Synopsis

Source of validity: Traditional
Rating (out of 5): 3

Cohosh, particularly Black Cohosh (Actaea racemosa, formerly Cimicifuga racemosa), has a long history of traditional use in supporting the female reproductive system. It has been used by Native American communities and later by Western herbalists primarily for alleviating symptoms associated with menopause, such as hot flashes, mood swings, and menstrual irregularities. The herb’s popularity increased in the 19th century and it became a common ingredient in patent medicines for "female complaints."

Scientific evidence for Black Cohosh's effectiveness is mixed. Some clinical trials suggest modest benefit for menopausal symptoms, particularly hot flashes and sleep disturbances, but meta-analyses and systematic reviews indicate that the effects are inconsistent and not robust across studies. The precise mechanism of action remains unclear, as Black Cohosh does not appear to have estrogenic effects in the body, contrary to early assumptions. Instead, it may act on serotonin receptors, which could explain its impact on mood and thermoregulation. Safety data indicate that short-term use is generally well-tolerated, but there have been rare reports of liver toxicity.

Overall, while Cohosh’s use is primarily justified by tradition and historical precedent, there is some, though not strong, scientific evidence supporting its role in managing certain menopausal symptoms. Its use for broader female reproductive health (such as fertility or cycle regulation) has less scientific backing.

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