Black Cohosh (cimicifuga racemosa)

What is black cohosh? What is it used for?

Black cohosh is a member of the buttercup family. It is a tall, flowering plant that grows in the U.S. and Canada, with a black stem and small white flowers. Black cohosh gets its name in part from an Algonquin word meaning "rough" in reference to the plant's root structure. It is also called black snakeroot, bugbane, bugwort and squawroot.

Black cohosh's roots and rhizome are used medicinally. Black cohosh contains several ingredients, including glycosides (such as acetin, deoxyactein and cimicifugoside) and isoflavones (such as formononetin). Other items found in black cohosh include aromatic acids, tannins, resins, fatty acids, starches, and sugars.

Native Americans used black cohosh for a wide range of conditions, from gynecological problems to rattlesnake bites. Studies conducted in Europe suggest that black cohosh may combat the effects of hot flashes associated with menopause, along with other symptoms such as night sweats; insomnia; nervousness; and irratibility. Another recent study suggests black cohosh may protect animals from osteoporosis. This effect has not been duplicated in human studies.

How much black cohosh should I take?

Black cohosh can be taken in several forms, from dried roots and rhizomes (300-2,000mg per day) to dry, powdered extracts (250mg three times per day). The recommended dose is 40mg of liquid black cohosh extract per day, with a ratio of 1mg of deoxyactein per 20mg of extract. Make sure to consult with your health provider for the proper dosages and types of black cohosh available.

What forms of black cohosh are available?

Powdered black cohosh root is widely available at most health food stores. It can also be found in teas, extracts (both solid and liquid) and tinctures.

What can happen if I take too much black cohosh? Are there any interactions I should be aware of? What precautions should I take?

The German Commission E has recommended that patients should not take black cohosh longer than six months at a time. Some patients taking high doses of black cohosh have reported mild side effects, including abdominal pain; diarrhea; dizziness; headaches; nausea; tremors; and a slowed heart rate.

Pregnant women should not take black cohosh, especially during the first two trimesters of pregnancy, because an overdose of the herb may stimulate contractions and lead to premature birth. As always, make sure to consult with a qualified health care professional before taking black cohosh or any other dietary supplement.

References

• Beuscher N. Cimicifuga racemosa L.- black cohosh. Z Phytotherapie 1995;16:301–310.
• Blumenthal M (ed.) The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston: Integrative Medicine Communications, 1998.
• Duker EM, Kopanski L, Jerry H, et al. Effects of extracts from cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Medica 1991;57:420-4.
• Gruenwald J. Standardized black cohosh (cimicifuga) extract clinical monograph. Quart Rev Nat Med Summer 1998;117–25.
• Liske E, Wüstenberg P. Therapy of climacteric complaints with cimicifuga racemosa: a herbal medicine with clinically proven evidence [abstract #98.0020]. Poster presentation. Ninth Annual Meeting of the North American Menopause Society, Toronto, Canada, September 16–19,1998.