Plant Profile

Black Cohosh

Compiled by the Omnia Sana editorial team from the plant database ·Last updated August 14, 2026

Actaea racemosa

Family: Ranunculaceae · Parts used: Root and rhizome · Also known as: Black snakeroot, Cimicifuga, Rattleweed

The complete database record: 2 documented constituents, 1 pharmacological action, 5 traditional / indicated uses, with 24 cited sources.

Botanical Description

Tall, woodland perennial herb rising from a thick, knotty, dark rhizome with wiry black roots. The leaves are large and compound (2-3-ternately divided), with sharply toothed, oval to lance-shaped leaflets. In summer it sends up tall, wand-like racemes of small, unpleasant-smelling white flowers held well above the foliage, giving rise to the old name 'bugbane'; the flowers lack petals and consist mainly of a fluffy cluster of white stamens.^[2]

Height: 1-2.5 m (flowering stems)

Habit: Tall, rhizomatous, woodland perennial herb

Leaves: Large, 2-3-ternately compound, with sharply toothed oval to lance-shaped leaflets

Flowers: Small, malodorous, petal-less white flowers with fluffy stamens in tall wand-like racemes

Stem: Tall, erect flowering stem well above the basal foliage

Root: Thick, knotty, dark rhizome with numerous wiry black roots

Fruit: Dry, follicle-like seed pods

Flowering Period: Summer (June-September)

Habitat & Distribution

Native to rich, shaded deciduous woodland and woodland margins of eastern North America, from southern Canada to Georgia, typically on moist, humus-rich soils.^[2]

Harvesting

The root and rhizome are dug in autumn, after the seeds have ripened and the foliage has died back and the plant's energy has returned to the rootstock; the rhizome is cleaned, cut and dried.^[2]

Parts: Root and rhizome

Season: Autumn

Key Constituents

Triterpene glycosides (actein, 23-epi-26-deoxyactein/cimicifugoside)^{[2, 7, 8]}

The compounds to which standardised extracts are normalised; act without measurable systemic oestrogenic effect.

Triterpene saponinsGlycosidesTerpenes / terpenoids

Phenolic acids (fukinolic and cimicifugic acids)^[7]

Antioxidant constituents of the root.

Phenolic acids

Pharmacological Actions

Anticancer (preclinical)^{[14, 15, 16, 17]}

Black cohosh (Actaea racemosa) extracts and the triterpene glycoside actein inhibit proliferation of human breast, colon and liver cancer cells and potentiate chemotherapy (preclinical).

Traditional & Indicated Uses

Anxiety^{[7, 18]}Good · 8/10

Reduces neurovegetative and psychological menopausal symptoms (including anxiety and low mood)

Evidence: 8

Label: Anxiety

more plants for anxiety →detailed sources →

Cancer (anticancer research)^{[14, 15, 16, 17]}Preliminary · 2/10

Ethanolic black cohosh extract inhibits growth of MCF-7 and MDA-MB-231 breast cancer cells; actein induces apoptosis/G1 arrest, inhibits breast, colon and HepG2 liver cancer cell growth and synergizes with doxorubicin, 5-FU, paclitaxel and simvastatin (preclinical).

Evidence: 2

Label: Cancer (anticancer research)

more plants for cancer (anticancer research) →detailed sources →

Low mood / depression^{[7, 18]}Good · 8/10

Reduces neurovegetative and psychological menopausal symptoms (including anxiety and low mood)

Evidence: 8

Label: Low mood / depression

more plants for low mood / depression →detailed sources →

Hot flashes^{[1, 3, 4, 6, 7, 19, 20, 21, 22]}Strong · 10/10

Relief of menopausal symptoms - hot flashes, sweating, sleep and mood disturbance (a meta-analysis supports benefit, though an earlier systematic review judged the evidence inconsistent)

Evidence: 10

Label: Hot flashes

more plants for hot flashes →detailed sources →

Menopause^{[1, 2, 3, 4, 5, 6, 7, 18, 19, 20, 21, 22]}Strong · 10/10

Reduces neurovegetative and psychological menopausal symptoms (including anxiety and low mood); Relief of menopausal symptoms - hot flashes, sweating, sleep and mood disturbance (a meta-analysis supports benefit, though an earlier systematic review judged the evidence inconsistent)

Evidence: 10

Label: Menopause

more plants for menopause →detailed sources →

Traditional Use & History

Black cohosh root was used by Native American peoples for gynaecological complaints, rheumatism and general malaise, and entered nineteenth-century Eclectic medicine as a remedy for menstrual and menopausal disorders. It remains best known today as a standardised extract for menopausal hot flashes, night sweats and mood disturbance.^{[2, 6]}

Preparations

Standardised extract^{[2, 7]}

Isopropanolic or ethanolic extracts of the dried root and rhizome, standardised to triterpene glycoside content, are the best-studied clinical form.

