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Black cohosh preparations are derived from the root and rhizome of a shrub-like plant (Cimicifuga racemosa) also known as black snakeroot. The name black cohosh is derived from the dark color and the rough and gnarly structure of the root. (Cohosh is Algonquin for "rough.") The plant is native to eastern forests of North America.
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Traditional Uses
Potential Benefits
How do scientists think it works?
Black Cohosh references
Traditional Uses: Black Cohosh is a popular Native American and folk remedy for female ailments and menstrual cramps, as well as fatigue, anxiety, rheumatoid arthritis, and respiratory conditions like bronchitis. It was an ingredient in Lydia Pinkham’s Vegetable Compound, a best-selling women’s patent medicine of the late 19th century, at which time the herb was listed in the U.S. Pharmacopoeia and National Formulary.   Under the name "shoma," Traditional Chinese Medicine has long employed other Cimicifuga species (e.g., C. foetida, C. simplex Wormsk.) for similar purposes, as well as for alleviation of fever, pain, and inflammation.

Potential Benefits: Black Cohosh is also widely used in Germany for discomfort from menopause. It may have uses as a sedative and anti-inflammatory, and can lower blood pressure and possibly help control diabetes.

How do scientists think it works? Animal studies have provided conflicting results on the question of whether black cohosh has estrogen-like effects in women. However, research involving animals and humans indicates that Black Cohosh contains substances with endocrine (hormonal) activity. In menopausal women and animals, Black Cohosh extract reduces the serum concentration of pituitary luteinizing hormone (LH), which is associated with negative physical and psychic effects of pre-menstrual syndrome and menopause, such as hot flashes, uterine spasms, depression, and dysmenorrhea. Numerous clinical studies indicate that the herb suppresses the increase in LH and may offer an effective, slower-acting alternative to estrogen therapy. Experiments conducted in vivo and in vitro indicate that the LH suppressive effect may be initiated by three types of compounds that (1) do not bind to estrogen receptors but suppress release of LH; (2) bind to estrogen receptors and suppress LH; (3) bind to estrogen receptors with no effect on LH. In experimental rodents, constituents of Black Cohosh reduced inflammation in response to influenza infections, via inhibition of interleukin 8—a compound that stimulates congregation of pro-inflammatory neutrophils (white blood cells).  In Europe, Black Cohosh extract is also used as a therapy for spastic parametropathy, a neurovegetative disorder of the pelvis.

Black Cohosh contains triterpene glycosides, including actein, racemoside, 27-deoxyactein, and cimicifugoside. An isoflavone called formononetin has been identified as binding to estrogen receptors in the rat uterus, and cimicifugoside is believed to affect the hypothalamus-pituitary system, with effects on the reproductive and nervous systems. Aromatic acids (ferulic acid and isoferulic acid) are believed responsible for the drug’s anti-inflammatory effects.

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Nature's Way Black Cohosh extract is standardized to 2.5% Triterpene Glycosides. 1 tavblet provides 40 mg of Black Cohosh, dried extract
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Types of products: It comes in capsules, concentrated drops, and extracts. The most popular products (e.g., Remifemin) are standardized to contain a minimum of 2.5% triterpene glycosides.

Safety: This herb promotes menstruation and should be avoided during pregnancy. It has other potential side effects, and is should be used under the supervision of an educated practitioner.

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Black Cohosh references
Duker EM, et al. Effects of extracts from C. racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Med 57(5):420-4, 1991.
Jarry H, Harnischfeger G. Studies on the endocrine effects of contents of cimicifuga racemosa 1. Influence on the serum concentration of pituitary hormones in ovariectomized rats. Planta Med 51: 46-49, 1985. [German]
Jaspersen-Schib R. Cimicifuga et troubles de la ménopause. Schwiez Apoth Ztg 128: 155-7, 1990 [French] Schwiez Apoth Ztg 127: 348-50, 1989 [German].
Lehmann-Willenbrock E, Riedel HH. clinical and endocrinologic studies of the treatment of ovarian insufficiency manifestations following hysterectomy with intact adnexa. Zentralblatt fur Gynakologie 110(10): 611-18. [German]
Shibata M et al. Pharmacological studies on the Chinese crude drug "Shoma." 1. Acute toxicity and anti-inflammatory action of Cimicifuga rhizoma, Cimicifuga dahuria maxim. Yagugaku Zasshi - J Pharm Soc of Japan. 95: 539-546.
Einer-Jensen, N., et al., "Cimicifuga and Melbrosia lack oestrogenic effects in mice and rats," Maturitas (1996), 25(2):149-53
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