Black Cohosh: Uses, Benefits, Side Effects and More!
By Dr Anuja Bodhare +2 more
Medically reviewed by Dr Anuja Bodhare
Last updated: May 26, 2026 Published on: Jul 15, 2022
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By Dr Anuja Bodhare +2 more
Table of Contents
Actaea racemosa is the botanical name for black cohosh, which belongs to the Ranunculaceae family. It is a perennial herb with a smooth erect stem and can grow up to eight feet tall. There is usually only one compound leaf per plant, and the leaves have a glossy dark green look. Black snakeroot, tall bugbane, black bugbane, macrotys, battle weed, columbine-leaved leontice, cordate rattle top, fake cohosh, papoose root are famous alternate names for black cohosh. Throughout the summer, feathery white flowers appear in an elongated raceme that can reach two feet in length. The flowers are notable for their striking beauty and their bittersweet smell. The fruit consists of an oval-shaped follicle. The rootstock is a thick, branching black rhizome with a mass of rootlets1.
Black cohosh is found in the northeastern forests of North America, as well as Alabama in the south, Eastern Kansas in the west, and northern Canada. While it may be abundant locally, the species has been declining in recent decades as a result of habitat degradation and over-harvesting1.
Rhizomes of black cohosh have biological effects due to active chemicals such as triterpene glycosides, phenyl propan derivatives such as isoferulic acid, and quinolizidine alkaloids such as cytisine and methylcytisine. Phenolic compounds, chromones, triterpenoids, and nitrogen-containing components are well-known constituents2. Tannins, resins, fatty acids, starch, and sugars are among the other ingredients present in black cohosh1.
Black cohosh has various potential uses due to its properties, such as:
It has been reported that black cohosh might have estrogen-like activity. According to the literature3, phytoestrogen, a component found in black cohosh extract, might be responsible for this activity. Black cohosh extract contains certain chemicals that might be helpful for the symptoms of postmenopausal syndrome (PMS). By binding to receptors in the brain might be involved in the thermoregulation mechanism (temperature regulation). As a result, black cohosh extract might reduce postmenopausal hot flashes through such a thermoregulation mechanism. However, more research is required to prove its effects for menopause.
In my experience, I have seen that in addition to managing hot flashes, black cohosh is commonly used to alleviate other menopausal symptoms. These may include night sweats (also known as vasomotor symptoms), vaginal dryness, heart palpitations, tinnitus (ringing in the ears), vertigo (dizziness), sleep disturbances, nervousness, and irritability. People may find black cohosh helpful against these various symptoms during menopause4.
Dr. Siddharth Gupta, B.A.M.S, M.D (Ayu)
The extract of black cohosh might also help with postmenopausal osteoporosis. The bone structure was maintained by inhibiting bone loss and lowering bone reabsorption in an osteoporosis rat model3.
According to one study3, the triterpenoids in black cohosh did not allow osteoclastic bone resorption in an animal model by decreasing osteoclast-like cells’ production and their resorbing activity, therefore boosting bone mineral density.
The glycoside (actein) might help the bone against oxidative damage to osteoblasts in osteoporotic patients, and deoxyactein might cause a significant increase in cell growth, collagen content, alkaline phosphatase action, and mineralization in the cells, thus protecting bone density3. However, more evidence is required to prove these effects of black cohosh on bone.
As I’ve noticed, in the use of herbs in Western tradition, black cohosh is potentially used for its pain-relieving properties in conditions such as arthritis and muscle-related issues. It is believed to help alleviate pain associated with these conditions6.
Dr. Smita Barode, B.A.M.S, M.S.
According to laboratory studies1, black cohosh extracts might have the potential to inhibit the growth of human breast cancer cells. Black cohosh extract’s possible cytotoxic and apoptotic (cell self-destruction) effect was observed on both androgen-dependent and independent prostate cancer cells.
Another study3 that looked at the effects of black cohosh extract and its main component, triterpene glycoside (actein), on cell development and steroid hormone metabolism in human breast cancer cell lines found that it did not increase cell proliferation or have any effect on estrogen concentration. Alternatively, they might have increased androgen production to help adult women with menopausal symptoms. However, more research is required to understand the effect of black cohosh on cancer cells completely. Moreover, a serious condition like cancer must be properly diagnosed and treated by a doctor. Therefore, kindly consult a doctor.
