Black Cohosh

“Black cohosh is perhaps the most extensively researched
of all herbs used for managing menopausal symptoms.
It is available in many different products…”.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

Remifemin® and Flordis Femular®

What commercially available products may have been used in clinical studies?

In Menopause and Natural Therapies: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa): Family: Ranunculaceae, last updated 19 January 2024, the (Australian) Jean Hailes for Women’s Health (JH) explain:

“Many of the clinical studies of black cohosh have used the commercially available product Remifemin®, or the extract Ze 450 (available as Flordis Femular®)”.4

Menopausal Symptoms

Is black cohosh an effective treatment for menopausal symptoms?

In Menopause and Natural Therapies: Hot Flushes and Night Sweats the JH note:


Black Cohosh
“Black cohosh is perhaps the most extensively researched of all herbs used for managing menopausal symptoms. It is available in many different products, which vary in quality and effectiveness, and it can be combined with other herbs to tailor a formula specifically for hot flushes. Evidence is conflicting: some studies show it is effective and others do not”.5

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

  • “Black cohosh has been studied for menopause symptoms in people. Most of the older studies were not of the highest quality. More recent studies have been of higher quality, but they have differed in the formulation, plant species, or dose used, so it’s difficult to know the herb’s effects with any certainty. Black cohosh has not been studied as much for conditions other than menopause”.6

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

  • “Research suggests that certain black cohosh extracts and some combination products containing black cohosh may reduce some menopause symptoms. Most of the research has been on a single extract called Remifemin. Research on other black cohosh products has had inconsistent results. Guidelines released in 2015 indicate that there is a lack of consistent evidence for any benefit from black cohosh for menopause symptoms. But a 2017 review of recent research suggests that black cohosh extracts approved for treatment in Europe seem to decrease menopause symptoms”.7

In What Black Cohosh Can (and Can’t) Do for Menopause Symptoms: Black Cohosh for Other Symptoms of Menopause a (United States) Cleveland Clinic doctor explains:

“Black cohosh is an excellent herb to support people experiencing menopausal symptoms to reduce pain, reduce fatigue and lift your mood — just not consistently for hot flashes,” Dr. Lin says”.8

Placebo or Not

Are the effects of black cohosh any better than a placebo?

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:

“Many women like to try herbal therapies for hot flushes and other menopausal symptoms. While black cohosh is generally considered safe and some women may find it helps them, at the moment there is not enough scientific evidence to show its effects are any better than placebo”.9

Vaginal Dryness

Is black cohosh an effective treatment for vaginal dryness?

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

“Black cohosh, taken orally (by mouth) or topically (as a cream or pessary), may be useful for treating vaginal dryness. Black cohosh pessaries or vaginal cream are available only from naturopaths”.10

Breast Cancer

Does black cohosh help to reduce hot flashes that are related to breast cancer treatment?

In Menopause and Natural Therapies: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa): Family: Ranunculaceae – Precautions the JH elaborate on:

“Black cohosh is often used in early menopause brought on by cancer treatments, especially breast, ovarian or endometrial cancer. Of all the herbs, black cohosh has the most research about its safety in support of its use. It appears to be safe in breast cancer patients, although further research is needed.[24] Women with breast cancer or other hormone-dependent tumours should always talk to their doctor before taking black cohosh”.11

Safe or Not

Is black cohosh safe?

The JH note:

“Black cohosh has been associated with liver damage in some people, but this is very rare. The majority of cases suspected of liver damage have in fact been shown NOT to be related to black cohosh”.12

The (United States) Mayo Clinic also note:

  • “Black Cohosh. Black cohosh has been popular among many women with menopausal symptoms. Studies of black cohosh’s effectiveness have had mixed results, and the supplement might be harmful to the liver in rare circumstances”.13

In What Black Cohosh Can (and Can’t) Do for Menopause Symptoms: How To Take Black Cohosh a Cleveland Clinic doctor explains:

“To ensure that you’re buying a safe, quality product, Dr. Lin recommends purchasing only organic black cohosh from reputable companies that have been independently verified by a third party such as ConsumerLab, U.S. Pharmacopeia or NSF International”.14

