Black Cohosh: Cimicifuga racemosa, bugwort, rattleroot, black snakeroot, macrotys, bugbane, fairy candles


Black cohosh is a tall perennial plant with white flowers and compound, toothed leaves. The plant reaches 3-8 feet. It grows in rich woods & woodland openings, with partial to total shade and moist soil. The flowers bloom May through August.


The Delaware used black cohosh in combination with other herbs as a female tonic. The Iroquois of New York used a strong tea from the root as a foot bath to soak sore, stiff areas of the body. The Cherokee used the roots to treat rheumatism and various female conditions. Many Native Americans used the plant juice as an insect repellent and applied to snake bites as a salve. In 19th-century America, black cohosh was used as a home remedy for rheumatism and fever, as a diuretic, to promote menstruation, to treat lung and neurologic conditions, and to relieve pain after childbirth.

Fun Fact: 

Black cohosh's fetid odor attracts butterflies but repels bugs, so it was given the names bugwort and bugbane.


The main active chemicals found in black cohosh roots and rhizome include triterpine glycosides, isoferulic acids, and phytoestrogens. Glycosides found in the plant are acetin, cimicifugoside, and 27 deoxyacteine, which in addition to phytoestrogens, help to provide relief of menopausal symptoms. Isoferulic acids provide anti-inflammatory effects and are useful in treating rheumatism and sore muscles.


Black cohosh is most commonly used to treat menopausal symptoms, which may include hot flashes, vaginal dryness, and night sweats. The phytoestrogens and glycosides may help to decrease the symptoms. Current studies shown black cohosh to be associated with an improvement in bone density related to phytoestrogen effects. Other uses include pain relief associated with rheumatoid arthritis and osteoarthritis related to the isoferulic acid’s anti-inflammatory effects.  Inconsistent evidence of effectiveness has been found in numerous clinical trials. Some studies report that black cohosh does relieve menopausal symptoms while other studies do not. One reason for the inconsistencies could be differences in the herbal products tested. In a study from 2005, 304 women found that when compared to a placebo, black cohosh helped with symptoms of menopause. The herb seemed to be more effective for women whose symptoms had begun recently than for those who had been postmenopausal for a longer time. The North American Menopause Society recommends using black cohosh as a nonprescription remedy for mild menopausal symptoms, but notes that the safety of this herb for women with breast cancer still remains uncertain.


The recommended dose ranges from 40 - 80 mg per day. The tablets should contain 1 mg of 27-deoxyactein. A black cohosh tincture dosage should equal 2 - 4 ml and taken three times per day in water or tea. Two capsules or tablets should provide the recommended daily dose. Teas may not be as effective in treating menopausal symptoms as the standardized extract. To make a black cohosh drink, pour 20 g of dried root in 34 oz of water. Boil and then simmer for 20 - 30 minutes until it is reduced by a third. Strain the liquid, cover, and store in the refrigerator for up to 48 hours. Drink one cup up to three times daily.

Contraindications/Interactions/Adverse Reactions:

Pregnant and breast-feeding women should avoid black cohosh because it may stimulate contractions & lead to premature labor. There is a possible association with liver toxicity, so those with liver damage should not take black cohosh. No studies have been completed on children, so black cohosh is not recommended for children. Very high doses of black cohosh may cause a slow heart rate, uterine cramps, headache, dizziness, tremors, joint pain, and light-headedness. Conflicting data have been found of the effects of black cohosh and cancer. Doctors suggest delaying use of black cohosh until chemotherapy and radiological cancer treatment is completed.

References Cited:

  1. Foster, S. (2009). Black Cohosh. Steven Foster Group, Inc.
  2. NIH. Office of Dietary Supplements. (2009). Black Cohosh.
  3. Lady Bird Johnson Wildflower Center. University of Texas at Austin. (2009). Plant Database.
  4. American Cancer Society. (2008, November 1). Black Cohosh. Retrieved from
  5. University of Maryland Medical Center (UMMC). 2009. Black Cohosh.
  6. Researched By: Janelle Janson