The Health Benefits of Blue Cohosh

Blue Cohosh Benefits May Be Overshadowed by Safety Concerns

Cohosh capsules, tincture, powder, and dried root

Verywell / Anastasia Tretiak

Blue cohosh (Caulophyllum thalictroides) is an herb available in dietary supplement form. Long used as medicine in Native American tribes, it's sometimes referred to as a uterine tonic (i.e., a substance that helps improve muscle tone in the uterus).

While blue cohosh is used in alternative medicine to enhance women's health, there's also some concern that it may have harmful effects.

Health Benefits

Because blue cohosh is thought to suppress muscle spasms, it's often used in alternative medicine to soothe cramps, such as menstrual cramps and stomach cramps. Proponents also suggest blue cohosh can help treat the following health issues:

Additionally, blue cohosh is said to promote menstrual flow, stimulate circulation, increase the flow of urine, and act as a laxative.

Since blue cohosh is thought to increase muscle tone in the uterus, it's also used in folk medicine as a childbirth aid.

So far, there's very limited scientific support for the purported health benefits of blue cohosh. The available research on the herb's health effects includes a 2012 study from Evidence-Based Complementary and Alternative Medicine, which found that certain compounds in blue cohosh may reduce inflammation.

In a series of laboratory experiments, researchers from the 2012 study determined that blue cohosh extract may inhibit the expression of some pro-inflammatory cells. Although the study's authors conclude that blue cohosh shows promise in the treatment of inflammation-related diseases, further research testing the herb's anti-inflammatory effects is lacking.

Blue Cohosh and Birth Defects

Some research shows that the use of blue cohosh during pregnancy may lead to the development of birth defects. For a report published in the Canadian Journal of Clinical Pharmacology in 2008, investigators analyzed the available research on the use and safety of blue cohosh during pregnancy and breastfeeding. Their findings indicate that blue cohosh may have effects that could interfere with the physiological development of the fetus when consumed during pregnancy.

The investigators also found case reports linking the use of blue cohosh at the time of delivery with the incidence of stroke, heart failure, and other serious cardiac events. Given these findings, the report's authors state that blue cohosh should be used with extreme caution during pregnancy and taken only under medical supervision.

Possible Side Effects

Blue cohosh may cause a number of adverse effects, including:

  • Chest pain
  • Diarrhea
  • Elevated blood sugar levels
  • High blood pressure

In addition, blue cohosh may aggravate many health problems, including angina, diabetes, and high blood pressure.

Since certain compounds found in blue cohosh may have estrogen-like effects, it may be harmful to people with hormone-sensitive conditions (such as hormone-dependent cancers, endometriosis, and uterine fibroids).

Keep in mind that supplements haven't been tested for safety and dietary supplements are largely unregulated. In some cases, the product may deliver doses that differ from the specified amount for each herb. In other cases, the product may be contaminated with other substances such as metals. 

Alternatives to Blue Cohosh

Cohosh dried root

Verywell / Anastasia Tretiak

Many other natural substances may help improve women's health. For example, there's some evidence that soy may help ease hot flashes in women undergoing menopause, strengthen bones, and slightly reduce the risk of breast cancer. 

For help in alleviating menstrual pain, consider the use of such remedies as omega-3 fatty acids, ginger, and dong quai (an herb used in traditional Chinese medicine). Undergoing massage or acupressure may also help soothe menstrual cramps.

In addition, research suggests that aromatherapy involving the use of essential oils of lavender, clary sage, and rose may help lessen menstrual cramps.

What to Look For

Many natural-foods stores and stores specializing in herbal products sell blue cohosh in dietary supplement form. You can also purchase blue cohosh supplements online. 

Due to the limited research and safety concerns, it's too soon to recommend blue cohosh as a treatment for any condition. If you're considering using it, make sure to consult your physician first. It's also important to note that self-treating and avoiding or delaying standard care may have serious consequences.

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Article Sources
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  • Blue Cohosh. Natural Medicines Database. Professional Monograph. 1/11/2019

  • Dugoua JJ, Perri D, Seely D, Mills E, Koren G. "Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation." Can J Clin Pharmacol. 2008 Winter;15(1):e66-73.
  • Lee Y, Jung JC, Ali Z, Khan IA, Oh S. "Anti-Inflammatory Effect of Triterpene Saponins Isolated from Blue Cohosh (Caulophyllum thalictroides)." Evid Based Complement Alternat Med. 2012;2012:798192.
  • Wu M, Hu Y, Ali Z, Khan IA, Verlangeiri AJ, Dasmahapatra AK. "Teratogenic effects of blue cohosh (Caulophyllum thalictroides) in Japanese medaka (Oryzias latipes) are probably mediated through GATA2/EDN1 signaling pathway." Chem Res Toxicol. 2010 Aug 16;23(8):1405-16.