A cousin of the buttercup and peony, black cohosh was one the most popular medicines of the 1800s. Even before then, Native Americans used this herb for PMS, menstrual cramps and menopausal issues. They also boiled the root for arthritis and sore throat. The early Americans thought it would help treat malaria and yellow fever as well. Later, herbalists discouraged its use except for female issues, specifically menopausal hot flashes and PMS.
In a 2017 study black cohosh and evening primrose were compared for reducing the occurrence of hot flashes, and black cohosh was determined to be more effective. Ten years earlier a study showed that black cohosh was even more effective for treating hot flashes and night sweats than fluoxetine, although the fluoxetine was found more effective for depression when patients self-scored their levels on Beck’s Depression Inventory. A 2015 study found that black cohosh helped with sleeping for post-menopausal women as well.
The German Commission E (Germany’s herbal experts) has recommended black cohosh for PMS. The University of Missouri concluded in a recent study that black cohosh does not have the usual estrogenic effect of other herbs and will not cause or stimulate growth of breast tumors. In very large doses, black cohosh can cause dizziness and vomiting. Generally, black cohosh is considered to be safe when using the recommended dosage. Pregnant and nursing women and children should not take black cohosh. Women who are already taking a prescription medication for postmenopausal hormone replacement therapy should speak to their doctor first before trying black cohosh.