Black Cohosh - Actaea/Cimicifuga racemosa

Traditional Uses

Black cohosh is a native North American herb that was known by botanists as early as 1705, although some reports suggest that American settlers knew it as far back as 1696. The former genus name Cimicifuga means “to drive away bugs,” giving rise to the common names bugwort and bugbane. Black cohosh was known as squaw root by Native Americans, suggesting traditional use as a women’s tonic. The plant was used by Indian tribes such as the Winnebagos, Penobscots, Delaware, Iroquois, and Cherokee for various ailments including arthritis, snakebite, coughs and other pulmonary conditions, diarrhea, and irregular menstruation, as well as to aid in childbirth. The Eclectic Physicians of the late 1800s valued it for the treatment of arthritis, women’s complaints, nervous problems, and post-childbirth pain. In the 19th century, Lydia Pinkham, an early pioneer for women's health, used black cohosh in her “Vegetable Compound” formula. Black cohosh was an official drug in The United States Pharmacopoeia from 1820 to 1926.

Scientific support for health benefits

A strong body of clinical research supports the use of black cohosh for easing both physical and psychological symptoms of menopause. More than 20 clinical trials involving more than 3,000 women have been conducted since the 1950s, most of them German. Results indicate that black cohosh is significantly more effective than placebo and as effective as conventional hormone replacement therapy (HRT) in relieving symptoms of menopause, including hot flashes, night sweats, headaches, heart palpitations, dizziness, and vaginal atrophy (Stolze, 1982; Stoll, 1987; Pethö, 1987; Warnecke, 1985). One study showed that black cohosh is as effective as diazepam (Valium) in relieving psychological symptoms of menopause, including nervousness and depression (Warnecke, 1985). Preliminary research offers some support for black cohosh’s traditional use as an anti-inflammatory agent in arthritic conditions (Hirabayashi, et al, 1995).

Recent research on black cohosh’s mechanism of action suggests that the plant works by normalizing levels of luteinizing hormone (LH), not through “estrogenic” activity, as was originally believed (Düker, et al, 1991; Einer-Jensen, et al, 1996).

Primary chemical constituents

Triterpene glycosides (actein, 27-deoxyactein, and cimicifugoside) and flavonoids. Extracts are often standardized to 1 mg triterpenes (calculated as 27-deoxyactein) per tablet.

Black Cohosh Rhizome

Possible substitutes

Many herbs are marketed for their impact on menopause symptoms, but none are backed by the amount and quality of positive research that supports black cohosh. In the opinion of many sources, black cohosh offers the highest quality for the price when it comes to relieving symptoms of menopause. Black cohosh differs from other botanicals used in the treatment of menopausal symptoms in that it is not believed to contain phytoestrogens.

In the US, one plant frequently found as an adulterant to black cohosh is yellow cohosh (Actaea americana), although it is not difficult to distinguish from A. racemosa in the wild. Worldwide, black cohosh may be substituted in the market by one or more species of Chinese Cimicifuga. The New Jersey extract company Pure World conducted research on the extracts of various companies and presented the results at the American Chemical Society (He, 2000). The findings suggest widespread substitution of Cimicifuga foetida for the official C. racemosa (now Actaea racemosa). This is an inappropriate substitution, since all the clinical research is on the North American species.[1] This highlights a need to protect the American market from an unresearched species, and an opportunity to persuade companies to cease buying C. foetida because of the risk of negative media and regulatory exposure.


