Black Cohosh

Many herbs we are familiar with today tend to have their roots in the European tradition. However, some herbs native to the Americas have proved to be so beneficial that they have become popular worldwide. Black Cohosh (Actaea Racemosa)  is one of these herbs.

Native to North America, this striking plant has a long history of use in Native American medicinal tradition, where the flower and root are typically the most commonly used part. It has even made its way to Traditional Chinese Medicine (TCM), where it is used for a wide variety of problems, though its most universal uses are all centered around women and their hormones.

Black Cohosh plant

Black Cohosh is a woman’s herb fit for a lifetime. This herb benefits most stages in a woman’s life after adolescence, especially for those stages in life where hormones seem to shift. Perimenopause is the most well-known time of hormonal shift for women and is also the time where Black Cohosh can be most beneficial.

PMS & Cramps

While most studies done on Black Cohosh have been on perimenopausal symptoms, it is traditionally used for many other issues. Native Americans traditionally used it for menstrual irregularities such as premenstrual syndrome (PMS) and extreme cramps. Some of this is attributed to its anti-inflammatory properties and its ability to improve the health of the uterine lining.

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Fertility & Polycystic Ovarian Syndrome (PCOS)

There is not much evidence that Black Cohosh can improve fertility alone. Still, there is a growing amount of evidence that it may enhance the fertility drug Clomid (clomiphene citrate) effectiveness, which further increases the chances of pregnancy. Clomid is a drug commonly given to women with PCOS when they’re trying to get pregnant. In addition to Black Cohosh likely boosting the effectiveness of this medication, it also helps regulate menstrual cycles in those afflicted with PCOS.


Black Cohosh may be of some use to women who suffer from uterine fibroids. One study in particular shows that this herb can reduce the size of fibroids by up to 30% and can prevent the formation of new fibroids.


Though this beautiful herb may help boost certain fertility medications, it’s not recommended during pregnancy, with one major exception. At the end of pregnancy, Black Cohosh can help induce labor or speed up a slowed labor. This herb works to promote the ripening of the cervix – but it can harm the baby’s development if it’s taken too early. It can also have some pretty severe side effects if you take too much. For this reason, Black Cohosh should only be taken under the supervision of a Midwife or Doctor during pregnancy.

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A phytoestrogen is a plant-based compound that acts like estrogen and can sometimes be used, by our bodies, in the same manner as estrogen. Black Cohosh is full of phytoestrogens, which is one of the main reasons scientists believe it works as well. Much research has been done on this herb. Much of the work has determined that the phytoestrogens present in Black Cohosh are a specific type called selective-estrogen receptor modifiers (SERMs). Specifically, Black Cohosh is a phytoestrogen that does not work on the uterus but works on the bones, brain, and vagina.


You may not be aware of this, but osteoporosis in women can (and often does) start during perimenopause. Estrogen plays an essential part in building bone and maintaining bone mass. As our estrogen production drops, our body’s ability to form bone drops, resulting in a net loss of bone mass. Black Cohosh’s phytoestrogen activity makes it a great herb to help with this particular issue. Its actions on the bone tend to be protective against this naturally occurring bone loss, which may help prevent osteoporosis in some women.

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Hot Flashes

Now we’ve come to the symptom most perimenopausal women are most interested in—hot flashes. Black Cohosh has been studied most extensively for its use in menopausal symptoms, with hot flashes having the most promising results. Most women who supplement with Black Cohosh tend to have fewer and far less extreme hot flashes, night sweats, chills, flushes, and even heart palpitations.

Other Perimenopausal Symptoms

Though the most commonly complained about symptom of perimenopause is the hot flash, there are some other symptoms that Black Cohosh can help with. This herb’s phytoestrogens can help reduce vaginal thinning, helping to reduce the occurrences of pain during intercourse and prevent vaginal dryness. Since these phytoestrogens do not affect the uterus, this herb can be used as a hormone replacement. One of the potential dangers of estrogen replacement during perimenopause is the potentially harmful effect estrogen has on the uterus. It can also help balance out mood swings, especially some of the swings down into depression. Though often, these mood swings are made worse by stress and anxiety. Breathwork, journaling, certain herbs, and even the simple act of brewing tea can all help reduce stress and anxiety. Try implementing one or more of these strategies along with You Me and Uni’s Meditative State of Mind herbal tea blend to help reduce that anxiety, stress and help maintain that balanced mood.

Side Effects and Cautions

  • The most common side effect is mild gastrointestinal distress. Other mild side effects include headache, rash, a feeling of heaviness, vaginal spotting or bleeding, and weight gain.
  • Since it is full of phytoestrogens, there is a major caution about taking this herb if you deal with estrogen-dependent cancers.
  • It is not recommended for adolescents and pregnant women because of its hormonal activity.
  • Though this herb does not have many drug interactions, it may reduce certain medications and therapies, including statins and the chemotherapy drug cisplatin.
  • There have been some reported cases of severe liver issues. Anyone who develops symptoms of liver trouble, such as abdominal swelling, dark urine, or jaundice, while taking black cohosh should stop using it and consult a health care provider.
  • Do not confuse Black Cohosh with Blue Cohosh. They are very different herbs with different benefits, and Blue Cohosh comes with quite a few extra cautions and side effects.

This beautiful herb full of feminine vitality can benefit most women around the time of their menstrual cycles, especially during perimenopause. Black Cohosh blends well with several other herbs that can also aid perimenopausal symptoms. It’s often found in blends that contain Red Clover or Wild Yam, both of which are amazing feminine herbs. Try adding a pinch of this herb to your next cup of Know Your Gut Trust Your Gut from You Me and Uni, which contains Red Clover, and see what it can do for you.

Anastacia Elizabeth Walden

Writer and Editor in Gainesville, FL

Owner of Walden Writes For Women




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