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The active chemicals in goldenseal have opposite effects on blood pressure. Berberine may lower it, but hydrastine may raise it. People with high blood pressure, heart disease, diabetes, glaucoma, or a history of stroke should not use it. If you don’t know what your blood pressure is, have your doctor take a reading and give you the okay before using this drug.

High doses of goldenseal may irritate the skin, mouth, and throat, and cause nausea and vomiting. Goldenseal douches may cause vaginal irritation.

In some animal studies, berberine calms the uterus, supporting its traditional use in stopping excessive menstrual flow and postpartum hemorrhage. But other studies show it stimulates uterine contractions.

Pregnant women should not use it. Women with heavy menstrual flow might try it and see if it helps. Postpartum hemorrhage is a potentially serious condition that requires prompt professional attention. If you’d like to try goldenseal in addition to standard therapy, discuss it with your physician.

For non-pregnant, non-nursing women who do not have high blood pressure, glaucoma, diabetes, or a history of heart disease or stroke, goldenseal may be used cautiously for brief periods of time in amounts typically recommended.

Goldenseal should be used in medicinal amounts. If goldenseal causes minor discomforts, such as stomach upset or mouth irritation, use less or stop using it.