Decoction^[2]

Traditional decoction of the dried, chopped root and rhizome.

Dosage

Standardised extract^{[7, 11, 12]}

The WHO monograph on Rhizoma Cimicifugae Racemosae gives a daily dosage of 40-60% isopropyl alcohol or ethanol extracts of the crude drug corresponding to 40 mg of drug, which matches the extract dose used in clinical studies. Educational reference only, not a prescription.

Tincture (1:10)^[13]

Health Canada's NNHPD monograph accepts a tincture among the methods of preparation for black cohosh and sets the dose as 40-2,400 mg of dried root and/or rhizome per day for adults 18 years and older; it states the quantity as dried-herb equivalent rather than a tincture volume. Neither the EU herbal monograph nor the WHO monograph gives a tincture posology - both specify standardised extract preparations only. Educational reference only, not a prescription.

Safety, Cautions & Contraindications

Safety note^[7]Serious

Rare reports of liver injury have prompted a precaution; large meta-analytic data found no evidence of hepatotoxicity, but stop use and seek advice if signs of liver problems occur (jaundice, dark urine, upper-abdominal pain).

Safety note^[8]Info

Current evidence does not show an increased risk of breast cancer or proliferation of oestrogen-sensitive tissue, but women with or at risk of hormone-sensitive cancer should use it only under medical guidance.

Safety note^[7]Caution

Not recommended during pregnancy or breastfeeding.

Dangerous Lookalikes

Actaea Pachypoda^{[23, 24]}Dangerous

Confused Part: Woodland rhizome dug as black cohosh; toxic baneberries (doll's eye and red baneberry) share very similar foliage and rhizomes and are gathered in mistake for it.

Confusion Context: Black cohosh (Actaea racemosa) is dug for its rhizome, but several related North American Actaea species - notably doll's eye (Actaea pachypoda) and red baneberry (Actaea rubra) - have very similar woodland foliage and rhizomes and are easily mistaken for it during harvesting. Those baneberries are toxic in all parts: ingestion causes burning of the mouth, severe vomiting and diarrhoea and seizures, and red baneberry can be fatal, especially in children. Peer-reviewed work confirms commercial black cohosh is frequently adulterated with other Actaea species, contributing to safety concerns. Because the plants look alike - especially in spring before flowers or fruit appear - this is a genuine hazard.

Distinguishing Features: Fruit (decisive when present): black cohosh bears a tall wand of fluffy white flowers that ripens to dry, papery seed pods. Baneberries instead bear clusters of shiny berries - chalk-white with a black eye (doll's eye) or glossy red (red baneberry). Any fleshy berries mean baneberry, not black cohosh., Flower: black cohosh has long, showy white bottlebrush flower spikes; baneberry flowers are in short, rounded fluffy clusters., Vegetative caution: in spring the leaves alone are very similar (Actaea foliage), so do not dig by leaf alone - the species are separated mainly on flowers and fruit. Confirm the plant in flower or fruit, or buy authenticated black cohosh.

Key Test: Identify the plant in flower or fruit before digging. Black cohosh has tall white bottlebrush flower spikes that turn into dry papery pods; baneberry makes clusters of shiny white-with-black-dot or red berries. If you see fleshy berries - or cannot confirm flowers or fruit - do not dig the root; the baneberries are toxic. When in doubt, buy authenticated black cohosh.

Reviewed By: Omnia Sana (owner-authorized)

Reviewed Date: 2026-07-07

Harvest Readiness

^{[9, 10]}

Part: rhizome

Signals: Dig the whole rootstock (rhizome with its fibrous roots) in autumn, after the plant has flowered and set seed and the foliage is dying back, when the roots are at their peak weight; dry in the shade., Confirm identity of the woodland plant before digging - the rhizome is confusable with toxic baneberry (Actaea pachypoda). See this plant's Dangerous Lookalikes.

