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Black Cohosh Warnings and Suggested Dosage

By Kathryn Meininger

Black cohosh, which has the scientific name Actaea racemosa or Cimicufuga racemosa, is a perennial plant native to parts of North America and is related to the buttercup. It is classified as a dietary supplement by the U.S. FDA. Its common names include black snakeroot, rattlesnake root and squaw root; insects avoid this plant, hence its other names of black bugbane and bugwort. Black cohosh is often used to treat symptoms of menopause, menstrual irregularities and joint pain. Consult your physician before taking black cohosh.

History and Appearance

The roots of black cohosh are gnarled and black, hence its name. Black cohosh should not be confused with blue cohosh -- their only similarity is that they are both an herbal root. It is a woodland plant that can grow as tall as nine feet. In the summer, it produces white flowers that emit an unpleasant odor. Black cohosh tea was used by Native Americans as a remedy for rattlesnake bites, arthritis, malaria and sore throat. In the 1800s, some physicians prescribed it for the "hysterical" diseases of women, including problems with lactation, menstrual irregularities and insomnia.


The underground roots and rhizomes of black cohosh are the parts used for medicinal purposes. They are used fresh or dried to make a tea, extract, capsules and tablets. The active compounds are the glycosides, isoferulic acids and phytoestrogens. The University of Maryland Medical Center recommends adults take 40 to 80mg standardized tablets or capsules per day, or 2 to 4mL of liquid in a tea or water three times daily. Black cohosh should not be given to children.


Currently, black cohosh is a popular alternative to hormonal medications used to lessen the symptoms of menopause, including hot flashes, mood swings, night sweats, heart palpitations and vaginal dryness. It is also used for migraine headaches and sleep disturbances, especially when related to menopause. Black cohosh contains anti-inflammatory substances and is also used for symptoms of arthritis.


Black cohosh is considered safe when taken in the recommended doses for a period of six months. If you are allergic to plants in the buttercup family, you may not be able to take this. The salicylates found in black cohosh are similar to those found in aspirin, so do not take this herb if you are allergic to aspirin. Taking high doses of black cohosh can cause headaches, excessive perspiration, dizziness and visual problems. Liver damage and liver failure have been associated with its use and should not be used if you have liver disease. More studies are needed, but black cohosh may not be safe if you have hormone-sensitive breast cancer, ovarian cancer, uterine cancer, fibroids or endometriosis, as it may function in the same way as estrogen. Do not take black cohosh if you are pregnant; there have been incidences of premature labor, miscarriage and vaginal bleeding associated with its use. Consult your physician before taking black cohosh to discuss all other medications and supplements you take to avoid interactions.

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