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Black Cohosh

Medically reviewed by Last updated on Mar 11, 2019.

What is Black Cohosh?

Black cohosh grows in open woods at the edges of dense forests from Ontario, Canada to Tennessee and west to Missouri. This perennial grows to 2.5 m and is topped by a long plume of white flowers. The term "black" refers to the dark color of the rootstalk. The name "cohosh" comes from an Algonquian word meaning "rough," referring to the feel of the rhizome.

Scientific Name(s)

Cimicifuga racemosa

Common Name(s)

Black cohosh also is known as baneberry, black snakeroot, bugbane, squawroot, cimifuga, rattletop, rattleweed, traubensilberberze, rattleroot, and wanzenkraut.

What is it used for?

Traditional/Ethnobotanical uses

The roots and rhizomes of this herb are used medicinally. A tea from the root has been recommended for sore throat. The Latin name cimicifuga means "bug-repellent" and the plant has been used for this purpose. American Indians used the plant to treat general fatigue, kidney ailments, malaria, rheumatism, sore throat, and gynecological disorders (eg, menstrual cramps, ease of labor). North American colonists used the herb for treating menstrual disorders, bronchitis, nervous disorder with spasms, swelling, fever, hysteria, itch, back pain, nervous disorders, snakebite, yellow fever, and uterine disorders. In traditional Chinese medicine, the herb was valued for its ability to reduce swelling, relieve pain, and lower fevers.

The plant has been used in Europe since the 17th century to treat joint pain, pain, and pain in pregnancy and labor. Black cohosh has also been used to treat influenza, smallpox, acute rheumatism, headache, cough, chorea, and other nervous system disorders. It was an important herb in the Eclectic medical movement in the United States in the 19th century, under the name "macrotys."

Old-time remedy "Lydia Pinkham's Vegetable Compound" (early 1900s) contained many natural ingredients, including black cohosh.

General uses

Black cohosh has been used to help manage some symptoms of menopause and as an alternative to hormone replacement therapy. It may be useful for treatment of high cholesterol or disease of the arteries. Clinical studies have not supported these uses.

What is the recommended dosage?

On the basis of clinical studies, the currently recommended daily dose of black cohosh is a 40% to 60% methanol or isopropranolol extract of 40 to 80 mg herb standardized to contain 1 mg of the triterpene 27-deoxyactein per 20 mg tablet. Therapeutic effects generally begin after 2 weeks, with maximum effects usually seen within 8 weeks.


Should not be used by patients with aspirin sensitivity.


Black cohosh should not be used in pregnancy and may cause premature birth in large doses. Avoid black cohosh during lactation.


None well documented.

Side Effects

There is a low incidence of adverse reactions.


Overdose may cause nausea, dizziness, nervous system and visual disturbances, reduced pulse rate, and increased perspiration. Case reports primarily document liver toxicity; however, cardiovascular and circulatory disorders and 1 case of convulsions have been reported.


1. Black Cohosh. Review of Natural Products. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health Inc; March 2011.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.