Evidence supporting the use of: Cohosh
For the body system: Vagina

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Table of Contents

Synopsis

Source of validity: Traditional
Rating (out of 5): 3

Cohosh—specifically, black cohosh (Actaea racemosa, formerly Cimicifuga racemosa)—has a long history of traditional use for supporting women’s reproductive health, particularly for the relief of menopausal symptoms such as hot flashes, night sweats, and vaginal dryness. Native American and early European settlers commonly used black cohosh root preparations for gynecological conditions, labor induction, and symptoms related to menstruation and menopause. The rationale for its use in supporting the vagina and related body systems stems from its effects on hormonal balance and its purported estrogenic or selective estrogen receptor modulator (SERM)-like activity, which may help alleviate vaginal atrophy and dryness associated with menopause.

Although black cohosh remains popular in herbal practice and is included in numerous supplements for women’s health, the scientific evidence is mixed. Some clinical studies and meta-analyses report modest benefits for menopausal symptoms, including vaginal symptoms, but others show little to no effect compared to placebo. The mechanism of action is not fully understood, and recent research suggests black cohosh does not act directly as a phytoestrogen. The traditional evidence for vaginal and reproductive support is therefore stronger than the scientific evidence, justifying a moderate rating.

It should be noted that blue cohosh (Caulophyllum thalictroides), a different plant, has also been used traditionally for female reproductive issues, but it is not recommended due to safety concerns. Black cohosh remains the primary cohosh species used for vaginal and menopausal support based on traditional use.

More about Cohosh
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Products containing Cohosh

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