The root of the black cohosh plant has been used for centuries as a panacea for women's health problems. Historically, Native American and folk healers have used black cohosh as a treatment for menopause symptoms, vaginal dryness, infertility, osteoporosis and pregnancy-related discomforts. Some modern midwives and naturopathic obstetricians still recommend black cohosh to pregnant women, although its use remains controversial. Consult a health care provider who is familiar with medicinal herbs before using black cohosh during pregnancy.
Common Uses
The National Institutes of Health acknowledges black cohosh's historic use as a treatment for infertility. Although this use persists in modern naturopathy, no studies have evaluated the herb's efficacy as an infertility treatment. The American Pregnancy Association advises against the use of black cohosh during all but the final stages of pregnancy, noting that the herb can stimulate contractions and cause preterm labor. Midwives may recommend black cohosh to prepare the uterus for labor or induce labor that has gone post-term.
Black vs. Blue Cohosh
Although no reports have directly linked black cohosh to birth defects, the National Institutes of Health refers to a 1996 case in which a baby born in New Zealand suffered from neurological damage after his mother took black cohosh, along with the unrelated herb blue cohosh, to induce labor. Similar case reports have linked blue cohosh to neurological problems and other serious side effects. The UMMC describes blue cohosh as "nicotine-like" and understudied, urging patients to avoid confusing the two herbs. Despite the similarity in name and traditional use, black and blue cohosh have different chemical compositions.
Side Effects
Preterm labor is the most significant risk associated with the use of black cohosh. For this reason, few health care providers recommend the use of the herb prior to the 35th week of pregnancy. Other potential side effects include abdominal pain, diarrhea, dizziness and nausea, according to the UMMC. No studies have conclusively linked black cohosh to liver disease, but the UMMC advises people with a history of liver disease to avoid the herb because of potential liver-related side effects.
Types
Black cohosh is available in several different forms, which may vary in their safety and efficacy for pregnant women. Teas containing black cohosh have been used for centuries, but the UMMC notes that these products may be less effective than capsules or standardized extracts. The UMMC recommends tablets or capsules containing at least 1 mg of the medicinal compound 27-deoxyactein per dose. Do not take black cohosh tinctures at any stage of pregnancy; these contain high concentrations of alcohol.
Similar Herbs
Your health care provider may recommend that you use other herbs instead of, or in addition to, black cohosh. The APA recommends red raspberry leaf to tone the uterus and prepare it for labor, but controversy exists regarding red raspberry's safety during the earliest stages of pregnancy. The Chinese herb dong quai has uterine-stimulating effects similar to black cohosh, and it may be used alone or in combination with other products. To prevent serious interactions, tell your health care provider about any herbal supplements you are interested in using.
Member Comments