Black Cohosh
Cimicifuga racemosa / Actaea racemosa
黑升麻
Pinyin: Hēi Shēng Má
Plant Family
Ranunculaceae
Part Used
Root and rhizome
Origin
Eastern North America (Appalachian region)
Safety Level
Caution
Overview
Black cohosh is a tall perennial plant with white, feathery flower spikes native to the rich woodlands of eastern North America. It was used by Native American tribes for women's health issues and as a general tonic. Today it is one of the most popular herbal supplements for menopausal symptoms, particularly hot flashes. It is important to distinguish black cohosh from blue cohosh (Caulophyllum thalictroides), which is a different plant.
Traditional Chinese Medicine Properties
Nature (四气)
cool
Flavors (五味)
bitter, acrid / pungent
Meridians (归经)
uterus, liver
Health Benefits
Traditional Uses
- Menopausal symptoms (hot flashes, night sweats, mood swings)
- Menstrual cramps and PMS
- Painful or delayed menstruation
- Inducing labor (traditional, only by trained practitioners)
- Arthritis and rheumatic pain
- Muscle pain and spasms
- Hysteria and nervous disorders (historical)
- Tinnitus and vertigo
Active Constituents
The key compounds responsible for this herb's therapeutic effects:
Usage & Dosage
How to Use
Used as tincture, capsules, tablets, standardized extracts, and tea. Very bitter taste - capsules or tincture are preferred. Standardized extracts are the most studied form. Important: Black cohosh is NOT a phytoestrogen - its mechanism of action is through the central nervous system, not estrogen receptors.
Suggested Dosage
Standardized extract: 40-80mg daily (standardized to 1 mg 27-deoxyactein). Tincture: 2-5ml 2-3 times daily. Dried root: 40-120mg daily. Recommended use: 3-6 months maximum, then re-evaluate.
Quality & Storage
Harvest Season
Autumn, after aerial parts die back. Roots are dug, cleaned, and dried.
Quality Indicators
Dark brown/black root with bitter taste. Standardized extracts should list triterpene glycoside content (27-deoxyactein). Look for brands like Remifemin (well-studied German product). Only use Cimicifuga racemosa - NOT Chinese cimicifuga (Sheng Ma / C. dahurica).
Storage
Dried root: airtight container, cool dark place, 2-3 years. Extracts/capsules: follow manufacturer directions, typically 2 years.
Safety Information
Contraindications
Breast cancer or history of breast cancer (controversial - studies are mixed)Other hormone-sensitive cancers (ovarian, uterine)Endometriosis or uterine fibroidsPregnancy (may induce labor)BreastfeedingLiver disease or hepatitisChildrenSeizure disorder (may lower seizure threshold)
Possible Side Effects
- Generally well-tolerated short-term (6 months or less)
- Mild digestive upset (nausea, diarrhea) - rare
- Headache
- Dizziness
- Rash (rare)
- Weight gain (controversial, not confirmed)
- Breast pain or enlargement (rare)
- Very rare but serious: liver damage / hepatitis (several case reports, causal link not proven)
Drug Interactions
- Hormone therapies (estrogen, HRT, tamoxifen - interaction unclear)
- Statins (may increase liver risk)
- Hepatotoxic medications (combined liver stress)
- Blood thinners (anticoagulants)
- Seizure medications (may lower seizure threshold)
- Antidepressants
- Alcohol (increases liver risk)
- Moderate interaction potential
Note: Always consult with a qualified healthcare practitioner before starting any herbal supplement, especially if you are pregnant, nursing, have medical conditions, or take medications.
References & Research
Information on this page is based on traditional herbal knowledge and modern scientific research. For a comprehensive list of references, please refer to our full citations page.
ℹ️ Disclaimer
This information is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. The FDA has not evaluated these statements. Always consult a qualified healthcare provider before using herbal supplements.
Related Herbs
Chaste Tree Berry
Vitex agnus-castus
Chaste tree is a large shrub with purple flower spikes and small dark berries. It has been used since ancient Greek and Roman times for women's health issues. The name "chaste tree" comes from its historical reputation for reducing sexual desire (used by monks as an anaphrodisiac). Modern herbalism uses it primarily for PMS, menstrual irregularities, and fertility support.
Red Raspberry Leaf
Rubus idaeus
Red raspberry leaf is the leaf of the common raspberry plant. It has been used for centuries as a women's health tonic, particularly during pregnancy and for menstrual health. It is considered safe and gentle enough for long-term use. The active compound fragarine is believed to be responsible for its effects on the uterus.
Red Clover
Trifolium pratense
Red clover is a common legume with pink-purple flower heads, found in meadows and fields worldwide. It is both an important forage crop and a medicinal herb. Red clover is one of the richest sources of isoflavones (phytoestrogens), which is why it has been studied extensively for menopausal symptoms and bone health. It has also been used historically as a blood purifier and respiratory remedy.
St. John's Wort
Hypericum perforatum
St. John's wort is a perennial herb with bright yellow flowers that bloom around St. John's Day (June 24), hence the name. The leaves have tiny transparent dots (oil glands) that look like holes when held up to light - hence "perforatum." It is one of the most widely studied and best-selling herbal supplements, primarily used for mild to moderate depression. Its effectiveness is well-supported by research.