Blue Cohosh is a powerful women's ally, who's main action is on the uterus. It has a wide variety of uses, dating from when Native American Chippewa wise-women used a strong decoction for contraceptive purposes.

Blue Cohosh is often used alone or in combination with other herbs for regulation the menstrual cycle and to ease painful cramps. It is also used in formulas to treat endometriosis, chlamydia and cervical dysplasia.

As a uterine tonic, it nourishes and revitalizes the uterine tissue in a variety of circumstances, including after pregnancy, miscarriage, abortion or coming off the Pill.

It is commonly used during the last 2-4 weeks of pregnancy to give the uterus a final toning, thus making the birthing process quicker. It can be used during birth to ease labor pains, jump-start a stalled labor. And after birth to deliver a retained placenta and stop bleeding by helping the uterus clamp down without causing the cervix to close as well. For these purposes, midwives usually use a combination of Blue and Black Cohosh, in equal amounts. Tinctures are used, because the herbs active ingredients are not water soluble. 40-60 drops of the combined tinctures are usually given every hour until contractions are even and strong.

Attempts to terminate Pregnancy

Blue Cohosh contains at least two uterine contracting substances, an oxytocic effect, {oxytocin is a hormone produced during childbirth which causes the uterus to contract} and a substance called Caulosaponin which is a unique substance found only in Blue Cohosh which causes the uterus to contract. It is also an estrogenic herb meaning it contains estrogen-like substances and can have estrogen-like side effects (those with estrogen-dependent tumors should not use this herb). If you are not suppose to use the pill, then you should not use this herb unless under the guidance of your herbalist.

Its abortive qualities are best extracted into an alcohol base, thus a tincture made from the root would be the best form to take.

When attempting to dislodge pregnancy causing the uterus to contract is desirable. Blue Cohosh can be used by itself or combined with other herbs. It is commonly used with Pennyroyal, an herb with abortifacient qualities and/or Black Cohosh, which will help to soften the cervix and relax the os, it also encourages coordinated uterine contractions and according to some sources black cohosh is used to temper the intensity of blue cohosh's contractibility.

However, my personal attempts to terminate pregnancy with blue cohosh, pennyroyal and black cohosh were not successful, and over the course of time that I have been maintaining this website I've seen some mixed results. {For more info, visit Sharing our Wisdom section.} I used commercial extracts purchased at the local health food store, they were also in a glycerine base rather than an alcohol base, I don't know if this might make a difference, it may. I have read that glycerine doesn't make as potent an extract as the alcohol does.

Susun Weed, who I went to visit some ago to pick her brain on this topic seems to have a high opinion of blue cohosh when it comes to terminating pregnancy. {An opinion I'm not so sure I share, but I value her experience, she's been doing this a whole lot longer than I have!} She spoke of using Blue Cohosh alone, in the dosages mentioned in her book, The Childbearing Year. When asked about the Emmenagogue Brew which contains pennyroyal, blue cohosh and black cohosh, she said that could be used as well, but seemed to prefer the blue cohosh. One thing I neglected to ask her is whether the blue cohosh she used/prescribed was something she was making herself, if so, it is quite possible that this would be a more potent extract, a better and therefore a more effective tincture.

Susun notes that the best time to use the herb(s) is before menstruation is due (5 days before is good, before that is a bit premature), and if that opportunity is missed, the next best time, in her opinion, is at 6 weeks pregnant (8 weeks from the last menstrual period), when many spontaneous abortions occur {a spontaneous abortion is what a miscarriage is called if it happens before the 10th week of pregnancy). At 6 weeks pregnant, this is the week that you would have bled if conception had not occurred.

This is another point I don't necessarily agree with Susun, that is, waiting until the 6th week of pregnancy to attempt to terminate it. In my opinion, I think it is best to start the herbs as soon as possible, the sooner they are started the better chances of them getting the flow going. I do agree with her on the point that using Blue Cohosh earlier than 5 days before menses is due would be premature.

Women who start the herbs with before menstruation is due, or with in the first week menstruation is late have the best chance to get menstruation started, in my opinion. The later menstruation gets the more time the pregnancy has to establish itself, getting a firm hold on the uterus. I think that using the herbs in the 6th week of pregnancy would be the last opportunity to attempt to end the pregnancy before resorting to the abortion clinic. At the 8th week of pregnancy, it becomes more dangerous to attempt to end the pregnancy on your own, and herbs to terminate pregnancy should not be used past the 7th week of pregnancy under any circumstances, the risks of having serious problems increases greatly. Herbs should not be used for more than two weeks at a time without a break.

Contradictions: As with any herb, don't over use. Blue Cohosh has a tendency to stress the kidneys if used in excess. Caulosaponin, a chemical found in blue cohosh has the action of narrowing the arteries, this can cause the arteries of the heart to narrow and as such it is not recommended for use by those who have kidney or heart problems of any kind, including heart disease, heart attacks, stroke or high blood pressure and low blood pressure. If your blood pressure is low, blue cohosh can lower it further. It should also not be used by those who are sensitive to estrogenic substances, such as estrogen-dependent tumors, or your physician has advised against the Pill. Be sure to drink plenty of water.⁴ Side effects noted elsewhere are pain in the arms & legs,¹² vomiting, and pounding headache. At first sign of side effects or toxicity Blue Cohosh should be discontinued.

Dosage Guidelines:
Abortifacient qualities of this herbs are best extracted in alcohol, purchase a tincture if at all possible.

Uni Tiamat gives these dosages in her book Herbal Abortion. ⁴
Standard decoction (root) Simmer 20-30 min. ¹/₂ to 1 cup 3-4 times a day
Standard Tincture: ¹/₂ - 1¹/₂ tsp. 3-4 times a day
Powered root: 1-5 #0 Capsules 3-4 times a day

Joy Gardener writes about Pennyroyal and Blue Cohosh:¹⁷
Boil 6 cups of water, pour over 2 tablespoons of blue cohosh, 2 tablespoons of pennyroyal and 2 tablespoons of peppermint (to improve taste, and may have some mild emmenagogue qualities) placed into a large jar, pour the boiled water over the herbs, cap tightly and steep for 20 minutes. Drink 5-6 cups per day for 5 days. Add honey if desired.
Joy writes "Menstruation should start by the 6th day. Bleeding should be not more than double your normal amount for the first day or two. She notes that American Pennyroyal is stronger than European pennyroyal.

Susun Weed gives these guidelines:
Blue Cohosh should be taken as a tincture, in a cup of warm water. At a dosage of 20 drops of tincture every 4 hours/5 days.
Can be toxic, in excess and can easily over tax the liver and kidneys. Headache and extreme nausea have been reported from using combinations of Blue Cohosh and Pennyroyal.
Continue for 1 full day after bleeding starts, to insure complete expulsion of all fetal material .

Summary:
An estrogenic herb
Two uterine contracting properties, one of which is found only in Blue Cohosh.
Should be taken as a tincture or decoction.
Has a wide variety of reproductive uses.

If you or anyone you know has attempted herbal abortion, I am currently collecting data for a herbal abortion database, I have created a questionnaire to assist me in collecting data, and any and all herbal abortion or emergency contraceptive experiences are welcome, pregnancies confirmed with a pregnancy test are most useful, but as stated, all experiences are welcome, even if pregnancy was not confirmed or menstruation was simply late. I have posted some of the database findings on the website. You can read about other women's experiences in the Sharing our Wisdom section, all of these women have helped to add to our body of knowledge.

Other Websites:

Blue Cohosh Alternative Nature Online Herbal

To order your herbs online:

Online herb shops

Fertility Awareness Section		Preventing and Ending Pregnancy