Basis: both

Constituent Note: NC State Extension (REF-3188) ties the autumn timing to a constituent peak: 'Most black cohosh is harvested in the fall, primarily because that is when the roots are at their peak in weight and bioactive constituents.'

Source Quote: The part used in medicine is the rhizome, gathered in the autumn and carefully dried in the shade.

Independent Confirmation: NC State Extension (REF-3188) independently confirms the autumn harvest of the entire rootstock: 'The entire root, including rhizome and fibrous roots, is harvested.'

Species Confirmed: 1

^{[9, 10]}

Part: root

Signals: Lift the fibrous roots with the rhizome in autumn, as the top dies back, when the whole rootstock is at peak weight; dry in the shade., Confirm identity of the woodland plant before digging - the rhizome is confusable with toxic baneberry (Actaea pachypoda). See this plant's Dangerous Lookalikes.

Basis: both

Source Quote: Most black cohosh is harvested in the fall, primarily because that is when the roots are at their peak in weight and bioactive constituents.

Independent Confirmation: King's American Dispensatory (REF-3187) independently gives the autumn rootstock collection: 'The part used in medicine is the rhizome, gathered in the autumn and carefully dried in the shade.'

Species Confirmed: 1

External Identifiers

GBIF ›Wikidata ›

References & Sources

Hedaoo, K. and Badge, A.K. and Tiwade, Y.R. and Bankar, N.J. and Mishra, V.H (2024) 'Exploring the Efficacy and Safety of Black Cohosh (Actaea racemosa) in Menopausal Symptom Management', Journal of Mid-life Health, 15(1), pp. 5-11. doi:10.4103/jmh.jmh_242_23 Meta-analysis / review
https://doi.org/10.4103/jmh.jmh_242_23
Salari, S. and Amiri, M.S. and Ramezani, M. and Moghadam, A.T. and Elyasi, S. and Sahebkar, A. and Emami, S.A (2021) 'Ethnobotany, Phytochemistry, Traditional and Modern Uses of Actaea racemosa L. (Black cohosh): A Review', Advances in Experimental Medicine and Biology, 1308, pp. 403-449. doi:10.1007/978-3-030-64872-5_24 Meta-analysis / review
https://doi.org/10.1007/978-3-030-64872-5_24
Drewe, J. and Boonen, G. and Culmsee, C (2022) 'Treat more than heat - New therapeutic implications of Cimicifuga racemosa through AMPK-dependent metabolic effects', Phytomedicine, 100, pp. 154060. doi:10.1016/j.phymed.2022.154060 Meta-analysis / review
https://doi.org/10.1016/j.phymed.2022.154060
Curtis, S. and Moore, A. and Breakspear, I (2026) 'Efficacy and safety of Actaea racemosa for relieving climacteric complaints', Menopause, 33(5), pp. 624-631. doi:10.1097/GME.0000000000002704 Meta-analysis / review
https://doi.org/10.1097/GME.0000000000002704
Beer, A.M. and Neff, A (2013) 'Differentiated Evaluation of Extract-Specific Evidence on Cimicifuga racemosa's Efficacy and Safety for Climacteric Complaints', Evidence-Based Complementary and Alternative Medicine, 2013, pp. 860602. doi:10.1155/2013/860602 Meta-analysis / review
https://doi.org/10.1155/2013/860602
Mohapatra, S., Iqubal, A., Ansari, M.J., Jan, B., Zahiruddin, S., Mirza, M.A., Ahmad, S. and Iqbal, Z (2022) 'Benefits of Black Cohosh (Cimicifuga racemosa) for Women Health: An Up-Close and In-Depth Review', Pharmaceuticals, 15(3), pp. 278. doi:10.3390/ph15030278 Clinical study
https://doi.org/10.3390/ph15030278
Castelo-Branco, C., Gambacciani, M., Cano, A., Minkin, M.J., Rachon, D., Ruan, X., Beer, A.M., Schnitker, J., Henneicke-von Zepelin, H.H. and Pickartz, S (2020) 'Review and meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms - an update on the evidence', Climacteric, 24(2), pp. 109--119. doi:10.1080/13697137.2020.1820477 Meta-analysis / review
https://doi.org/10.1080/13697137.2020.1820477
Fritz, H., Seely, D., McGowan, J., Skidmore, B., Fernandes, R., Kennedy, D.A., Cooley, K., Wong, R., Sagar, S., Balneaves, L.G. and Fergusson, D (2013) 'Black cohosh and breast cancer: a systematic review', Integrative Cancer Therapies. doi:10.1177/1534735413477191 Meta-analysis / review
https://doi.org/10.1177/1534735413477191
Felter, H. W. and Lloyd, J. U (1898) 'Cimicifuga (Actaea racemosa / Cimicifuga racemosa, black cohosh) — King's American Dispensatory'. Available at: https://www.henriettes-herb.com/eclectic/kings/cimicifuga.html Traditional / reference
https://www.henriettes-herb.com/eclectic/kings/cimicifuga.html
North Carolina State University Extension 'Black cohosh (Actaea racemosa L.)'. Available at: https://content.ces.ncsu.edu/black-cohosh-actaea-racemosa-l Traditional / reference
https://content.ces.ncsu.edu/black-cohosh-actaea-racemosa-l
European Medicines Agency (HMPC) (2018) 'European Union herbal monograph on Cimicifuga racemosa (L.) Nutt., rhizoma, Revision 1'. Available at: https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-cimicifuga-racemosa-l-nutt-rhizome-revision-1_en.pdf Traditional / reference
