Blue cohosh grows throughout North America. The roots of this flower are used medicinally. Blue cohosh is not related to black cohosh (Cimicifuga racemosa). However, both herbs are primarily used to treat women’s health problems.
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Traditional practitioners consider blue cohosh to be a uterine tonic and an agent that stimulates menstrual blood flow, and it is used as a remedy for lack of menstruation.
Blue cohosh is a traditional remedy for lack of menstruation. It is considered an emmenagogue (agent that stimulates menstrual blood flow) and a uterine tonic. No clinical trials have validated this traditional use.
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Blue cohosh has been used traditionally for easing painful menstrual periods. Women of childbearing age using this herb should stop using it as soon as they become pregnant.
Blue cohosh , although unrelated to black cohosh, has also been used traditionally for easing painful menstrual periods. Blue cohosh, which is generally taken as a tincture, should be limited to no more than 1–2 ml taken three times per day. The average single application of the whole herb is 300–1,000 mg. Blue cohosh is generally used in combination with other herbs. Women of childbearing age using this herb should cease using it as soon as they become pregnant—the herb was shown to cause heart problems in an infant born following maternal use of blue cohosh.2
Native Americans are believed to have used blue cohosh flowers to induce labor and menstruation.1 Blue cohosh is a traditional remedy for lack of menstruation. It is considered an emmenagogue (agent that stimulates menstrual flow) and a uterine tonic. No clinical trials have validated this traditional use. It has also been used traditionally to treat painful periods (dysmenorrhea). Early 20th century physicians in the United States who treated with natural remedies (known as Eclectic physicians) used blue cohosh for these same purposes and also to treat kidney infections, arthritis, and other ailments.
A saponin from blue cohosh called caulosaponin is believed to stimulate uterine contractions.3 Several other alkaloids may be active in this herb. However, current research about the active constituents of blue cohosh is insufficient.
Blue cohosh is generally taken as a tincture and should be limited to no more than 1–2 ml taken three times per day. The whole herb (300–1,000 mg per day) is sometimes used. Blue cohosh is generally used in combination with other herbs.
Large amounts of blue cohosh can cause nausea, headaches, and high blood pressure. Blue cohosh should only be used under medical supervision and in limited amounts. Using blue cohosh during pregnancy has been brought into question by reports of an infant developing a stroke and another infant being born with congestive heart failure.4 , 5 Safety studies need to be completed to determine whether blue cohosh is safe to use during pregnancy.
1. Castleman M. The Healing Herbs. New York: Bantam Books, 1991, 120-3.
2. Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr 1998;132:550-2.
3. Foster S. Herbal Renaissance. Salt Lake City: Gibbs-Smith Publisher, 1993, 48-50.
4. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004 351:302-3.
5. Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr 1998;132:550-2.
Last Review: 07-22-2014
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