Herbs & Supplements:
Blue Cohosh
Caulophyllum thalictroides

Principal Proposed Uses
  • Regulating Menstrual Cycle, Inducing Labor

Warning: Blue cohosh is a toxic herb, and TNP strongly recommends against using it.

Blue cohosh is a flowering herb native to North America, growing in forested areas from the southeastern United States to Canada. Sometimes known as squaw root or papoose root, the herb may have been used medicinally by native Americans, although this is controversial. Other common names for the herb include yellow ginseng and blue ginseng. Blue cohosh should not be confused with the similarly named (but unrelated and much safer) black cohosh. Blue cohosh was used in the 1800s by European settlers and African Americans, primarily for gynecologic conditions.¹ Blue cohosh also has a reputation as an herb that can induce abortions, although concerns regarding its efficacy and safety make this use extremely ill-advised.² In addition, it has been used for the treatment of arthritis, cramps, epilepsy, inflammation of the uterus, hiccups, colic, and sore throat.

What Is Blue Cohosh Used for Today?

Blue cohosh is widely prescribed by herbalists and midwives today. A recent survey published in the Journal of Nurse-Midwifery found that 64% of certified nurse-midwives who prescribe herbal medicines use blue cohosh to induce labor.³ It has also been used for a wide variety of menstrual problems, including several that it would not be logical to believe the same treatment could cure. For instance, blue cohosh has been used to start menstrual periods that were late in coming and to stop excessive or ongoing menstrual flow. However, there is little to no credible evidence that blue cohosh is effective for any of the conditions for which it has been used. Furthermore, several published reports cite cases of serious side effects to infants apparently caused by blue cohosh (see Safety Issues).

Dosage

Blue cohosh is usually used as a tincture. Dosages range from 5 to 10 drops taken every 2 to 4 hours.

Safety Issues

There are many serious safety concerns with blue cohosh.

Some of the compounds found in blue cohosh, such as caulophyllosaponin, methylcytisin, and caulosaponin, appear to constrict coronary vessels, limiting blood flow to the heart and reducing its ability to pump.⁴ One published case report documents profound heart failure in a child born to a mother who used blue cohosh to induce labor.⁵ Severe medical consequences were seen in another child as well.⁶ Other blue cohosh constituents are known to interfere with the ability of a newly fertilized ovum to implant in the uterus, damage the uterus and thyroid, and cause severe birth defects in cattle and laboratory rats.^7,8,9

Given these reports, the availability of safe alternatives for stimulating labor, and the lack of studies to document the herb's efficacy and safety, TNP.com strongly advises against using blue cohosh.

Last reviewed March 2002 by Medical Review Board

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