https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-cimicifuga-racemosa-l-nutt-rhizome-revision-1_en.pdf
World Health Organization (2002) 'Rhizoma Cimicifugae Racemosae'. Available at: https://iris.who.int/items/6418d8af-5200-4e6b-9bf5-004f3aa62a37 Traditional / reference
https://iris.who.int/items/6418d8af-5200-4e6b-9bf5-004f3aa62a37
Health Canada, Natural and Non-prescription Health Products Directorate (2026) 'Natural Health Product Monograph: Black Cohosh - Actaea racemosa'. Available at: https://webprod.hc-sc.gc.ca/nhpid-bdipsn/dbImages/mono_black-cohosh_english.pdf Traditional / reference
https://webprod.hc-sc.gc.ca/nhpid-bdipsn/dbImages/mono_black-cohosh_english.pdf
Einbond, L.S. and Shimizu, M. and Nuntanakorn, P. and Seter, C. and Cheng, R. and Jiang, B. and Kronenberg, F. and Kennelly, E.J. and Weinstein, I.B (2006) 'Actein and a fraction of black cohosh potentiate antiproliferative effects of chemotherapy agents on human breast cancer cells', Planta Medica, 72(13), pp. 1200-1206. doi:10.1055/s-2006-947225 Preclinical
https://doi.org/10.1055/s-2006-947225
Rice, S. and Amon, A. and Whitehead, S.A (2006) 'Ethanolic extracts of black cohosh (Actaea racemosa) inhibit growth and oestradiol synthesis from oestrone sulphate in breast cancer cells', Maturitas, 56(4), pp. 359-367. doi:10.1016/j.maturitas.2006.10.002 Preclinical
https://doi.org/10.1016/j.maturitas.2006.10.002
Einbond, L.S. and Soffritti, M. and Degli Esposti, D. and Wu, H.-A. and Balick, M. and Ma, H. and Redenti, S. and Roter, A (2018) 'A transcriptomic analysis of black cohosh: Actein alters cholesterol biosynthesis pathways and synergizes with simvastatin', Food and Chemical Toxicology, 120, pp. 356-366. doi:10.1016/j.fct.2018.06.064 Preclinical
https://doi.org/10.1016/j.fct.2018.06.064
Einbond, L.S. and Soffritti, M. and Degli Esposti, D. and Park, T. and Cruz, E. and Su, T. and Wu, H.-A. and Wang, X. and Zhang, Y.-J. and Ham, J. and Goldberg, I.J. and Kronenberg, F. and Vladimirova, A (2009) 'Actein activates stress- and statin-associated responses and is bioavailable in Sprague-Dawley rats', Fundamental and Clinical Pharmacology, 23(3), pp. 311-321. doi:10.1111/j.1472-8206.2009.00673.x Preclinical
https://doi.org/10.1111/j.1472-8206.2009.00673.x
Shahmohammadi, A., Ramezanpour, N., Mahdavi Siuki, M., Dizavandi, F., Ghazanfarpour, M., Rahmani, Y., Tahajjodi, R. and Babakhanian, M (2019) 'The efficacy of herbal medicines on anxiety and depression in peri- and postmenopausal women: A systematic review and meta-analysis', Post Reproductive Health, 25(3), pp. 131--141. doi:10.1177/2053369119841166 Meta-analysis / review
https://doi.org/10.1177/2053369119841166
Borrelli, F. and Ernst, E (2008) 'Black cohosh (Cimicifuga racemosa) for menopausal symptoms: a systematic review of its efficacy', Pharmacological Research, 58(1), pp. 8--14. doi:10.1016/j.phrs.2008.05.008 Meta-analysis / review
https://doi.org/10.1016/j.phrs.2008.05.008
Pokushalov, E., Ponomarenko, A., Garcia, C., Kasimova, L., Pak, I., Shrainer, E., Romanova, A., Kudlay, D., Johnson, M. and Miller, R (2025) 'Assessing the combined effects of Black Cohosh, Soy Isoflavones, and SDG Lignans on menopausal symptoms: a randomized, double-blind, placebo-controlled clinical trial', European Journal of Nutrition, 64(3). doi:10.1007/s00394-025-03588-y Randomized trial
https://doi.org/10.1007/s00394-025-03588-y
Tanmahasamut, P., Vichinsartvichai, P., Rattanachaiyanont, M., Techatraisak, K., Dangrat, C. and Sardod, P (2014) 'Cimicifuga racemosa extract for relieving menopausal symptoms: a randomized controlled trial', Climacteric, 18(1), pp. 79--85. doi:10.3109/13697137.2014.933410 Randomized trial
https://doi.org/10.3109/13697137.2014.933410
Pockaj, B.A., Gallagher, J.G., Loprinzi, C.L., Stella, P.J., Barton, D.L., Sloan, J.A. and others (2006) 'Phase III double-blind, randomized, placebo-controlled crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1', Journal of Clinical Oncology, 24(18), pp. 2836--2841. doi:10.1200/JCO.2005.05.4296 Randomized trial
https://doi.org/10.1200/JCO.2005.05.4296
United Plant Savers 'Distinguishing Black Cohosh from Look-Alikes'. Available at: https://unitedplantsavers.org/distinguishing-black-cohosh-from-look-alikes/ Traditional / reference
https://unitedplantsavers.org/distinguishing-black-cohosh-from-look-alikes/
Jiang, B. and Ma, C. and Motley, T. and Kronenberg, F. and Kennelly, E.J (2011) 'Phytochemical fingerprinting to thwart black cohosh adulteration: a 15 Actaea species analysis', Phytochemical Analysis, 22(4), pp. 339-51. doi:10.1002/pca.1285 Preclinical
https://doi.org/10.1002/pca.1285

