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Blue cohosh is used primarily for uterine weakness and has historically been used by midwives as an aid to childbirth. It is considered a uterine stimulant in most circumstances because it improves uterine muscle tone. Blue cohosh also has an antispasmodic effect on cramps. Blue cohosh is classified as an emmenagogue, meaning it stimulates menstrual flow. It dilates blood vessels in the uterus and promotes circulation in the pelvis, making it helpful for women who experience scanty, spotty menstrual flow; irregular periods; difficult, painful periods; and cramping.