Black Cohosh

Common Name: Black cohosh, black snakeroot, rattle root, bugbane, fairy candle, macrotys

Family: Ranunculaceae

Parts Used: Root, rhizome

Native To: Eastern North America

Geographic Distribution: Black cohosh is native to the woodlands of Eastern North America, ranging from Georgia to Ontario and Quebec, and from Missouri and Arkansas through the Appalachian regions, Pennsylvania, New York, and Massachusetts.

Botanical Description: Black cohosh is a tall perennial plant that can grow up to 8 feet in height. It has smooth, furrowed stems and tripinnately compound leaves with serrated margins. The plant’s creamy-white flowers appear on tall racemes, lacking petals but emitting a distinct, often unpleasant scent that attracts flies and other pollinators. The rhizome is dark and knotty, reflecting the plant’s rugged appearance, which inspired the name “cohosh,” meaning “rough” in the Algonquin language.

Key Constituents: Black cohosh contains a variety of bioactive compounds, including triterpene glycosides, isoferulic acid, salicylic acid, tannins, resins, phytosterols, fatty acids, and starch.

Sustainability Issues: Black cohosh is considered an at-risk plant, listed as endangered in several states, including Massachusetts and Illinois. It is included in the United Plant Savers (UpS) “At-Risk” list. Due to its declining population in the wild, it is recommended that cultivated sources or alternative herbs be used. Vitex, motherwort, and skullcap are suggested alternatives for supporting hormonal balance, menstrual issues, and anxiety.

Harvesting Guidelines: Black cohosh can be cultivated from seeds or by dividing its rhizomes. It thrives in woodland shade but can also grow in partial or full sun. The root is typically harvested in the fall after the aerial parts of the plant have died back.

Uses

Black cohosh is a valuable herb with a rich history of use among Indigenous peoples in North America, particularly for its medicinal properties related to gynecological health, muscle pain, and inflammatory conditions. The Cherokee, Delaware, Iroquois, Micmac, and Penobscot tribes have all used black cohosh for a variety of ailments. The Cherokee, for example, used it to alleviate menopausal symptoms, as well as for treating snake bites, a use reflected in the plant’s alternative name “black snakeroot.”

The American Eclectic physicians of the 19th century also valued black cohosh for its ability to treat various conditions, including muscle aches, rheumatism, and menstrual discomfort. Dr. Finley Ellingwood recommended it for relieving pain during labor, while Dr. Harvey Wickes Felter highlighted its effectiveness in addressing uterine conditions like dysmenorrhea and ovarian neuralgia.

Today, black cohosh is most commonly used to support the female reproductive system, especially during menopause. The German Commission E has approved its use for premenstrual discomfort, dysmenorrhea, and neurovegetative symptoms of menopause. Black cohosh is also used as a pelvic tonic to strengthen the muscles of the uterus in cases of prolapse and to ease menstrual cramps. However, it is not recommended during pregnancy except during labor or when the birth date is overdue.

Research suggests that black cohosh may work by binding to serotonin receptors, which could explain its role in alleviating menopausal discomforts like hot flashes and mood swings. Some studies also suggest its potential analgesic properties, providing relief from muscle pain, particularly conditions like rheumatism and arthritis.

Herbalists have noted its efficacy in treating dull, aching muscle pain with significant stiffness and tenderness. Black cohosh is often recommended for individuals experiencing cold, aching pain, sometimes accompanied by depression or mood imbalances.

A Cochrane Database review of black cohosh’s effectiveness for menopausal symptoms concluded that while evidence for its effectiveness was inconclusive, further studies are needed. Despite these mixed findings, the herb has shown promise in clinical trials and remains widely used for its hormonal and pain-relieving properties.

Actions

• Alterative: Supports overall wellness by promoting balance in bodily systems
• Analgesic: Relieves pain, particularly in muscles and joints
• Anti-inflammatory: Reduces inflammation, particularly in rheumatic conditions
• Anti-rheumatic: Eases symptoms of rheumatism and arthritis
• Antispasmodic: Helps relieve muscle spasms and cramps
• Emmenagogue: Stimulates menstruation and supports menstrual health

Taste

Black cohosh has a bitter taste, which is common in herbs used for their tonic and therapeutic properties.

Energetics

The energetics of black cohosh are described as cooling and drying. This means it may be useful for conditions characterized by heat, inflammation, or excess moisture, such as hot flashes during menopause or fluid retention.

Traditional Benefits

• Menopausal Support: One of the primary uses of black cohosh is for alleviating menopausal symptoms such as hot flashes, night sweats, and mood swings.
• Menstrual Support: It is frequently used to ease menstrual cramps, especially in cases of uterine congestion and dysmenorrhea.
• Pain Relief: Black cohosh is effective for treating muscle pain, rheumatism, and arthritis. It helps relieve dull, aching, and stiff sensations.
• Uterine Prolapse: The herb is used to strengthen the muscles of the uterus, particularly in cases of prolapse or weakness.
• Neurological Pain: Black cohosh also has a history of use for nerve-related pain, including headaches and neuralgia.

Safety

Black cohosh is generally considered safe when used as directed, but there are precautions to be aware of:

• Pregnancy: It should not be used during pregnancy, except under the supervision of a healthcare provider during labor or when the birth date is overdue.
• Breastfeeding: It is not recommended for breastfeeding women.
• Liver Health: There have been isolated cases of liver issues related to black cohosh, though these are rare. It is important to monitor liver function if using this herb for extended periods.
• Adverse Effects: Some individuals may experience mild gastrointestinal discomfort or dizziness. Overuse can cause symptoms like impaired vision or circulation.

Ways to Use

• Decoction: 1 cup (½ – 1 teaspoon dried root simmered in 8 fl oz water), 3 times a day
• Tincture: 2-4 mL (1:5, 60%) 3 times a day

Black cohosh is a versatile herb with a long history of use for both women’s health and pain relief. Its cooling and drying qualities make it especially useful for conditions involving inflammation and heat. However, care should be taken in its use, particularly during pregnancy and breastfeeding.