Black cohosh extract might have the potential to inhibit the anaphylaxis reaction (an acute and severe allergic reaction to an antigen) induced by immunoglobulin E. It may also inhibit the cytokines mRNA, suggesting its possible anti-allergic effect3. However, more investigations are needed to ascertain these claims.
The extract of black cohosh rhizome might have a kind of pain-killing effect in rats by acting on the opiate receptor1. According to animal studies2, the extract of black cohosh might also have antidepressant action. But, more research will be required to prove these effects of black cohosh.
Black cohosh extract might have anti-diabetic properties by activating the protein kinase enzyme. In diabetic mice, the black cohosh extracts might have the potential to lower body weight, may increase glucose metabolism, and improve insulin sensitivity2. Ensure that you consult a doctor for proper diagnosis and treatment of conditions such as diabetes. Kindly do not self-medicate as these claims need to be ascertained by further research.
The extract of black cohosh rhizomes might exert anti-inflammatory action on rats. Interleukin levels and neutrophil levels might have an effect when ferulic acid and isoferulic acid is administered to virus-infected mice2. Therefore, it might be helpful in reducing inflammation, but more research is required to scientifically back-up these effects.
Though there are studies that show the potential use of black cohosh in various conditions, but these are insufficient and there is a need of further studies to establish the true extent of benefits of black cohosh on human health.
I would like to highlight that it’s important for individuals with liver disorders to seek guidance from a doctor before using black cohosh products. Additionally, if someone experiences symptoms of liver trouble like abdominal swelling, dark urine, or jaundice while taking black cohosh, they should discontinue its use and promptly consult a doctor. These precautions are necessary to ensure the safe and appropriate use of black cohosh5.
Dr. Rajeev Singh, BAMS
Black cohosh can be used in the following ways:
Your Ayurvedic physician will prescribe you the form and dosage of black cohosh as and when needed based on your consultation with them. You must consult them before taking any herbal supplements. Do not discontinue or replace an ongoing treatment of modern medicine with an ayurvedic/herbal preparation without consulting a qualified doctor.
Also Read: Behada: Uses, Benefits, Side Effects & More!
Some of the side effects noted with the use of black cohosh are:
According to the safety studies2 of black cohosh on pregnant and breastfeeding women, black cohosh usage is contraindicated during pregnancy and lactation. Therefore, it should only be taken under the supervision of a physician. No research has been done on the safety studies of black cohosh in children. Therefore, do not use black cohosh without a doctor’s prescription.
When black cohosh is combined with iron products, the tannins in the plant can interact with the iron and produce insoluble complexes. So, it should be taken at least two hours apart if you are taking iron supplements2.
Also Read: Vasavaleha – Benefits, Side Effects, Precautions & More!
It is a perennial herb, botanically known as Actaea racemosa, belonging to the Ranunculaceae family1.
Black cohosh might be helpful for rheumatism, menstruation disorders, dropsy (tissue swelling), lung problems, cough, liver problems, sore throat, pain, inflammation, backache, insomnia, snakebite, convulsions, fits, epilepsy, nervous excitability, asthma, delirium, neuralgia (nerve pain), ulcers, scrofula, smallpox, cholera, and measles1. However, more research is required to prove these potential effects of black cohosh on humans.
Menopausal women commonly use black cohosh due to its estrogenic activity. It has effects similar to estrogen and might be helpful for hot flashes, depression and bone loss3. However, these effects need to be backed up by more scientific research.
Black cohosh is used in the form of dried rhizome,dried root, roottincture,, rhizometincture,rhizome extract,, root extract,, and rhizome decoction, as and when prescribed by your Ayurvedic physician1.
No, black cohosh usage is contraindicated during pregnancy and lactation2.
Black cohosh’s side effects are inflammation of gastric and intestinal mucosa,nausea and vomiting,muscle damage,, altered mental status,, hyponatremia, and lung tumours2.
It is considered safe safe at the prescribed level except for pregnant and breastfeeding women2.
Black snakeroot, tall bugbane, black bugbane, macrotys, battle weed, columbine-leaved leontice, cordate rattle top, fake cohosh, papoose root are the common names of black cohosh1.
No, black cohosh reduces the hot flashes. It binds to serotonin receptors in the brain (hypothalamus) and might help with reduce postmenopausal hot flashes through this thermoregulation mechanism3.
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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