An anti-spasmodic herb often used in conjunction with Blue Cohosh, some herb books will even go as far to say that it can be used instead of Blue Cohosh, but this is incorrect. Black Cohosh is a unique herb and deserves its own place in the spotlight, and credit for its own attributes. Black Cohosh has been in the herbal news lately for its value in treating all sorts of 'female complaints'; pms, cramps, hormonal imbalances, menopause symptoms such as hot flashes and depression.

The German Commission E, a panel sponsored by the German government to evaluate herbal therapies has given Black Cohosh it's seal of approval. "Scientifically speaking, black cohosh suppresses the secretion of luteinizing hormone (LH); sudden bursts of LH have been linked to the occurrence of hot flashes, night sweats, and other menopausal symptoms." ⁶ Luteinizing hormone is what causes ovulation to happen. If black cohosh has the ability to suppress this hormone, perhaps it could be used to inhibit ovulation. Research has shown that alcoholic extracts decrease luteinizing hormone secretions in menopausal women. But I don't believe it has the ability to decrease LH enough to suppress ovulation. Nature has a way of compensating, but it is an interesting possibility.

Black cohosh also has a balancing effect on hormone production, particularly estrogen.

Black cohosh should not be used for more than 6 months at a time at normal doses. Generally, when taking herbs over the long term they should be taken for 3 weeks on and one week off. For menstrual stimulating & abortifacient purposes any herb including black cohosh should not be used any longer than 10 days, since doses taken are often higher than the recommended dosages, and toxic build up or side effects could result, even with herbs generally known as being safe.

Contradictions: Black cohosh can depress heart rate, anyone with any type of heart disease should not use this herb. Other possible side effects include dizziness, diarrhea, nausea, headaches, shakes, low pulse, vomiting. Side effects occurring with prolonged use may include uterine irritation, abdominal pain (see cautions on ectopic pregnancy), abnormal blood clotting (which could cause problems when using herbs to end pregnancy, possibly hemorrhage), liver problems, it could encourage breast tumors. And should not be taken by anyone who has been advised not to take oral contraceptives.⁷

Black cohosh also should not be combined with anti-depressents.

The Botanical Safety Handbook notes: occasional gastrointestinal discomfort; large doses of black cohosh may cause vertigo, headache, nausea, impaired vision, vomiting, and impaired circulation; estrogenic effect and lowering of blood pressure has been recorded.

In five different studies using doses equivalent to 40 mg/day crude herb there was no case reports of toxic effects from the herb, and there appears to be no specific toxicity associated with any of its known constituents. A few side effects were noted; dizziness, GI distress, headache and weight gain.⁸

Using Black Cohosh to disrupt pregnancy, black cohosh is a helper herb, helping to prepare the cervix to release the contents of the uterus. It is often used during childbirth to help ripen the cervix in preparation for delivery. It is best used combined with blue cohosh or combines well with vitamin c & dong quai.

Dosage:
Standard Decoction (root): Simmer 5-15., 1-4 Tbsp., 3-4 times a day.
Standard Tincture: ¹/₄ - 1 tsp., 3-4 times a day.
Powdered (root): 1-4 #0 capsules, 3-4 times a day. ⁴
Pre-made Capsules: Women who have used black cohosh in combinations seem to be successful when dosages are in the range of 500 to 1000 mg every four hours.
Other sources: