Black Cohosh

Latin
Actaea racemosa

Black cohosh root and rhizome extracts are used mainly for menopausal symptoms. Reviews suggest possible benefit for overall symptoms and hot flashes, but product identity, liver reports, and uncertainty around hormone-sensitive conditions keep the safety context important.

Also Known As

Cimicifuga racemosa Black Snakeroot Bugbane

Latin: Actaea racemosa

Traditional Context

Black cohosh is not the TCM herb Sheng Ma and is not a classical Traditional Chinese Medicine material. Its traditional record comes from Indigenous North American use and later Western herbal medicine.

Primary Actions

  • Traditionally used for menstrual cramps and reproductive complaints
  • Traditionally used for musculoskeletal discomfort

Secondary Actions

  • Historically used for sore throat and other complaints

Classical References

  • Indigenous North American and Western herbal medicine traditions

Modern Research

Active Compounds

  • Triterpene glycosides
  • Actein
  • Cimicifugoside
  • Phenolic acids

Studied Effects

  • Overall menopausal symptoms and hot flashes, with preparation-dependent results
  • Liver safety and product-authentication concerns
  • Potential effects in hormone-sensitive conditions

PubMed References

Safety & Interactions

Contraindications

  • Pregnancy or breastfeeding
  • Active liver disease without medical guidance

Cautions

  • Rare but sometimes serious liver injury has been reported, although causation and product identity are uncertain.
  • Use in people with hormone-sensitive breast or uterine conditions remains uncertain.
  • Commercial products may contain the wrong herb or undeclared mixtures.

Drug Interactions

Black cohosh appears to have a relatively small overall interaction risk, but laboratory evidence raises questions about tamoxifen, some chemotherapy medicines, simvastatin, and CYP3A4 substrates. Clinical relevance is not established for several of these findings.

  • Tamoxifen … Laboratory findings suggest possible interference with tamoxifen action. Clinical relevance is not known. (Uncertain) Source: Memorial Sloan Kettering About Herbs
  • Doxorubicin and docetaxel … Preclinical data suggest possible increased toxicity. Clinical significance is not established. (Uncertain) Source: Memorial Sloan Kettering About Herbs
  • Simvastatin and other statins … Preliminary laboratory research suggests altered statin activity or adverse-effect risk. (Uncertain) Source: NCCIH Menopausal Symptoms
  • CYP3A4 substrate medicines … Laboratory data suggest possible altered metabolism, but clinical relevance is not known. (Uncertain) Source: Memorial Sloan Kettering About Herbs

Conditions

Frequently Asked Questions

What is Black Cohosh used for?

Black Cohosh is traditionally used to Traditionally used for menstrual cramps and reproductive complaints, Traditionally used for musculoskeletal discomfort. Research has investigated its effects on: Overall menopausal symptoms and hot flashes, with preparation-dependent results; Liver safety and product-authentication concerns.

What are other names for Black Cohosh?

Black Cohosh is also known as Cimicifuga racemosa, Black Snakeroot, Bugbane. In TCM: Actaea racemosa.

Is Black Cohosh safe during pregnancy?

Black Cohosh is not recommended during pregnancy.

What are the contraindications for Black Cohosh?

Black Cohosh should not be used in: Pregnancy or breastfeeding; Active liver disease without medical guidance. Consult a qualified healthcare provider before use.

Does Black Cohosh interact with any medications?

Black Cohosh may interact with: Tamoxifen - Laboratory findings suggest possible interference with tamoxifen action. Clinical relevance is not known. - (Uncertain severity); Doxorubicin and docetaxel - Preclinical data suggest possible increased toxicity. Clinical significance is not established. - (Uncertain severity); Simvastatin and other statins - Preliminary laboratory research suggests altered statin activity or adverse-effect risk. - (Uncertain severity); CYP3A4 substrate medicines - Laboratory data suggest possible altered metabolism, but clinical relevance is not known. - (Uncertain severity). Always inform your healthcare provider of any herbal supplements you are taking.