Selected studies & references

ReviewEfficacy and safety of Actaea racemosa for relieving climacteric complaints source↗ (2026)

ReviewExploring the Efficacy and Safety of Black Cohosh (Actaea racemosa) in Menopausal Symptom Management source↗ (2024)

ReviewTreat more than heat - New therapeutic implications of Cimicifuga racemosa through AMPK-dependent metabolic effects source↗ (2022)

ReviewEthnobotany, Phytochemistry, Traditional and Modern Uses of Actaea racemosa L. (Black cohosh): A Review source↗ (2021)

ReviewReview and meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms - an update on the evidence source↗ (2020)

ReviewThe efficacy of herbal medicines on anxiety and depression in peri- and postmenopausal women: A systematic review and meta-analysis source↗ (2019)

ReviewBlack cohosh and breast cancer: a systematic review source↗ (2013)

ReviewDifferentiated Evaluation of Extract-Specific Evidence on Cimicifuga racemosa's Efficacy and Safety for Climacteric Complaints source↗ (2013)

All 17 studies in the Knowledge Finder →

Educational use only. This profile summarises traditional and scientific sources for reference. It is not medical advice and not a substitute for a qualified practitioner. Some plants carry safety cautions and drug interactions - always check before use.
This profile is assembled automatically from the Omnia Sana plant database, which we curate by hand. How this site is built.

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