Black Cohosh is a perineal herb native to eastern North America and Canada, it's also known as baneberry, black snakeroot and bug root. Its roots and rhizomes are used to make herbal supplement products. It is most commonly used for the relief of menopausal symptoms like hot flushes and night sweats as well as other menopausal symptoms, menstrual cramps and premenstrual syndrome.

The exact mechanism of how Black Cohosh may help reduce Vasomotor symptoms is currently still being studied. Due to an estrogen deficiency and relative deficiency of serotonin during peri-menopause (and post menopause for some), night sweats and hot flashes occur. The working theory is that Black Cohosh may help with adjusting the level of serotonin levels in the brain, modulating estrogen receptors in the body, and acts as an antioxidant. The combination of which could reduce the occurrence of hot flashes and night sweats. However, at this point the clinical research supporting the efficacy is inconsistent to non-existent.

Research has found that Black Cohosh interacts with medicines used for cholesterol control (statin group of medicines). Other medicines which are metabolized by the liver and anti-cancer medicine like cisplatin can greatly damage the liver when these medicines are used along with black cohosh.

The side effects of black cohosh in itself is low. Contaminants within the supplement or heavy metals present in the supplement may be causing various side effects. Musculoskeletal pain, uterine bleeding, breast pain, dizziness, nausea, vomiting, etc. are common side effects. One of the most serious issue with the use of black cohosh is liver damage which can be mild (liver enzymes elevation only) or may be severe enough to cause liver failure.

Menopausal women who also have liver disease, breast cancer, endometrial cancer, thrombo-embolic disease (DVT, stroke, etc), uterus abnormalities like fibroid, endometriosis, and undiagnosed vaginal bleeding should avoid taking Black Cohosh before talking with their health care provider.

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Ayurveda. Ayurveda has been using Black Cohosh for improving overall reproductive well-being in women. It is believed that black cohosh maintains hormonal balance, and menstrual cycle, and improves fertility. However, Ayurveda does not clearly mention whether Black Cohosh can decrease vasomotor symptoms.

Traditional Chinese Medicine. Both traditional Chinese medicine and western herbal tradition have been using black cohosh for a long time. Traditional Chinese medicine has used it to reduce musculoskeletal pain and spasms, support liver and brain functions, and tonify the kidney and uterus but has not clearly illustrated its usefulness in treating menopausal symptoms.