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”.15

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”.16

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

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

New or Updated

  1. 8 Myths and Truths About Menopausal Hot Flashes
  2. BMS TV: Complementary and Alternative Therapies
  3. Black Cohosh
  4. Black Cohosh
  5. Black Cohosh Extracts In Women With Menopausal Symptoms: An Updated Pairwise Meta-Analysis
  6. Complementary & Alternative Therapies
  7. Deciding About Hormone Therapy Use
  8. Dietary Supplements
  9. Dietary Supplements
  10. Dietary Supplements
  11. Dietary Supplements [Topics]
  12. Dietary Supplements: Are Dietary Supplements Safe?
  13. Dr Louise Newson: The Truth About the Menopause & HRT
  14. Drugs and Supplements: Herbs, Supplements and Vitamins [Topics]
  15. Effectiveness of Natural Therapies: Good Questions To Ask
  16. Emerging Research In the Management of Menopausal Symptoms
  17. Frequently Asked Questions (FAQ)
  18. Herbs and Supplements [Topics]
  19. Hot Flashes
  20. Hot Flashes
  21. Hot Flashes: Diagnosis & Treatment – Alternative Medicine: Dietary Supplements – Black Cohosh
  22. Hot Flashes: What Can I Do? [+ Video: What Are the Signs and Symptoms of Menopause?]
  23. How Long Does Menopause Last? – Ask Dr Jean
  24. How To Find Relief for Hot Flashes At Night
  25. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause
  26. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms of Menopause [+ Video: Talking Menopause With Your GP] [Other Languages and Formats]
  27. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Treating Menopause Symptoms [+ Video] [Other Languages and Formats]
  28. Let’s Talk About Perimenopause
  29. Lots of Women Try Herbs Like Black Cohosh for Menopausal Symptoms Like Hot Flushes – But Does It Work?
  30. Managing Menopause
  31. Mayo Clinic Minute: Help With Hot Flashes Due To Menopause [+ Video Courtesy: Mayo Clinic News Network]
  32. Mayo Clinic Minute: How Lifestyle Changes May Help Manage Menopause Symptoms [+ Video]
  33. Mayo Clinic Q and A: Perimenopause Transitions and Concerns
  34. Menopause
  35. Menopause
  36. Menopause Management Options: Natural & Complementary Therapies – Herbal Therapies and Remedies for Menopause
  37. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Menopause Medication Tracker
  38. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
  39. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  40. Menopause Patient Information [Videos] 5. Lifestyle Advice In Menopause & Perimenopause
  41. Menopause Preparedness Toolkit Video Series: Lifestyle Tips for Menopause
  42. Menopause Preparedness Toolkit Video Series: Treating Vasomotor Symptoms of Menopause
  43. Menopause Preparedness Toolkit: A Woman’s Empowerment Guide
  44. Menopause Symptoms and Relief
  45. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  46. Menopause Treatments: What Works, What Doesn’t
  47. Menopause and Natural Therapies: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa)
  48. Menopause, Perimenopause, Hormone Therapy and Other Treatments With Madelyn Butler, MD [Podcast]
  49. Menopause: Diagnosis & Treatment
  50. Menopause: Ensuring A Tranquil Transition
  51. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  52. Menopause: Things You Can Do
  53. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  54. Mymenoplan.org [My Menoplan, United States]
  55. National Center for Complementary and Integrative Health
  56. National Center for Complementary and Integrative Health: 4 Tips: Start Talking With Your Health Care Providers About Complementary Health Approaches
  57. National Center for Complementary and Integrative Health: 5 Tips: What You Should Know About Popular Herbs
  58. National Center for Complementary and Integrative Health: 6 Tips: How Herbs Can Interact With Medicines
  59. National Center for Complementary and Integrative Health: Black Cohosh
  60. National Center for Complementary and Integrative Health: Dietary and Herbal Supplements
  61. National Center for Complementary and Integrative Health: Herbs At A Glance
  62. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  63. National Center for Complementary and Integrative Health: Natural Doesn’t Necessarily Mean Safer, or Better
  64. National Center for Complementary and Integrative Health: Placebo Effect
  65. Natural Remedies To Help Manage Perimenopause Symptoms
  66. Natural Therapies
  67. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  68. Non-Estrogen Treatments for Menopausal Symptoms
  69. Nonhormone Treatments for Hot Flashes and Night Sweats
  70. Office of Dietary Supplements [United States]: Background Information: Dietary Supplements
  71. Office of Dietary Supplements [United States]: Dietary Supplement Fact Sheets
  72. Office of Dietary Supplements [United States]: Dietary Supplements: What You Need To Know
  73. Perimenopause and Menopause Symptom Checklist
  74. Questions and Answers on Dietary Supplements
  75. Review & Meta-Analysis: Isopropanolic Black Cohosh Extract iCR for Menopausal Symptoms – An Update on the Evidence
  76. Safety of Natural Therapies
  77. Supplements for Menopausal Symptoms — Solutions or Snake Oil?
  78. Symptoms of Menopause
  79. Therapy for the Effects of Menopause
  80. The Truth About Menopause Supplements | Dr Sarah Berry
  81. Tips To Help Manage Menopause Symptoms
  82. Urogenital Atrophy Explained – A British Menopause Society Video
  83. Using Natural Therapies In the Menopause Transition – Webinar
  84. Vaginal Dryness
  85. Vaginal Dryness
  86. Vaginal Dryness After Menopause: How To Treat It? I’m postmenopausal and often have vaginal dryness, which makes intercourse painful. Is there anything I can do about it?
  87. Vaginal Dryness: What To Do About It
  88. Video Series-2022: Perimenopause: Signs, Symptoms, and Solutions
  89. Video Series-2023: NAMS 2023 Nonhormone Therapies Position Statement for Bothersome Menopause Symptoms
  90. Video Series-2023: New FDA-Approved Nonhormone Option for the Treatment of Hot Flashes
  91. Video Series-2023: Premature and Early Menopause
  92. Video Series-2024: Preparing for Your Menopause Health Care Visit
  93. Webinars: Previous – Non-Hormonal Pharmacological Interventions For VMS
  94. Webinars: Previous – Non-Pharmacological Interventions For VMS
  95. Weight Gain In Menopause: Systematic Review of Adverse Events In Women Treated With Black Cohosh
  96. What Black Cohosh Can (and Can’t) Do for Menopause Symptoms
  97. What Everyone Should Know About Menopause Symptoms
  98. Why Didn’t Anyone Tell Me This? Episode 3: Dr Annice Mukherjee: Your Essential Menopause Toolkit

