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Black cohosh, a member of the buttercup family, is a plant native to North America. It was used in Native American medicine and was a home remedy in 19th-century America.
Common Names—black cohosh, black snakeroot, macrotys, bugbane, bugwort, rattleroot, rattleweed
Latin Names—Actaea racemosa, Cimicifuga racemosa
What It Is Used For
Black cohosh has a history of use for rheumatism (arthritis and muscle pain) but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause.
Black cohosh has also been used for menstrual irregularities and premenstrual syndrome, and to induce labor.
How It Is Used
The underground stems and roots of black cohosh are commonly used fresh or dried to make strong teas (infusions), capsules, solid extracts used in pills, or liquid extracts (tinctures).
What the Science Says
Study results are mixed on whether black cohosh effectively relieves menopausal symptoms. An NCCAM-funded study found that black cohosh, whether used alone or with other botanicals, failed to relieve hot flashes and night sweats in postmenopausal women or those approaching menopause.
Most studies to date have been less than 6 months long, so the safety of long-term use is unknown.
NCCAM is funding studies to further understand the potential effects of black cohosh on hot flashes and other menopausal symptoms.
There are not enough reliable data to determine whether black cohosh is effective for rheumatism or other uses.
Side Effects and Cautions
Black cohosh can cause headaches and stomach discomfort. In clinical trials comparing the effects of the herb and those of estrogens, a low number of side effects were reported, such as headaches, gastric complaints, heaviness in the legs, and weight problems.
No interactions have been reported between black cohosh and prescription medicines.
Black cohosh has been linked to a few cases of hepatitis (inflammation of the liver), but it is not clear whether black cohosh caused the problem.
It is not clear if black cohosh is safe for women who have had breast cancer or for pregnant women.
Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides), which has different properties, treatment uses, and side effects than black cohosh. Black cohosh is sometimes used with blue cohosh to stimulate labor, but this therapy has caused adverse effects in newborns, which appear to be due to blue cohosh.
Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.