Natural Range in United States

Black cohosh [Actea racemosa (L.) formerly Cimicifuga racemosa (L.) Nutt], member of the Ranunculaceae family, is a native medicinal plant found in rich woodlands from Maine to Georgia, west to Missouri, Indiana, and Ontario. In North Carolina it can be found at elevations up to 4,000 feet. It is an herbaceous perennial reaching a mature height of well above four feet and can grow at a rate of 18 to 22 inches per month during the growing season. The leaves are large with three pinnately compound divisions and irregularly toothed leaflets. Tall plumes of cream to white flowers, on a wand-like raceme, bloom from May to July, often-towering over six feet. From August to October, seeds develop in capsules and make a rattling sound when they are mature and ready to be harvested. Of economic importance are the rhizomes and roots. The rhizome is dark brown to black in color; is thick and knobby; and produces large buds on the upper surface. The rhizomes also have fibrous roots attached. When the leaves on the plant start to die back in the fall, the root is harvested, cleaned, and dried.


Sustainable wild harvest

The potential for sustainable harvest of black cohosh is high, based on its biology and ecology. The plant is abundant, and traders believe that with little effort, it can be collected without damaging local populations. However, since the part collected is the root, there are inevitable questions about sustainability. Research is now underway to determine the recovery rate after harvesting a given percentage of a population (see MARKET & REGULATORY).

The opinion of United Plant Savers is, “With the huge demands placed on wildcrafted black cohosh and the reduction of its native habit, there really isn't such a thing as sustainable wild harvest at this time.”

It does seem possible that if market demand were to increase suddenly and substantially, local populations could be placed at risk. Black cohosh is being considered by USFWS for listing in CITES Appendix II. At this time, the agency has only made a request for information (Federal Register, June 12, 2001):


Relative to other root crops like goldenseal and ginseng, cultivation of black cohosh is not difficult and reportedly is even more economical than wild harvest. Divisions are the quickest means of propagation as seed requires an extended period of stratification to emerge.

Black Cohosh seedlings in MoonBranch Botanicals nursery


Regulatory issues related to wild harvest

Permits are required for harvest of black cohosh on US Forest Service land. The plant is not currently listed as threatened or endangered, but is considered “at risk” by United Plant Savers. The significant increase in demand for wild harvested material during the late 1990s prompted TRAFFIC (the trade monitoring-organization of the World Wildlife Fund and the World Conservation Union) to recommend black cohosh as a priority species for future study on US Forest Service lands.

Results of a pilot black cohosh population study are included in Appendix 1. Initial study objectives were to refine the sampling procedure required for a full-scale population study in North Carolina’s Pisgah National Forest. Future objectives include assessment of the impact of root harvest on the sustainability of Actaea racemosa and A. americana in the wild. (A. americana is included because wild harvesters may not differentiate between the two species.)

Regulatory issues related to marketing

Black cohosh is regulated in the US as a dietary supplement when labeled as such, or as a food in the absence of dietary supplement labeling. After the initial passage of the Dietary Supplement Health and Education Act (DSHEA) in 1994, vague structure/function claims such as “black cohosh supports women’s health” were the only type possible in product labeling and advertising, as manufacturers were forbidden to imply that products could treat, prevent, or cure any disease. However, a 2000 FDA ruling took menopause out of the “disease” category (along with other normal, common conditions of life, such as menstruation), and clarified the types of health claims that could be made for products intended to help with associated symptoms. According to this ruling, “black cohosh helps ease symptoms of menopause” is now a perfectly legal structure function claim.

Black cohosh is officially approved for use as a drug for menopausal complaints and menstrual disorders in Europe, which is one of its major markets. In the US, the FDA has recently begun sending warning letters to companies using supplement herbs in functional food products, although black cohosh has not yet been the subject of any such letters. The history of use of this botanical should protect it from problems in this area, but the risk exists that food companies could be alarmed by the FDA threats and voluntarily discontinue using black cohosh in functional food products.

Disclaimer: The information contained herein these Plant Profile pages are for educational and conservation uses only. All information contained on these Plant Profile pages was procured through our research from available public documents and electronic media sources.


Yellow Creek Botanical Institute

North Carolina Consortium on Natural

Medicines and Public Health


USDA, United States Forest Service

USDA, ARS and University Cooperative Research and Extension

Black Cohosh blackcohosh

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Black Cohosh cut root by the ounce

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