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Menopause and Natural Therapies: Hot Flushes and Night Sweats. Last Updated: 19 January 2024 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-herbs Accessed: 14 June 2024
  2. Black Cohosh: Introduction. Updated: 30 June 2020. Office of Dietary Supplements https://ods.od.nih.gov/factsheets/BlackCohosh-HealthProfessional/ Accessed: 14 June 2024
  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: 14 June 2024
  4. Menopause and Natural Therapies: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa): Family: Ranunculaceae. Last Updated: 19 January 2024 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/natural-therapies-supplements/menopause-herbs Accessed: 14 June 2024
  5. Menopause and Natural Therapies: Hot Flushes and Night Sweats. Last Updated: 19 January 2024 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-herbs Accessed: 14 June 2024
  6. Black Cohosh: How Much Do We Know? Last Updated: May 2020. National Center for Complimentary and Integrative Health https://www.nccih.nih.gov/health/black-cohosh Accessed: 14 June 2024
  7. Black Cohosh: What Have We Learned? Last Updated: May 2020. National Center for Complimentary and Integrative Health https://www.nccih.nih.gov/health/black-cohosh Accessed: 14 June 2024
  8. What Black Cohosh Can (and Can’t) Do for Menopause Symptoms: Black Cohosh for Other Symptoms of Menopause. 03 August 2022. Cleveland Clinic https://health.clevelandclinic.org/what-is-black-cohosh/ Accessed: 14 June 2024
  9. Taylor, S. and 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: 14 June 2024
  10. Menopause and Natural Therapies: Vaginal Changes. Last Updated: 19 January 2024 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-herbs Accessed: 14 June 2024
  11. Menopause and Natural Therapies: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa) Family: Ranunculaceae. Last Updated: 19 January 2024 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-herbs Accessed: 14 June 2024
  12. Menopause and Natural Therapies: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa) Family: Ranunculaceae. Last Updated: 19 January 2024 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-a-z/menopause/menopause-herbs Accessed: 14 June 2024
  13. Hot Flashes: Diagnosis & Treatment – Alternative Medicine: Dietary Supplements – Black Cohosh. 12 December 2023. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 14 June 2024
  14. What Black Cohosh Can (and Can’t) Do for Menopause Symptoms: How To Take Black Cohosh. 03 August 2022. Cleveland Clinic https://health.clevelandclinic.org/what-is-black-cohosh/ Accessed: 14 June 2024
  15. 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: 14 June 2024
  16. 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: 14 June 2024
Topic Last Updated: 14 June 2024 – Topic Last Reviewed: 14 June 2024

Print Friendly, PDF & Email
/by