Everything You Need to Know About

Black cohosh (Actaea racemosa)

Botanical family: Ranunculaceae
Parts used: Fruits, Roots & Berries
Black cohosh (Actaea racemosa)
by Malek Murison
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Overview and Health Benefits

Black cohosh, a tall and graceful plant of the buttercup family (Ranunculaceae) found in North American woodlands, has a long history of traditional use, particularly by Native Americans (Salmón, 2020). It has found its place in modern herbal medicine primarily for its uses in women's health. Scientific studies have begun to support these traditional uses, particularly focusing on its efficacy in managing menopausal symptoms.

Key Benefits for Health and Wellbeing:

  • Menopausal Symptom Relief: Notably effective in reducing hot flashes, night sweats, and mood swings.
  • Menstrual Discomfort: Used to alleviate premenstrual syndrome (PMS) and menstrual cramps.
  • Mood Regulation: May help in managing mood swings and irritability associated with menopause.
  • Sleep Improvement: Beneficial in improving sleep quality disrupted by menopausal symptoms.

Expanding on these benefits, black cohosh has been most widely recognised for its safety and efficacy in alleviating menopausal symptoms (German Commission E, 2014; Henneicke-von Zepelin, 2017). Studies have indicated its effectiveness in reducing the frequency and intensity of hot flashes and night sweats, common and often distressing symptoms of menopause (Beer & Neff, 2013). This has made it a popular alternative to hormone replacement therapy, with the added advantage of fewer side effects in comparison.

Black cohosh also helps relieve pain and spasm – including uterine cramps and breast pain, but also useful for nerve and muscle pain, neuralgia, arthritis and headaches (McIntyre, 2019).

Mood regulation is another area where black cohosh shows potential. Fluctuations in mood and increased irritability can be challenging during menopause, and this herb has been used to help stabilise mood swings, contributing to a more balanced emotional state (Briese et al., 2007).

Lastly, the impact of menopause on sleep quality cannot be understated. Black cohosh has been noted to aid in improving sleep patterns disrupted by menopausal symptoms, such as night sweats and anxiety, thereby promoting better overall sleep quality (Jiang et al., 2015).

Safety Profile

When considering the use of black cohosh, it is essential to be aware of certain cautions and contraindications. Primarily, black cohosh should be avoided during pregnancy (except during labour under qualified supervision), as it may stimulate uterine contractions, posing a risk to the developing foetus. There is also a potential risk of liver damage, highlighted in rare case reports, necessitating caution in individuals with pre-existing liver conditions (Nisbet and O’Connor, 2007).

In terms of medication interactions, black cohosh may interact with certain drugs. For instance, it could potentially interfere with hormone therapies, including birth control pills and hormone replacement therapy, altering their effectiveness. Additionally, because of its potential effects on liver enzymes, it could interact with medications metabolised by the liver, such as certain statins used for cholesterol management.

As with any herbal remedy, it is advisable to consult with a healthcare professional before incorporating black cohosh into your regimen, especially if you have a pre-existing medical condition or are taking prescription medications. 

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Key Body Systems Black cohosh (Actaea racemosa) relates to

Black cohosh (Actaea racemosa)
Endocrine and or Reproductive System
Black cohosh (Actaea racemosa)
Nervous system

Energetics

Black cohosh (Actaea racemosa)
Warming
Black cohosh (Actaea racemosa)
Drying

Key actions

  • Anti-inflammatory
  • Antispasmodic
  • Emmenagogue
  • Sedative
  • Analgesic
Black cohosh (Actaea racemosa)

Key uses

  • Menopausal symptoms (hot flushes, sleep disturbances, mood changes)
  • Joint pain and rheumatism

Where to Find Black cohosh (Actaea racemosa)

Black cohosh (Actaea racemosa)

Black cohosh is a tall perennial plant that can reach up to two metres in height.. Its most distinctive feature is its long, wand-like spikes of white or creamy-white flowers that bloom in the summer. These flowers form a dense, elongated cluster at the top of the stem. The plant also sports large, compound leaves that are divided into smaller leaflets, giving it a lush, feathery appearance.

You'll typically find black cohosh in the deciduous forests of North America, primarily in the eastern United States and parts of Canada. It favours shaded or semi-shaded areas, thriving in rich, moist, well-drained soils. The cooler, forested environments provide the ideal conditions for this herb to flourish.

The plant is at risk, so it must not be foraged / gathered from the wild for medicinal use, but rather cultivated. It is quite easy to cultivate, and can be propagated by seeds or rhizome division. It is listed as endangered in the states of Massachusetts and Illinois in the United States (United Plant Savers, n.d.), and is tagged as “at risk” on the United Plant Savers list (United Plant Savers, 2022).

References

Beer, A.-M., Neff, A. (2013). Differentiated Evaluation of Extract-Specific Evidence on Cimicifuga racemosa's Efficacy and Safety for Climacteric Complaints. Evidence-Based Complementary and Alternative Medicine, 2013, 1-14. https://doi.org/10.1155/2013/860602

Briese, V., Stammwitz, U., Friede, M., & Henneicke-von Zepelin, H.-H. (2007). Black cohosh with or without St. John's wort for symptom-specific climacteric treatment—results of a large-scale, controlled, observational study. Maturitas, 57(4), 405-414. https://doi.org/10.1016/j.maturitas.2007.04.008 

German Commission E. (1989). Black Cohosh. cms.herbalgram.org/commissione/Monographs/Monograph0024.html

Henneicke-von Zepelin, H.-H. (2017). 60 years of Cimicifuga racemosa medicinal products: Clinical research milestones, current study findings and current development. Wiener Medizinische Wochenschrift, 167(7), 147-159. https://doi.org/10.1007/s10354-016-0537-z 

Jiang, K., Jin, Y., Huang, L., Feng, S., Hou, X., Du, B., ... & Zheng, J. (2015). Black cohosh improves objective sleep in postmenopausal women with sleep disturbance. Climacteric, 18(4), 559-567. https://doi.org/10.3109/13697137.2015.1042450 

McIntyre, A. (2019). The complete herbal tutor. Aeon. 

Nisbet BC, O’Connor RE. (2007). Black cohosh-induced hepatitis. Del Med J. Nov;79(11):441-4. https://pubmed.ncbi.nlm.nih.gov/18203607/ 

Salmón, E. (2020). Iwígara: American Indian ethnobotanical traditions and science. Portland, OR: Timber Press.

United Plant Savers. (n.d.). Black cohosh—Actaea racemosa. https://unitedplantsavers.org/species-at-risk-list/black-cohosh-actaea-racemosa/ 

United Plant Savers. (2022). Species at-risk list. https://unitedplantsavers.org/species-at-risk-list/