Black Cohosh (Actaea racemosa L [formerly Cimicifuga racemosa])
History
and traditional use
Native Americans used black cohosh for relieving pain during menstruation and child birth.(7) In addition, they found it useful for rheumatism, malaise, kidney ailments, malaria, sore throat, and snakebite.(3,15) Cimicifuga comes from the Latin “to drive away” and reflects some of the common names of the herb: “bugbane” and “bugwort”.(7) Black cohosh remained popular among the early European settlers and became a component of the famous Lydia Pinkham’s Vegetable Compound, a patent medicine of the 19th century for menstrual stress and nervous tension.(15) The Eclectic Physicians of the time prescribed black cohosh for treatment of rheumatism.(15) More recently, women have used black cohosh for treatment of menopausal symptoms, including hot flashes, joint aches, and neurovegetative symptoms.(3) Black cohosh is taken to treat PMS, dysmenorrhea,(16) osteoarthritis,(17) menstrual migraine,(18) and rheumatoid arthritis.(19) Over 2 million women worldwide use the herb.(6)
The North American Menopause Society recommends black cohosh for mild hot flashes.(20)
Herbalists consider black cohosh to be an antispasmodic, emmenagogue (promoting menstruation), diaphoretic, sedative, and alterative (1,21) with aphrodisiac, antitussive, and expectorant properties.(22) Black cohosh achieved special prominence as a “partus preparator”, given to women in the last 4 weeks of pregnancy to aid in childbirth.(12)
Preparation and Dosage: Black cohosh is prepared as an alcohol tincture (40-60% ethanol) from the fresh root.(12) Herbalists prescribe 10-40 drops of standardized tincture or a decoction of 1 tsp. of the root simmered 15 minutes in 1 cup of water, taken at 1 cup three times daily.(1,9) Native Americans applied the macerated root externally for snake bites.(7)
Of the modern formulas, Remifemin (GlaxoSmithKline) is the most commonly used, usually at 20-40 mg (1-2 capsules; each standardized to 1 mg triterpene glycosides expressed as 26-deoxyactein) BID15 with 4-12 weeks before clinical effect seen.(23)