Black Cohosh for Menstruation

Menstrual problems such as pain and bloating affect millions of teen girls and women every month. According to Penelope Ody, author of “Healing with Herbs,” menstrual problems respond well to herbal remedies 2. Black cohosh is one herb that has a long reputation for relieving some menstrual symptoms. However, there have been no long-term studies conducted on this herb and it may cause serious side effects.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Historical Usage

According to the Office of Dietary Supplements, black cohosh, or Actaea racemosa, is a perennial plant of the buttercup family and is native to North America. It has long been used in Native American medicine and can treat a wide variety of gynecological problems and other ailments. Since the 19th century, black cohosh was used to induce menstruation, and alternative healers have prescribed the herb for menstrual problems and inflammation of the ovaries and uterus. It was used to relieve labor pains also.

Common Menstrual Problems

Menstrual problems are often related to the rapid fall in progesterone levels in relation to estrogen levels. Menstrual pain, or dysmenorrhea, is usually the first menstrual problem teens experience. It often begins two to three years after the first period, explains the University of Maryland Medical Center or UMMC 1.

Usually, pain subsides with age and doesn’t cause any other serious side effects. In some cases, mood disturbances, very heavy bleeding, amenorrhea—or absence of a period for three months or more—may also occur. In severe cases, menstrual problems may be related to infection, fibroids, endometriosis—tissue growth outside the uterus—or a tumor.


Tori Hudson, a naturopathic doctor with the National College of Natural Medicine, explains that black cohosh acts as a relaxant on the uterus to relieve dysmenorrhea and congestive and spasmodic menstrual cramps, even when they’re severe 2. The herb can also help improve menstrual irregularities and treat premenstrual syndrome, which includes symptoms such as fatigue, bloating, anxiety and depression. The medical community isn’t sure how black cohosh works to relieve menstrual problems. In the past they believed it had estrogen-like effects in the body, but that’s no longer considered to be the reason.

Adults can take 40 to 80mg black cohosh daily, according to UMMC. Choose black cohosh tablets standardized to contain 1mg of 27-deoxyactein. In tincture form, you can use 2 to 4mL in water or tea three times daily.


Black cohosh may cause several side effects such as:

  • dizziness
  • headaches
  • nausea
  • vomiting
  • diarrhea
  • joint pain
  • slow heart rate
  • tremors

However, these problems are usually associated with higher doses. Do not take black cohosh if you are pregnant or breastfeeding, have liver damage, a history of breast cancer, endometriosis or fibroid tumors, or abuse alcohol. Pregnant and breastfeeding women should also avoid using it, advises UMMC. Seek advice from your doctor or a naturopath before taking black cohosh.