 6 months.

Side effects of Black Cohosh may include nausea, vomiting, uterine contractions, and bradycardia. Because studies on this herb are lacking, side effects from long term use or from using too much at one time are not well known. More research is needed to determine how safe and effective this herb may be in humans.

Black cohosh is not related to blue cohosh. Blue cohosh, Calilophyllum thalictroides, has very weak nicotine-like activity, offering the potential for toxicity. It is considered dangerous.

Consumers should be aware that the herbal marketplace is entirely unregulated. Thanks to the 1994 Dietary Supplement and Health Education Act (DSHEA), herbal products don't have to be proven safe or effective to be sold. There is also no guarantee that the herbal product is what it says it is.

For More Information

• HCRC FAQ Sheet: Nutritional Supplements
• Ellen Coleman. Herbs for Health
• Maida Taylor, MD, MPH, FACOG, Alternatives to Hormone Replacement Therapy, Comprehensive Therapy. 23(8):514-32, 1997 August.
• Search the HCRC and NCAHF Websites