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Blue Cohosh Benefits, Side Effects & Safety Information

Published: 13th May 2018. Last updated: 21th July 2019.

Shaun Ward MSc ANutr

Staff Writer


Blue Cohosh is a plant that originates in the woodlands of America and was traditionally used by the Native Americans.

"Cohosh" is the Indian word for “rough”, referring to the appearance of the plant roots.

This plant has been used for helping issues with the female reproductive system, such as the absence of menstruation, menstrual cramps, and menstrual bleeding.

However, its most well-known use if for inducing labor and reducing the pain of childbirth.

Other uses of this plant are to treat muscle spasms, constipation, sore throat, hiccups, epilepsy, hysterics, and joint pain.

Dietary supplements, containing the roots, or extracts of the roots, are now widely available. However, large issues remain over the safety of blue cohosh, as some experts have not deemed it appropriate for consumption.

The Potential Benefits Of Blue Cohosh

Below we've listed every potential benefit we've found with credible scientific backing:

Blue Cohosh May Help With Child Birth

Some people opt to take blue cohosh in the last 3-6 weeks of pregnancy as a labor ‘preparator’. This is due to the belief that it can facilitate labor, prevent extended pregnancies, shorten labor duration, reduce labor pain, and prevent other complications.

Interestingly, reports even suggest that ~64% of midwives have mentioned using blue cohosh as a labour-inducing aid – mainly during home-birth practices as opposed to birthing centers and hospitals.

This supplement has even been referred to an “oxytocic drug” – defined as inducing labor or strengthening labor contractions during childbirth, and to control bleeding after childbirth.

However, although blue cohosh is theorized to achieve these effects by stimulating blood flow to the uterus, there is a scarce amount of research on its pharmacological activity.

Very limited evidence suggests that blue cohosh does indeed have oxytocic and vasoconstrictive effects in the uterine muscle [1], although more contradicting evidence is available to reject this position.

If blue cohosh does have some degree of benefit, it is likely the saponin content which offers these uterine stimulating effects [2].

However, there are no quality clinical trials to support any therapeutic application for blue cohosh, and major concerns regarding its toxicity outweigh any potential benefit.

Blue Cohosh May Protect The Heart

Certain components of blue cohosh are speculated to protect the heart and prevent heart disease.

Similar to the proposed effects on the female reproductive system, the saponin content is the main component that seems to be initiating any potential benefits. Specifically, saponin may be able to suppress the production of proinflammatory molecules and other mediators of inflammation that could stop the formation of fatty-acid build up on arterial walls [3].

Another component may be an alkaloid from the roots of blue cohosh called caulophine, which has shown to protect against injury to cardiac muscle cells, possibly via its antioxidant activity [4].

Magnoflorine is another alkaloid within blue cohosh that has demonstrated in animal models to decrease arterial blood pressure in rabbits and reduce strain on the heart [5].

However, there is currently no clinical evidence to suggest blue cohosh is effective for the treatment of any cardiovascular condition.

Blue Cohosh Safety And Side Effects Information

Most scientific research recommends to avoid consuming blue cohosh as many adverse effects have been documented [6].

Although blue cohosh has been used by pregnant women, lab data suggests it may actually disturb the development of an embryo or fetus by affecting its structure and function [7].

This is because plant extracts within blue cohosh contain toxic alkaloids that have shown in other animals to alter physiological development [8].

In fact, some native populations have even used blue cohosh to induce abortion [9].

There are also currently 3 case reports of blue cohosh use during pregnancy that have led to adverse birth defects in newborns, including heart attacks, seizures, and reduced oxygen supply to the organs [10] [11] [12].

There are also many side effects associated with blue cohosh consumption, such as diarrhea, increases in blood pressure, elevations in blood sugar, and stomach cramps.

Based on the available scientific information, there is no supporting evidence to suggest blue cohosh should be used in any situation. This is especially important for pregnant women who can cause irreversible damage to themselves and their child.

If an individual chooses to supplement with blue cohosh, medical and professional supervision is an essential requirement.

There is an urgent need to study the use of this supplement by midwives in order to fully establish its safety and legality [13].


Blue Cohosh is a plant that was traditionally consumed by Native Americans but is now mainly used by pregnant women to induce labor.

It is now sold in supplement form, with proposed benefits to facilitate childbirth and protect the heart.

However, blue cohosh contains toxic alkaloids that have been linked to many adverse effects. Use of this supplement may disturb the development of the embryo or fetus and lead to birth defects.

More common side effects are diarrhea, stomach cramps, and increased in blood pressure.

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