Black Cohosh

“A substantial number of studies in people
have evaluated black cohosh for menopause symptoms.
Much less research has been done on black cohosh for…”.1

Umbrella

What may the Black Cohosh Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Actaea Racemosa
  • Black Bugbane
  • Black Cohosh
  • Black Snakeroot
  • Bugbane
  • Bugwort
  • Cimicifuga Racemosa
  • Fairy Candle
  • Macrotys
  • Rattleroot
  • Rattleweed

Definition

What is black cohosh?

DotS the definition of black cohosh may vary. In Black Cohosh: Introduction the definition used by (United States) Office of Dietary Supplements (ODS) is:

“Black cohosh (Actaea racemose or Cimicifuga racemosa), a member of the buttercup family, is a perennial plant native to North America”.2

Studies

What have studies found about the effectiveness of black cohosh for menopausal symptoms?

In Menopause–Biology, Consequences, Supportive Care, and Therapeutic Options: Current Therapeutic Options – Complementary and Herbal Therapies, published 06 September 2023, the authors elaborate on:

“In numerous trials, black cohosh, not to be confused with blue cohosh, which has known liver toxicity, has been shown to be safe with limited efficacy in some single-site clinical trials. However, the HALT study, which was the most rigorous and comprehensive clinical trial to date, consisting of 351 participants, demonstrated no improvement with black cohosh over placebo among perimenopausal women experiencing VMS”.3

Menopausal Symptoms

Is black cohosh an effective treatment for menopausal symptoms?

In Menopause and Natural Therapies: Hot Flushes and Night Sweats the (Australian) Jean Hailes for Women’s Health (JH) note:


Black Cohosh
“Some evidence suggests that the herb black cohosh helps to manage hot flushes.

When the herb St John’s wort is combined with black cohosh or passionflower, it may reduce hot flushes and improve your mood”.4

In Black Cohosh: How Much Do We Know? last updated November 2024, the (United States) National Center for Complimentary and Integrative Health (NCCIH) note:

  • “A substantial number of studies in people have evaluated black cohosh for menopause symptoms. Much less research has been done on black cohosh for other conditions”.5

In Black Cohosh: What Have We Learned? the NCCIH also note:

  • “A 2023 review of 22 studies of products containing black cohosh extracts, alone or in combination with other herbs, found that they were potentially beneficial for overall menopause symptoms. Data on specific symptoms showed improvements in hot flashes but not anxiety or depressive symptoms
  • It’s uncertain whether black cohosh can reduce hot flashes related to breast cancer treatment
  • There aren’t enough reliable data to show whether black cohosh is effective for other uses”.6

Vaginal Dryness

Is black cohosh useful for treating vaginal dryness?

In Menopause and Natural Therapies: Vaginal Changes the JH explain:

“Black cohosh may be useful for treating vaginal dryness. Ask your health practitioner about black cohosh pessaries and vaginal cream”.7

Effective or Not

Is black cohosh effective for the treatment of menopausal symptoms?

In Hot Flashes: Diagnosis & Treatment – Alternative Medicine: Dietary Supplements the (United States) Mayo Clinic note:

  • “Black Cohosh. Many people use black cohosh to ease menopause symptoms. Studies of how well black cohosh works have had mixed results. And it’s rare, but there may be a link between black cohosh and liver damage”.8

Liver Damage

Is there an association between black cohosh and liver damage in some people?

In Black Cohosh: What Do We know About Safety? last updated November 2024, the NCCIH elaborate on:

  • “While black cohosh has been used safely in research studies that lasted as long as a year and is generally well tolerated, concerns have been raised that it may cause liver damage in some people.
    • Cases of liver damage—some very serious—have been reported in people taking products labeled as black cohosh. These problems are rare, and it’s uncertain whether black cohosh was responsible for them. If you take black cohosh, consult your health care provider if you develop symptoms of liver damage such as dark urine and fatigue…”.9

Breast or Uterine Cancer

Is black cohosh safe for women who have had hormone-sensitive conditions such as breast or uterine cancer?

