Blue cohosh (Caulophyllum thalictroides)

Traditional Indications

Blue cohosh is antispasmodic, antirheumatic, diuretic, emmenagogue and uterine tonic. It is an excellent uterine tonic that may be used in any situation where there is a weakness or loss of tone. It may be used at any time during pregnancy if there is a threat of miscarriage. Similarly, because of its anti-spasmodic action, it will ease false labour pains and dysmenorrhoea. However, when labour does ensue, the use of Blue Cohosh just before birth will help ensure an easy delivery, hence its traditional use as a partus preparatory. In all these cases it is a safe herb to use. As an emmenagogue it can be used to bring on a delayed or suppressed menstruation whilst ensuring that the pain that sometimes accompanies it is relieved. (1)


Blue cohosh has been used as a medicinal herb in eastern North America. It was commonly used as traditional medicines for the treatment of menopausal symptoms, rheumatic pain, and as anti-inflammatory remedy. Particularly, extract of blue cohosh roots has been used as anti-inflammatory antipyretic in traditional medicines. Results demonstrate that constituents of Blue cohosh exert anti-inflammatory effects through the inhibition of expression of Nitric oxide synthases (iNOS) and pro-inflammatory cytokines, iNOS, TNF-α, IL-1β, and IL-6 therefore, blue cohosh may have therapeutic potential for the treatment of inflammation-related diseases. (2)

Blue cohosh is one of several medicinal plants used as herbal fertility treatments in North America from colonial times to 1900s that can be used in combination with assisted reproductive technology (ART) to lower the cost and increase the success rate of infertility treatment. (3)

Blue cohosh is part of a combination of herbal medicines that have been traditionally used in the third trimester to prepare a woman for delivery. This preparation is called ‘mother’s cordial’ or ‘partus preparatus’. In addition to Blue cohosh, a partus preparatus typically contains, Black cohosh Cimicifuga racemosa, Raspberry Rubus idaeus, Squaw vine / Partridge berry Mitchella repens (4) and Milk thistle Silybum marianum.

According to a survey of midwives in the United States, approximately 64% of midwives reported using Blue cohosh as a labour-inducing aid. (5) Blue cohosh needs to prescribe by a level 8 qualified herbalist or health care practitioner under supervision.

1. PFAF. Caulophyllum thalictroides 2019.
2. Lee Y, Jung J-C, Ali Z, Khan IA, Oh S. Anti-Inflammatory Effect of Triterpene Saponins Isolated from Blue Cohosh (Caulophyllum thalictroides). Evidence-based complementary and alternative medicine : eCAM. 2012;2012:798192-.
3. Lans C, Taylor-Swanson L, Westfall R. Herbal fertility treatments used in North America from colonial times to 1900, and their potential for improving the success rate of assisted reproductive technology. Reproductive biomedicine & society online. 2018;5:60-81.
4. Edward Mills J-JD, Dan Perri, Gideon Koren. Herbal Medicines in Pregnancy and Lactation An Evidence-Based Approach: Taylor & Francis Medical, an imprint of the Taylor & Francis Group; 2006.
5. Dugoua JJ, Perri D, Seely D, Mills E, Koren G. Safety and efficacy of blue cohosh (Caulophyllum thalictroides) during pregnancy and lactation. The Canadian journal of clinical pharmacology = Journal canadien de pharmacologie clinique. 2008;15(1):e66-73.



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