Black Cohosh

Introduction

Black cohosh (Actaea racemosa or Cimicifuga racemosa), a member of the buttercup family, is a perennial plant native to North America. Other, mostly historical, names for this herb include snakeroot, black bugbane, rattleweed, macrotys, and rheumatism weed. Black cohosh has a long history of use. Native Americans used it, for example, to treat musculoskeletal pain, fever, cough, pneumonia, sluggish labor, and menstrual irregularities. European settlers used black cohosh as a tonic to support women’s reproductive health.
Today, black cohosh is most commonly used for menopausal symptoms, including hot flashes (also called hot flushes) and night sweats (together known as vasomotor symptoms), vaginal dryness, heart palpitations, tinnitus, vertigo, sleep disturbances, nervousness, and irritability . Menopause, which typically occurs in women at about 51 years of age, is the cessation of menstruation and the end of a woman’s reproductive period .
This fact sheet provides an overview of the use of black cohosh to relieve menopausal symptoms.

Black Cohosh Dietary Supplements

Preparations of black cohosh are made from its roots and rhizomes (underground stems). They are sold as dietary supplements in such forms as powdered whole herb, liquid extracts, and dried extracts in pill form .

Available preparations vary considerably in their chemical composition, in part because the compounds in black cohosh that may be responsible for any relief of menopausal symptoms are not known. Substances in black cohosh that may account for its activity include triterpene glycosides such as actein, 23-epi-26-deoxyactein, and cimicifugoside; resins, such as cimicifugin; and aromatic acid derivatives such as caffeic, isoferulic, and fukinolic acids.

Products containing black cohosh extract are frequently standardized to provide at least 1 mg triterpene glycosides per daily dose . Remifemin, a commercial black cohosh product used in several studies included in a 2012 Cochrane review described below, is an extract currently standardized to be equivalent to 40 mg black cohosh root/rhizome (extracted with isopropyl alcohol) per daily dose of two tablets, but it is not standardized to triterpene glycoside content . The product has been on the market for years and has been reformulated over time .

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