Black Cohosh

“Black cohosh is the most extensively researched of all herbs used for managing menopausal symptoms, and is available in many different formulations, which vary in…”.1

Umbrella
What may the Black Cohosh Umbrella include?

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

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

Definition

What is black cohosh?

The (United States) National Center for Complementary and Integrative Health (NCCIH) explain:

  • “Currently, black cohosh is promoted as a dietary supplement for hot flashes and other menopausal symptoms. It’s also been promoted for other conditions, including menstrual cramps and premenstrual syndrome, and to induce labor”.2

Menopausal Symptoms

Is black cohosh an effective treatment for menopausal symptoms?

In Menopause & Herbs: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa): Family: Ranunculaceae, the (Australian) Jean Hailes for Women’s Health (JH) explain:

Black Cohosh

“Black cohosh is the most extensively researched of all herbs used for managing menopausal symptoms, and is available in many different formulations, which vary in quality and efficacy. Many of the clinical studies of black cohosh have used the commercially available product Remifemin®, or the extract Ze 450 (available as Flordis Femular®)”.3

In Black Cohosh: How Much Do We Know? the 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”.4

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”.5

Vaginal Dryness

Is black cohosh an effective treatment for vaginal dryness?

In Menopause & Herbs: 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.

Linseed (flaxseed) has been shown to reduce vaginal dryness by a mildly oestrogenic action of ‘plumping up’ the vaginal cells”.6

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”.7

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”.8

In Complementary/Alternative Therapies for Menopausal Women: Complementary and Alternative Treatments – Herbal Treatments: Black Cohosh the (British) Women’s Health Concern (WHC) explain:

“This North American traditional herb can help hot flushes although never as well as HRT. Black cohosh does not help with anxiety or low mood, but black cohosh can interact with other medicines and there are unknown risks regarding safety”.9

Questions To Ask

If I choose to use black cohosh, what are some good questions to ask?

In Effectiveness of Natural Therapies: Good Questions To Ask the JH explain:

“Before taking a natural therapy, have a discussion with your natural therapist about the available evidence of effectiveness. Some good questions to ask are:

  • Do clinical trials exist?
  • Is the use of this medicine based on traditional knowledge or historical use?
  • What is the most effective dose for me?
  • What are the potential side effects?
  • Are there interactions with any of the medications I am currently taking?”10

Breast Cancer

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

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

  • “The research is inconsistent on whether black cohosh helps to reduce hot flashes that are related to breast cancer treatment. People with breast cancer should avoid using black cohosh before talking with their health care provider”.11

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 Natural Remedies for Hot Flashes: Do Mother Nature’s Treatments Help Hot Flashes? Use With Caution the North American Menopause Society note:

“Keep in mind that herbal supplements are not as closely regulated as prescription drugs. The amount of herbal product, quality, safety, and purity may vary between brands or even between batches of the same brand. Herbal therapies may also interact with prescription drugs, resulting in dramatic changes in the effect of the botanical, the drug, or both. To be safe, tell your healthcare provider about all botanical therapies you are considering and always stop all herbal treatments at least 2 weeks before any planned surgery”.12

In Herbal Medicine: Summary the (United States) MedlinePlus also note:

“If you are thinking about using an herbal medicine, first get information on it from reliable sources. Make sure to tell your health care provider about any herbal medicines you are taking”.13

In 4 Tips: Start Talking With Your Health Care Providers About Complementary Health Approaches the NCCIH’s third tip “to help you and your health care providers start talking” is:

“If you are thinking about using an herbal medicine, first get information on it from reliable sources. Make sure to tell your health care provider about any herbal medicines you are taking”.14

Health Topics A-Z

Where may I find Health Topics 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?

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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.

