Actaea racemosa

Black Cohosh

Ranunculaceae

Evidence: LimitedCaffeine Free North AmericaWomen's WellnessRelaxation

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Identity

Common Name: Black Cohosh
Scientific Name: Actaea racemosa
Botanical Family: Ranunculaceae
Native Region: Eastern North America
Cultivation Regions: Eastern North America, Europe (cultivated)
Plant Parts Used: Rhizome, Root
Synonyms: Cimicifuga, Black Bugbane, Black Snakeroot
Caffeine Level: Caffeine Free

A tall woodland perennial with deeply divided toothed leaves and a long slender wand of fluffy white feathery flower spikes; the thick dark knobby rhizome is medicinal.

Historical Background

Black cohosh (black bugbane) has been used by Native American peoples of eastern North America for centuries for women's and rheumatic concerns, later carried into 19th-century Eclectic medicine. Its knobby root is decocted for a respected but cautionary place in women's herbalism.

Earliest recorded uses: Native American traditions for centuries; adopted into 19th-century Eclectic medicine as a women's herb.

Traditional preparations:

Root decoction
Women's formula with dong quai
Short-term menopausal tea

Traditional Uses

These uses document historical traditions and do not imply proven effectiveness.

Native American Traditions

Women's health and rheumatic comfort root decoction.

Modern Herbalism

Menopausal and women's nervine tonic.

Flavor & Aroma

EarthySlightly BitterGreenAstringent

Aroma: Earth, slightly bitter, green

Tea Information

Suitable for Tea

Yes

Preparation Methods

Decoction

Steeping Temperature

200°F (93°C)

Steeping Time

15-20 minutes simmer (decoction)

Recommended Vessel

Saucepan (decoction)

Blends Well With

Dong Quai, White Peony, Licorice Root, Chasteberry, Red Raspberry Leaf

200°F (93°C) 15-20 minutes simmer (decoction)

Safety & Cautions

Contraindications

Avoid in pregnancy, estrogen-sensitive conditions, and liver disease; discontinue with signs of liver injury (jaundice, dark urine); caution with hormonal therapy. EU authorities caution about rare hepatotoxicity.

Drug Interactions

May interact with hormonal therapy and liver-metabolized drugs; rare hepatotoxicity reports; consult a clinician.

Pregnancy

Avoid.

Children

Not recommended for children.

Allergies

Possible in those sensitive to Ranunculaceae; rare.

Known Adverse Effects

Generally well tolerated short-term; may cause GI upset, headache, rash, or liver effects. Rare serious liver reactions reported.

Research Summary

Evidence Level: Limited

Black cohosh has a tradition for menopausal symptoms; trial results are mixed and inconclusive, and rare serious liver injury has been reported. It is not a treatment for menopause, PMS, or any disease and should be used only with clinician guidance and liver monitoring.

Evidence levels reflect the currently available scientific literature and may change as new research emerges. Where evidence is limited or conflicting, this is stated plainly.

References & Sources

EMA HMPC · Cimicifugae rhizoma monograph (2010)
MSKCC · Black cohosh information (2022)

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