Black Cohosh Benefits and Uses

Black cohosh is a herb that has been rising in popularity for supporting women’s hormonal health, enhancing female fertility, and managing menopause-related symptoms. Continue reading to learn about black cohosh benefits and how it may improve hormonal health for women.  

What is black cohosh ?

Black cohosh is a herb native to North America. It is a member of the buttercup family and has been used traditionally by indigenous cultures for its medicinal properties. (8) 

Preparations of black cohosh are made using the roots and underground stems of the plant, which are called rhizomes. Black cohosh supplements can be found in powdered, liquid, and pill form. (5) 

The technical (Latin) names for black cohosh are Actaea racemosa and Cimicifuga racemosa. Black cohosh is also known by a few other names, including: 

• Baneberry
• Black snakeroot 
• Bugbane 
• Bugwort
• Macrotys
• Rattleroot 
• Rattleweed (8)(15) 

Benefits of black cohosh 

Black cohosh has been used traditionally by indigenous cultures for many ailments, such as muscle pain, fever, cough, pneumonia, delayed labor, and menstrual irregularities. (9) 

More recently, however, it has been studied for its effects on women’s health. Black cohosh is considered to be a phytoestrogen, a plant-based compound that has similar properties to the hormone estrogen. (16) It is believed that black cohosh may mimic the effects of estrogen in the body, and as a result, it may help to manage menopause symptoms, improve fertility, and hormonal health in females. (9)  

1. Fertility 

Some studies have suggested that black cohosh supplementation may work similarly to  ethinyl oestradiol in improving fertility and successful pregnancy rates when combined with clomiphene citrate. (11)(12)

Clomiphene citrate is a medication used to trigger ovulation in females who are not able to ovulate and thus cannot become pregnant. (13) Although clomiphene citrate can help induce ovulation, it is often not sufficient on its own to increase pregnancy rates. (10)  For this reason, clomiphene citrate is often prescribed with ethinyl oestradiol, a bioidentical hormone, that thickens the lining of the uterus to improve pregnancy outcomes. (2)One randomized control trial including 134 patients examined the effectiveness of clomiphene citrate combined with black cohosh or ethinyl oestradiol for improving fertility. The study, found that the group taking black cohosh had faster maturation of eggs, a thicker uterine wall, and higher amounts of estrogen and progesterone, hormones that are essential for a successful pregnancy. (3)(10) Additionally, the study also found that taking black cohosh produced similar pregnancy rates as taking ethinyl oestradiol. (10) 

2. Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility. The condition affects between 6 to 12% of females of reproductive age in the United States. Individuals with PCOS often have higher levels of androgens (e.g. testosterone). Androgens are sex hormones that are essential for both male and female reproductive health; however, females produce far less than males. Excess androgen production can prevent ovulation, the release of eggs from the ovaries, and therefore, interfere with fertility. (1)

A randomized controlled trial conducted in 2013 compared the effect of black cohosh and clomiphene citrate on ovulation in women with PCOS. The study included 100 women and was split evenly into two groups, with one group receiving black cohosh and one group taking clomiphene citrate. The study found that ovulation, uterine thickness, and pregnancy rates were higher in the group taking black cohosh. The authors, therefore, concluded that black cohosh may be used as an alternative to clomiphene citrate for inducing ovulation in females with PCOS. (6)

3. Menopausal symptoms 

Menopause, a natural transition marked by the end of menstruation, is associated with various symptoms that can negatively impact quality of life. Symptoms associated with menopause may include hot flashes, night sweats, sleep disturbances, mood swings, hair loss, and weight gain. (14)

A 2016 trial compared the effect of black cohosh and menopausal hormone replacement medication on body weight, menopausal symptoms, and metabolic parameters in 174 menopausal women. The metabolic parameters measured included lipids (cholesterol), glucose (blood sugar), and insulin. Menopausal symptoms improved in the group taking both black cohosh and hormone replacement medication; however, there was no effect on metabolic parameters. (4)

A 2018 randomized control study compared the effectiveness of black cohosh or evening primrose oil supplementation for reducing menopause symptoms in 80 postmenopausal women. While both herbs improved hot flash severity, black cohosh also reduced the number of hot flashes the women experienced. (7)

Risks and adverse effects of black cohosh

Black cohosh is generally safe to use with the guidance of a healthcare practitioner. There are a few mild side effects associated with its use, including:

• Cramping
• Feeling heavy
• Headache 
• Rash 
• Stomach upset 
• Vaginal spotting or bleeding 
• Weight gain 

A few rare cases of liver damage have been reported from the use of commercial and unregulated black cohosh products. Ensure you purchase your supplements from a reputable source and speak with your health care practitioner before taking black cohosh products. (8) 

The bottom line 

Black cohosh is a herb native to North America that has been used for centuries for its medicinal properties. Black cohosh may be effective for improving female hormonal health and fertility due to its possible estrogen-mimicking effects in the human body. There are a few mild side effects associated with its use. Always speak with your healthcare practitioner before starting any new supplements.