Actea racemosa
Scientific Name: Black Cohosh
Other Names: Cimicifuga racemosa
Should I take it?
Black cohosh grows in wooded areas as a tall perennial bush with jagged-edged leaves and long stalks of white flowers. It is named for its rough, dark roots and rhizomes--the parts used in making medicine. "Cohosh" is derived from an native North American word that means rough. Rhizomes are fleshy extensions of plant stems that run along or under the ground and often produce shoots and roots for new plants.
Black cohosh was introduced to European settlers by the native people of eastern and central North America. Native Americans used the juice of the plant to repel insects and they applied a salve of black cohosh to snake bites. They used a tea made from the dried roots for menstrual cramps and difficult childbirth. As a drink, black cohosh was also used for coughs and sore throats, as well as for upset stomach.
In 1986, the FDA concluded that not enough was known about black cohosh to include it on the list of herbal products generally recognized as safe (GRAS). In Germany, however, it has been recognized for more than 15 years as effective for relieving menstrual and menopausal complaints.
Dosage and Administration
The active chemical in black cohosh is believed to be a glycoside called 27-deoxyacetin. Glycosides are chemicals that decompose into a sugar and other substances. Many glycosides have medicinal effects. The activity of black cohosh may vary greatly from individual to individual, however. Additionally, black cohosh usually needs to be taken daily for several weeks before it reaches full effectiveness.
In Europe, the use of black cohosh is fairly common. Commercial preparations of black cohosh include tablets that may be standardized to contain one mg of glycoside per 20 mg tablet. Standardization by the manufacturer should assure the same amount of active ingredient in every batch of the commercial preparation. Standardization of herbal products is not required by the U.S. Food and Drug Administration (FDA), so not every product sold in the United States will contain the same amounts of active ingredients. Liquid extracts and tinctures of black cohosh are also available. Extracts are concentrated liquid preparations usually made by soaking chopped or mashed plant parts in a liquid such as alcohol, which is then strained to remove the solid plant parts. Tinctures are less concentrated than extracts, but they are prepared in similar ways.
A commercial black cohosh product has been introduced to the non-prescription market in the United States after years on the German market. Its manufacturer suggests that its use be limited to 6 months or less because no long-term studies have been done to evaluate longer therapy.
Dried roots or rhizomes of black cohosh can also be made into a tea that may be taken one time to three times a day. Rhizomes are fleshy extensions of plant stems that run along or under the ground and often produce shoots and roots for new plants. The tea is made by chopping or grating up to 2,000 mg (2 grams) of the dried roots or rhizomes, dropping them into boiling water, and allowing them to simmer for about 10 minutes. The tea is then strained to remove the solid particles before drinking it.
Typical doses are:
| Commercially available tablets | 1 tablet to 4 tablets (20 mg to 80 mg) | Twice a Day |
| Liquid extract | 0.3 mL to 2 mL | Daily |
| Tincture | 2 mL to 4 mL | Daily |
| Dried root/rhizome | 300 mg to 2000 mg (0.3 gram to 2 grams) | Daily |
Summary
Black cohosh is used primarily by women to relieve hot flashes, mood swings, and other uncomfortable symptoms of menopause and to lessen menstrual cramps and bloating.
Risks
Individuals with liver conditions should avoid taking black cohosh, which may cause liver damage in rare cases. Because black cohosh may affect levels of the female hormone estrogen, it may cause uterine contractions; therefore, it should not be taken by pregnant women. Not much is known about how black cohosh affects children or whether it is passed to babies in breast milk, so women who are breast-feeding should not take black cohosh.
Side Effects
Large doses of black cohosh are reported to have resulted in:
- Low heart rate
- Seizures
- Temporary vision changes
Side effects commonly associated with taking black cohosh in any amount include:
- Dizziness
- Headache
- Sweating
- Upset stomach
- Weight gain
Interactions
Because it may interfere with estrogen in the body, black cohosh could lessen the effects of hormone replacement therapy or oral contraceptives.
Last Revised July 21, 2007
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Should I take it? 
