Black cohosh (actaea racemosa)

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Other names for black cohosh

black cohosh
black snakeroot

Synopsis of black cohosh

Black cohosh (Actaea racemosa, formerly Cimicifuga racemosa) is a perennial herb native to eastern North America, traditionally used by Native American tribes and early European settlers for its women’s health benefits, especially in managing menopausal symptoms. The rhizome and root of the plant are used medicinally and are rich in triterpene glycosides (e.g., actein, cimicifugoside), phenolic acids, flavonoids, and aromatic acids, which contribute to its hormone-modulating, anti-inflammatory, and nervous system–calming effects.

Black cohosh is most commonly used to:

  • Alleviate menopausal symptoms such as hot flashes, night sweats, mood swings, and vaginal dryness
  • Ease menstrual discomfort, including cramps and irregular cycles
  • Support sleep, mood stability, and mental clarity during hormonal transitions
  • Act as a nervine and mild sedative, calming the central nervous system
  • Provide gentle anti-inflammatory and musculoskeletal support, occasionally used in rheumatic conditions

Unlike phytoestrogens such as soy, black cohosh does not contain plant estrogens but is believed to modulate estrogen receptors or affect the serotonergic system, particularly in the hypothalamus, which regulates temperature and mood. It is typically used in standardized extracts or tinctures, with common doses ranging from 20 to 80 mg per day, often taken short-term (up to 6 months).

Historical Use:

Black cohosh has a long history in Native American medicine, where it was used to treat gynecological conditions, childbirth complications, sore throats, snakebites, and musculoskeletal pain. The Cherokee, Iroquois, and other tribes employed it for women’s reproductive health, leading to its later nickname, “squaw root.”

In the 19th-century Eclectic medical tradition, black cohosh was a major herb for treating “female disorders,” neuralgia, hysteria, and rheumatism. It was included in formulas for uterine toning and menopausal balance, often combined with herbs like dong quai or chaste tree.

While its popularity declined with the rise of pharmaceutical hormone therapy, black cohosh experienced a resurgence in the late 20th century as a natural alternative for menopausal support, particularly in Europe and the United States.

Today, black cohosh remains one of the most widely used botanical remedies for menopause, backed by both traditional knowledge and clinical research, though it should be used cautiously in those with liver conditions and under guidance for long-term use. It offers a non-hormonal, plant-based approach to navigating midlife hormonal changes with greater comfort and balance.

Black cohosh is used for these health conditions

Afterbirth Pain (Traditional)
Breasts (swelling and tenderness) (Traditional)
Cancer (natural therapy for) (Traditional)
Dysmenorrhea (Traditional)
Endometriosis (Traditional)
Estrogen (low) (Traditional)
Fibroids (uterine) (Traditional)
Hot Flashes (Scientific)
Infertility (Traditional)
Menopause (Scientific)
Menorrhagia (Traditional)
Menstrual Irregularity (Traditional)
Menstruation (scant) (Traditional)
PMS (general) (Traditional)
PMS Type A (Traditional)
PMS Type D (Traditional)
PMS Type H (Traditional)
PMS Type P (Traditional)
PMS Type S (Traditional)
Vaginal Dryness (Traditional)

black cohosh is used to support these body systems

Estrogen (Scientific)
Female Reproductive System (Scientific)
Glandular System (Traditional)
Nerves (Traditional)
Ovaries (Traditional)
Reproductive System (Scientific)
Uterus (Traditional)
Vagina (Traditional)