  1. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 1. Misunderstanding – MHT Will Make You Put on Weight
  2. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 6. Myth – Complementary Medicines and Therapies Are As Effective As MHT and Safer
  3. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 9. Misunderstanding – Non-hormonal Medications Are As Effective As MHT for Hot Flushes
  4. Actaea Racemosa L. Is More Effective In Combination With Rhodiola Rosea L. for Relief of Menopausal Symptoms: A Randomized, Double-Blind, Placebo-Controlled Study
  5. Bioidentical Hormones Explained – A British Menopause Society Video
  6. Bioidentical Hormones: Are They Safer?
  7. Black Cohosh
  8. Black Cohosh Black Cohosh
  9. Complementary Medicine Options for Menopausal Symptoms: Black Cohosh
  10. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  11. Complementary/Alternative Therapies for Menopausal Women
  12. Dietary Supplement Fact Sheets
  13. Dietary Supplements
  14. Dietary Supplements
  15. Dietary Supplements
  16. Dietary Supplements [Topics]
  17. Dietary Supplements: What Is Safe? Common Misconceptions About Dietary Supplements
  18. Dietary Supplements: What You Need To Know
  19. Drug Interactions: What You Should Know
  20. Drugs and Supplements: Herbs, Supplements and Vitamins [Topics]
  21. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  22. Effectiveness of Natural Therapies: Good Questions To Ask
  23. Frequently Asked Questions (FAQ)
  24. HRT and Alternatives
  25. Herb Society of America
  26. Herbal Medicine
  27. Herbal Supplements and Heart Medicines May Not Mix
  28. Herbal Supplements: What To Know Before You Buy
  29. Herbs At A Glance: Black Cohosh
  30. Herbs and Phytoestrogens
  31. Herbs and Supplements [Topics]
  32. Hot Flash Relief Without Hormones
  33. Hot Flashes: Diagnosis & Treatment – Alternative Medicine: Dietary Supplements – Black Cohosh
  34. Hot Flashes: Manage Without Medication?
  35. Hot Flashes: What Can I Do?
  36. Hot Stuff: What’s New About Hot Flashes?
  37. How Long Does Menopause Last? – Ask Dr Jean
  38. Information About Menopause [Multiply Languages] [Videos]
  39. Is It Really ‘FDA Approved?’ [Food and Drug Administration, United States]
  40. Lifestyle and Behaviour Changes for Menopausal Symptoms
  41. Lifestyle and Behavioural Modifications for Menopausal Symptoms
  42. Making Sense of Menopausal Hormone Therapy Means Understanding the Benefits As Well As the Risks
  43. Managing Menopause: Don’t Let Symptoms of Menopause Reduce Your Quality of Life
  44. Menopause
  45. Menopause
  46. Menopause & Herbs: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa)
  47. Menopause Explained – A British Menopause Society Video
  48. Menopause FAQs: Expert Answers To Frequently Asked Questions About Menopause
  49. Menopause FAQs: Hot Flashes – Q. Is it safe to take dietary supplements or herbal therapies for my menopause symptoms?
  50. Menopause Management: Natural & Complementary Therapies – Herbal Therapies and Remedies for Menopause
  51. Menopause Matters
  52. Menopause Symptoms and Relief
  53. Menopause Treatment
  54. Menopause – Complementary Therapies [Multiply Languages] [Video]
  55. Menopause – What Are the Symptoms? [Multiply Languages] [Video]
  56. Menopause: Complementary Therapies for Menopausal Symptoms [Video Interview Stories]
  57. Menopause: Diagnosis & Treatment
  58. Menopause: Menopause – Hormone Treatments
  59. Menopause: Non-HRT and Lifestyle Options [Video Interview Stories]
  60. Menopause: Non-Hormonal Treatment & Relief for Hot Flashes
  61. National Center for Complementary and Integrative Health
  62. National Center for Complementary and Integrative Health: 4 Things To Know About Menopausal Symptoms and Complementary Health Practices
  63. National Center for Complementary and Integrative Health: 4 Tips: Start Talking With Your Health Care Providers About Complementary Health Approaches
  64. National Center for Complementary and Integrative Health: 5 Tips: What You Should Know About Popular Herbs
  65. National Center for Complementary and Integrative Health: 6 Tips: How Herbs Can Interact With Medicines
  66. National Center for Complementary and Integrative Health: Black Cohosh
  67. National Center for Complementary and Integrative Health: Dietary and Herbal Supplements
  68. National Center for Complementary and Integrative Health: Herbs At A Glance
  69. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  70. National Center for Complementary and Integrative Health: Know the Science: 9 Questions To Help You Make Sense of Health Research
  71. National Center for Complementary and Integrative Health: Know the Science: How Medications and Supplements Can Interact
  72. National Center for Complementary and Integrative Health: Menopausal Symptoms: In Depth: What the Science Says About Complementary Health Approaches for Menopausal Symptoms
  73. National Center for Complementary and Integrative Health: Natural Doesn’t Necessarily Mean Safer, or Better
  74. National Center for Complementary and Integrative Health: Rhodiola
  75. National Center for Complementary and Integrative Health: Safe Use of Complementary Health Products and Practices
  76. National Center for Complementary and Integrative Health: Traditional Chinese Medicine: In Depth
  77. National Center for Complementary and Integrative Health: Using Dietary Supplements Wisely
  78. Natural Medicines
  79. Natural Remedies for Hot Flashes: Do Mother Nature’s Natural Remedies Work?
  80. Natural Therapies
  81. Natural Therapies & Supplements
  82. Natural Therapies & Supplements
  83. Non-Hormonal Treatment Options for Menopausal Symptoms
  84. NonHormonal Treatments for Menopausal Symptoms
  85. Office of Dietary Supplements [United States]
  86. Questions and Answers on Dietary Supplements
  87. Safety of Natural Therapies
  88. Symptoms of Menopause
  89. Tips for Dietary Supplement Users
  90. Understanding Menopause – Booklet
  91. Urogenital Atrophy Explained – A British Menopause Society Video
  92. Vaginal Dryness
  93. 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?
  94. Video Series-2018 – The Truth About Nonpharmacologic Options for Hot Flushes
  95. What You Need To Know
  96. What You Need To Know About Dietary Supplements
  97. Women’s Wellness: Hot Flashes and Night Sweats Happen After Menopause
  98. Women’s Wellness: How To Treat Vaginal Dryness After Menopause
  99. Women’s Wellness: Treating Hot Flashes and Night Sweats Without Hormones [+ Video Courtesy: Mayo Clinic News Network]

