Traditional uses:
The herb has a long history for being prescribe for female problems. The Algonquian natives use to boil the herb and use it to treat symptoms of menstrual irregularities, promote lactation, fatigue, sore throat, arthritis, rashes, bronchitis, hysteria, etc.

Physiology:
Black cohosh is considered an emmenogogue, or a substance that promotes menstrual flow. However, secondary to its balancing effect the herb is also prescribed for excessive menstrual flow. The herb has no significant drug interactions, Black cohosh as actually shown to reduce some of the negative effects of estrogen replacement therapy.

In addition, one study concerning estrogen dependent cancer cells Black cohosh was prescribed with Tamoxifen (ant-estrogen medication). Black cohosh appeared to act synergistically (when two herbal ingredients together produce a greater effect than the two individual ingredients can produce on their own i.e. 1+1 = 3) with the cancer medication to help stop the proliferation of cancer cells of the breast.

Recent studies have also shown that black Black cohosh has an affinity for serotonin receptors in the brain which may prove beneficial to those individuals who suffer from depression. Individuals who combine Black cohosh with St. John's Wort have reported excellent results with mild depression.

Clinical studies:
As a women ages and she approaches menopause estrogen production decreases. Research has shown that Black cohosh actualy reduces some of the common side effects associated with menopause including night sweats, insomnia, nervousness, and irritability, etc. Jarry H, Harnischfeger G, Düker E. Studies on endocrine effects of the contents of Cimicifuga racemosa. In vitro binding of compounds to estrogen receptors. Planta Medica 1985;51:316–9. Einer-Jensen N, Zhao J, Andersen KP, Kristoffersen K. Cimicifuga and Melbrosia lack estrogenic effects in mice and rats. Maturitas 1996;25:149–53.

Recent studies also indicate that Black cohosh may protect animals from osteoporosis (disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse). Kadota S, Li JX, Litt Y, et al. Effects of cimicifugae rhizome on serum calcium and phosphate levels in low calcium dietary rats and on bone mineral density in ovariectomized rats. Phytomed 1996/7;3:379–85.

Today, the herb is primarily prescribed for gynecological problems, PMS symptoms, amenorrhea, and the symptoms of menopause. Clinical studies have shown Black cohosh to significantly reduce the symptoms of menopause including: hot flashes, perspiration, heart palpitations, sleep disturbances, depression, and vertigo. Black cohosh has also been beneficial to women who are status post hysterectomy.

Precautions and/or adverse effects:
Individuals with preexisting medical conditions should consult with their physician particularly if they are taking prescription or over-the-counter-medications or supplements. Women who are pregnant or breast feeding and children should also consult with there physician prior to taking any new supplements. There are very few side effects reported with Black cohosh at the time of this writing. However, excessive amounts of Black cohosh may produce gastrointestinal discomfort. Pregnant women should not take Black cohosh secondary to the potential of the herb to induce premature labor.