In Black Cohosh: What Do We know About Safety? last updated November 2024, the NCCIH elaborate on:

  • “It’s uncertain whether black cohosh is safe for women who have had hormone-sensitive conditions such as breast or uterine cancer”.10

Health Care Provider

What if I choose to use black cohosh?

If you choose to use black cohosh, it may be in your best interest to also choose to talk to your health care providers about this.

In Lots of Women Try Herbs Like Black Cohosh for Menopausal Symptoms Like Hot Flushes – But Does It Work? published 20 September 2023, the authors note:

“Women experiencing troublesome menopausal symptoms, such as hot flushes, should talk to their doctor about the best treatment options for them”.11

In Menopause–Biology, Consequences, Supportive Care, and Therapeutic Options: Current Therapeutic Options – Complementary and Herbal Therapies, the authors note:

“Consideration of over-the-counter remedy use should include a shared decision-making plan to perform intermittent monitoring of liver and renal function because such therapies are not regulated by most national regulating bodies and have been shown to contain doses that differ from that on the label and occasional impurities that could cause harm”.12

Health Topics A-Z

Where may I find Health Topics A-Z related to Black Cohosh?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Black Cohosh?

Your Country may have Links similar to:

Links

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    Black Cohosh
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    Black Cohosh
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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Black Cohosh: How Much Do We Know? Last Updated: November 2024. National Center for Complimentary and Integrative Health https://www.nccih.nih.gov/health/black-cohosh Accessed: 04 April 2025
  2. Black Cohosh: Introduction. Updated: 30 June 2020. Office of Dietary Supplements https://ods.od.nih.gov/factsheets/BlackCohosh-HealthProfessional/ Accessed: 04 April 2025
  3. Davis, S. R, Pinkerton, JA., Santoro, N., Simoncini, T. Menopause–Biology, Consequences, Supportive Care, and Therapeutic Options: Current Therapeutic Options – Complementary and Herbal Therapies. Published 06 September 2023 https://www.cell.com/cell/fulltext/S0092-8674(23)00905-4 Accessed: 04 April 2025
  4. Menopause and Natural Therapies: Hot Flushes and Night Sweats. Last Updated: 07 October 2024 | Last Reviewed: 08 January 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-herbs Accessed: 04 April 2025
  5. Black Cohosh: How Much Do We Know? Last Updated: November 2024. National Center for Complimentary and Integrative Health https://www.nccih.nih.gov/health/black-cohosh Accessed: 04 April 2025
  6. Black Cohosh: What Have We Learned? Last Updated: November 2024. National Center for Complimentary and Integrative Health https://www.nccih.nih.gov/health/black-cohosh Accessed: 04 April 2025
  7. Menopause and Natural Therapies: Vaginal Changes. Last Updated: 07 October 2024 | Last Reviewed: 08 January 2025. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-herbs Accessed: 04 April 2025
  8. Hot Flashes: Diagnosis & Treatment – Alternative Medicine: Dietary Supplements. 04 March 2025. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 04 April 2025
  9. Black Cohosh: What Do We Know About Safety? Last Updated: November 2024. National Center for Complimentary and Integrative Health https://www.nccih.nih.gov/health/black-cohosh Accessed: 04 April 2025
  10. Black Cohosh: What Do We Know About Safety? Last Updated: November 2024. National Center for Complimentary and Integrative Health https://www.nccih.nih.gov/health/black-cohosh Accessed: 04 April 2025
  11. Taylor, S. Davis, S. Lots of Women Try Herbs Like Black Cohosh for Menopausal Symptoms Like Hot Flushes – But Does It Work? 20 September 2023 https://theconversation.com/lots-of-women-try-herbs-like-black-cohosh-for-menopausal-symptoms-like-hot-flushes-but-does-it-work-211272 Accessed: 04 April 2025
  12. Davis, S. R, Pinkerton, JA., Santoro, N., Simoncini, T. Menopause–Biology, Consequences, Supportive Care, and Therapeutic Options: Current Therapeutic Options – Complementary and Herbal Therapies. Published 06 September 2023 https://www.cell.com/cell/fulltext/S0092-8674(23)00905-4 Accessed: 04 April 2025
Topic Last Updated: 04 April 2025 – Topic Last Reviewed: 04 April 2025

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