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Menopause & Herbs: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa): Family: Ranunculaceae. Last Updated: 12 March 2020 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/natural-therapies-supplements/menopause-herbs Accessed: 12 September 2020
  2. Black Cohosh: Background. Last Updated: May 2020. National Center for Complimentary and Integrative Health https://www.nccih.nih.gov/health/black-cohosh Accessed: 12 September 2020
  3. Menopause & Herbs: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa): Family: Ranunculaceae. Last Updated: 12 March 2020 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/natural-therapies-supplements/menopause-herbs Accessed: 12 September 2020
  4. 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: 12 September 2020
  5. 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: 12 September 2020
  6. Menopause & Herbs: Vaginal Changes. Last Updated: 12 March 2020 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/natural-therapies-supplements/menopause-herbs Accessed: 12 September 2020
  7. Menopause & Herbs: Herbal Medicine Glossary (Alphabetical) – Black Cohosh, Actaea Racemosa, (Previously Known As Cimicifuga Racemosa): Family: Ranunculaceae. Last Updated: 12 March 2020 | Last Reviewed: 20 November 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/natural-therapies-supplements/menopause-herbs Accessed: 12 September 2020
  8. Hot Flashes: Diagnosis & Treatment – Alternative Medicine: Dietary Supplements – Black Cohosh. 24 April 2020. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 12 September 2020
  9. Complementary/Alternative Therapies for Menopausal Women: Complementary and Alternative Treatments – Herbal Treatments: Black Cohosh. Reviewed: August 2017. Women’s Health Concern https://www.womens-health-concern.org/help/factsheets/fs_menopausecomptherapies.html Accessed: 12 September 2020
  10. Effectiveness of Natural Therapies: Good Questions To Ask. Last Updated: 10 January 2020 | Last Reviewed: 15 June 2016. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/natural-therapies-supplements/effectiveness-of-natural-therapies Accessed: 12 September 2020
  11. 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: 12 September 2020
  12. Natural Remedies for Hot Flashes: Do Mother Nature’s Treatments Help Hot Flashes? Use With Caution. North American Menopause Society https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/natural-remedies-for-hot-flashes Accessed: 12 September 2020
  13. Herbal Medicine: Summary. Page Last Updated on: 09 September 2020. Topic Last Reviewed: 21 September 2017. MedlinePlus https://www.nlm.nih.gov/medlineplus/herbalmedicine.html Accessed: 12 September 2020
  14. 4 Tips: Start Talking With Your Health Care Providers About Complementary Health Approaches. 3. This Page Last Modified: 09 October 2019. National Center for Complementary and Integrative Health  https://nccih.nih.gov/health/tips/ttt Accessed: 12 September 2020

Topic Last Updated: 12 September 2020 – Topic Last Reviewed: 12 September 2020
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