Black Cohosh

Black Cohosh is commonly considered for hormonal health, specifically during perimenopause and menopause. While this is true, it has many other benefits including:

Dysmenorrhea (painful periods). Black Cohosh exhibits spasmolytic and anti-inflammatory properties, which can help relax uterine muscles and reduce cramping. It may also modulate pain perception by acting on central nervous system receptors, including serotonin and dopamine pathways.

Premenstrual syndrome (PMS). Its ability to influence neurotransmitters including serotonin, dopamine and GABA may help regulate mood, reduce irritability and ease breast tenderness associated with PMS.

Amenorrhoea (an absent period). By supporting the hypothalamic-pituitary-ovarian (HPO) axis and encouraging a gentle oestrogenic response, Black Cohosh may help restore menstrual cycles in individuals with functional amenorrhea not caused by structural issues.

Arthritis and rheumatism. Traditionally used for inflammatory joint conditions, Black Cohosh contains triterpene glycosides with anti-inflammatory and analgesic properties, helping reduce pain and stiffness associated with osteoarthritis and rheumatic disorders.

Neuralgia. Its nervine and anti-inflammatory actions may soothe nerve pain and reduce muscular tension. Historically, it was used for conditions involving sharp, shooting pain such as sciatica or trigeminal neuralgia.

Respiratory conditions including whooping cough and asthma. The spasmolytic effects of Black Cohosh may help relieve coughing fits and bronchial spasms. It was traditionally used to soothe the respiratory tract and reduce inflammation in the lungs and airways.

The root of Black Cohosh contains the highest concentration of active constituents, particularly triterpene glycosides. These compounds are responsible for most of Black Cohosh’s medicinal properties. The root is the commonly used part used in herbal teas, liquid extracts and dietary supplements.

Triterpene glycosides (saponins and cimicifugan).

These are the primary active constituents in Black Cohosh. They exhibit anti-inflammatory and analgesic activity by inhibiting COX-2 enzymatic activity and suppressing pro-inflammatory cytokines.

These actives are theorised to have a modulatory effect on serotonin, dopamine and GABA receptor activity. Therefore, improving menopausal symptoms such as hot flashes, alterations to mood and sleep disturbances.

Phenolic compounds (ferulic acid, caffeic acid and fumarolic acid).

These actives have potent antioxidant properties, helping to neutralise free radicals and reduce oxidative stress. They exert anti-inflammatory effects through modulation of NF-κB, a transcription factor that regulates inflammatory cytokine production.

Black Cohosh is an oestrogen modulator, meaning it modulates the receptors that oestrogen works on rather than influencing oestrogen itself. It is believed to act as a Selective Oestrogen Receptor Modulator (SERM), primarily influencing oestrogen receptor beta (ERβ) rather than oestrogen receptor alpha (ERα). This means it can mimic some oestrogen-like effects in certain tissues such as the brain, bones, and cardiovascular system while avoiding stimulation of tissues like the breast and uterus. The modulatory effect Black Cohosh has on neurotransmitters including serotonin, dopamine and oestrogen may indirectly influence oestrogen receptor sensitivity and thermoregulation, contributing to relief from hot flushes.

Black Cohosh has been shown to reduce the severity and frequency of hot flushes, particularly for perimenopausal and postmenopausal individuals. For adults, it is not recommended to exceed a daily dose of 3 mL of a 1:2 liquid Black Cohosh extract. Always follow dosage recommendations and consult with a naturopath or medical herbalist if using other medications or herbal products.

There are no hard and fast rules in herbalism, as it is tailored to the individual. Some practitioners recommend taking Black Cohosh during the first two weeks of the menstrual cycle, when oestrogen levels are naturally rising, to help support hormonal balance. However, it is also commonly and safely used throughout the entire cycle, depending on the person’s needs. Black Cohosh can be taken at any time of day, as there is no evidence to suggest that timing affects its effectiveness.

Black Cohosh is safe for daily use within the recommended dosage range. For adults, it is not recommended to exceed a daily dose of 3mL of a 1:2 liquid Black Cohosh extract.

It is not currently advised to take Black Cohosh for longer than 6 months due to limited controlled studies over long periods of time. Always follow dosage recommendations and consult with a naturopath or medical herbalist if using other medications or herbal products.

While evidence is limited, some research suggests that Black Cohosh may support fertility in certain cases. A 2021 study found that women with polycystic ovary syndrome (PCOS) experienced improved pregnancy rates when Black Cohosh was used alongside clomiphene citrate, a common fertility medication.

Black Cohosh can be successfully grown in New Zealand by mimicking its native woodland environment. It prefers partial shade, rich and moist but well-draining soil. Adding organic matter such as compost or leaf mulch helps improve soil quality. Propagation is best done through root division in spring or autumn, as seed germination is slow. It is important to water the juvenile plant regularly, especially in drier regions. While mulching helps retain moisture and suppress weeds. Typically, Black cohosh takes 2–5 years to fully establish and flower.

The best time to plant Black Cohosh in New Zealand is during early spring or autumn, when soil temperatures are mild and moisture levels are stable. These seasons provide ideal conditions for root development before the extremes of summer heat or winter cold. If propagating by root division, autumn is especially effective, as the plant enters dormancy and experiences less transplant shock. For seed propagation, sowing in autumn allows natural cold stratification over winter, improving germination in spring.

The best time to harvest Black Cohosh in New Zealand is in late autumn, once the plant's foliage begins to die back. This indicates that the plants energy has returned to the root system, where the medicinal compounds are highly concentrated. Harvesting during autumn ensures the highest potency of active constituents, particularly the triterpene glycosides. It is important to wait until the plants are at least 3 to 5 years old, to ensure their roots are mature before harvesting. Once harvested, clean the roots thoroughly and dry them for storage or use.

Fairy-candle is an alternative name used for Black Cohosh, due to the plants ethereal-looking flowers. These can be harvested during New Zealand’s summertime and used for aesthetic purposes.

Fan, C. W., Cieri-Hutcherson, N. E., & Hutcherson, T. C. (2021). Systematic review of Black Cohosh (Cimicifuga racemosa) for management of polycystic ovary syndrome-related infertility. Journal of Pharmacy Practice, 089719002110122. https://doi.org/10.1177/08971900211012244

Gorzkiewicz, J., Bartosz, G., & Sadowska-Bartosz, I. (2021). The potential effects of phytoestrogens: The role in neuroprotection. Molecules, 26(10), 2954. https://doi.org/10.3390/molecules26102954

Kritiksha Hedaoo, Badge, A. K., Tiwade, Y. R., Bankar, N. J., & Mishra, V. H. (2024). Exploring the efficacy and safety of Black Cohosh (Cimicifuga racemosa) in menopausal symptom management. Journal of Mid-Life Health, 15(1), 5–11. https://doi.org/10.4103/jmh.jmh_242_23

Marciano, M., & Vizniak, N. A. (2020). Evidence informed botanical medicine. Professional Health Systems.

Szmyd, M., Lloyd, V., Hallman, K., Aleck, K., Mladenovik, V., McKee, C., Morse, M., Bedgood, T., & Dinda, S. (2018). The effects of Black cohosh on the regulation of oestrogen receptor (ERα) and progesterone receptor (PR) in breast cancer cells. Breast Cancer: Targets and Therapy, 10, 1–11. https://doi.org/10.2147/bctt.s144865

Wobser, R. W., & Takov, V. (2020). Black Cohosh (Actaea racemosa, Black bugbane, Black snakeroot, Fairy candle). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470187/