BT-099 · Ranunculaceae

Black cohosh

Actaea racemosa

Evidence: LimitedCautionWild-harvested

Its smell repels insects, so its old Latin name, Cimicifuga, means “bedbug chaser”.

Other names: Black snakeroot; formerly Cimicifuga racemosa
Part used: Root and rhizome
Region: North America
Use: Healing

Photo: H. Zell · CC BY-SA 3.0 · Wikimedia Commons

In short

What is Black cohosh?

Black cohosh (Actaea racemosa) is a plant of the Ranunculaceae family. Traditions that use it: North America. Part used: root and rhizome.

What is Black cohosh used for?

Traditional use: The Cherokee and other Indigenous peoples used the root for women’s health, rheumatism and snakebite. Scientific evidence: limited. The EMA recognises the root extract for menopause symptoms such as hot flushes as a well-established use.

Is Black cohosh safe?

Safety label: caution. Rare cases of liver damage have been reported; people with liver disease should not use it.

Traditional use

North America

The Cherokee and other Indigenous peoples used the root for women’s health, rheumatism and snakebite.

Today

One of the most used herbal medicines for menopause symptoms in Europe.

In nature

Where it grows: Deciduous forests of eastern North America.
Harvest season: Root and rhizome are dug in autumn.
Local names: karayılan otu, yılan kökü

Mix-up risk

Some commercial products have been found to contain other, Asian Actaea species.

Preparation

Used as a standardised root extract.

What science says

The EMA recognises the root extract for menopause symptoms such as hot flushes as a well-established use. The NCCIH says study results are inconsistent.

Safety

Caution

Rare cases of liver damage have been reported; people with liver disease should not use it.

Drug interactions

Medicine or substance	Why it matters
Drugs that burden the liver	Rare cases of liver injury have been reported.
Hormone therapy and some breast cancer drugs (tamoxifen)	Ask the oncologist before combining.

This list is not complete. If you take regular medication, ask your pharmacist or doctor before trying Black cohosh.

Conservation

Note: Most commercial products are made from roots dug in the wild; populations are declining in some areas.
Alternative: Products made from cultivated root.