Black Cohosh for Menopause Relief

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What is Black Cohosh?

Black Cohosh (Actaea racemosa or Cimicifuga racemosa) is a perennial herb native to North America. Its roots and rhizomes have been used for centuries for medicinal purposes by Native American tribes. Black Cohosh contains several bioactive compounds, including triterpene glycosides, such as actein and cimicifugoside, which have estrogenic effects. The roots and rhizomes of the plant are harvested and dried to make supplements in the form of capsules, tablets, or liquid extracts.

History and Other Names

Black Cohosh has a long history of medicinal use dating back to the Native American tribes of North America and has been used in traditional Native American medicine for centuries to treat menopause symptoms and now is also gaining popularity as a proper women’s health supplement. The name “cohosh” is derived from an Algonquian word meaning “rough,” which describes the plant’s gnarled root. Black Cohosh is also known as “black snakeroot,” “bugbane,” and “rattleweed.”

Black Cohosh Hormone Effects

Black Cohosh functions as a phytoestrogen by mimicking the action of the hormone estrogen and restoring hormonal balance compensating for the declining levels of estrogen in menopausal women. Black cohosh has strong evidence to support its use for women’s health and is used in the herbal world as an alternative for hormone replacement therapy.

A study was conducted on 174 women to compare the influence of Black cohosh and menopausal hormone therapy on metabolic parameters, body weight, and menopausal symptoms in menopausal women. Out of these women, some were having hormone replacement therapy while others were using black cohosh. After the follow-up time of 1 year, results demonstrated that metabolic parameters and body weight did not change while menopausal symptoms improved significantly in both groups (1).

A study on 80 menopausal women who were having hot flushes found that daily taking 20mg supplementation of black cohosh for 8 weeks significantly reduced the severity and number of  hot flushes and improved quality of life compared with before starting the supplement (2).

Another study on 84 Iranian early post-menopausal women to evaluate the efficacy of Black cohosh was conducted. Women took 6.5mg of Black cohosh tablet daily for 8 weeks and recordings were taken at 4 and 8 weeks. Significant improvement in vasomotor (hot flashes and night sweats) symptoms was found with better results at 8 weeks than 4 weeks (3).

Black cohosh has been used in Germany as a natural remedy for PMS, dysmenorrhea, and menopause since the early 1940s. It is still a well-liked non-hormonal alternative to oestrogen therapy. RemifeminTM has been used by more than 6.5 million menopausal women in Germany since 1956. Despite being an unapproved drug in the US, black cohosh is now widely accessible as a dietary supplement.

Black cohosh’s efficacy in treating menstruation and menopausal disorders has been shown since the 1960s in published results of European clinical trials. Five clinical studies (none double-blinded) comparing RemifeminTM with a placebo and/or oestrogen replacement for the treatment of menopausal symptoms have been conducted since the 1980s. After 6–8 weeks of treatment, 80% of patients in the large, open, multicenter study with data on 629 individuals gathered by 131 general practitioners reported positive outcomes. Hot flushes, sweating, headaches, vertigo, palpitations, and tinnitus were all improved (4).

Black Cohosh Other Benefits

Aside from its menopause-relieving effects, Black Cohosh is also used to relieve menstrual cramps and regulate menstrual cycles. Some studies have shown that Black Cohosh can reduce menstrual cramps’ intensity and duration.

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Any Known Side Effects or Interactions

Black Cohosh is generally safe when taken as directed. Still, some women may experience side effects such as stomach upset, headache, and dizziness. Rarely, Black Cohosh can cause liver damage (5), so it is essential to monitor liver function regularly when taking Black Cohosh. Black Cohosh may interact with certain medications, including oral contraceptives and hormone therapy (6).

Takeaway message

Black Cohosh is a natural remedy that has been used for centuries to relieve menopause symptoms. Several studies have shown that Black Cohosh is effective in reducing the frequency and severity of hot flashes and improving sleep quality in menopausal women. Black Cohosh is generally safe when taken as directed, but it may cause side effects in some women. It is crucial to consult a healthcare provider before taking Black Cohosh, especially if taking any medications.


  1. Friederichsen L, Nebel S, Zahner C, Bütikofer L, Stute P. Effect of CIMicifugaracemosa on metaBOLIC parameters in women with menopausal symptoms: a retrospective observational study (CIMBOLIC). Arch Gynecol Obstet. 2020 Feb;301(2):517-523. doi: 10.1007/s00404-019-05366-8. Epub 2019 Nov 16. PMID: 31734757; PMCID: PMC7033259.
  2. Mehrpooya M, Rabiee S, Larki-Harchegani A, Fallahian AM, Moradi A, Ataei S, Javad MT. A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes. J Educ Health Promot. 2018 Mar 1;7:36. doi: 10.4103/jehp.jehp_81_17. PMID: 29619387; PMCID: PMC5868221.
  3. Mohammad-Alizadeh-Charandabi S, Shahnazi M, Nahaee J, Bayatipayan S. Efficacy of black cohosh (Cimicifugaracemosa L.) in treating early symptoms of menopause: a randomized clinical trial. Chin Med. 2013;8(1):20. Published 2013 Nov 1. doi:10.1186/1749-8546-8-20
  4. Summary of data for chemical selection. Black cohosh.
  5. Adnan, M. M., Khan, M., Hashmi, S., Hamza, M., AbdulMujeeb, S., & Amer, S. (2013). Black Cohosh and Liver Toxicity: Is There a Relationship? Case Reports in Gastrointestinal Medicine, 2014.
  6. Charrois, T. L., Sandhu, G., & Vohra, S. (2006). Black Cohosh Practical Management of Adverse Effects and Drug Interactions. Canadian Pharmacists Journal / Revue des Pharmaciens du Canada.

Disclaimer: The information presented here is for informational and educational purposes only and is not intended to be used as medical advice. Any statements or claims about the possible health benefits conferred by any products or lifestyle changes have not been evaluated by medical professionals or the Food & Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. You should consult your health practitioner before changing your diet, taking supplements, or starting any exercise or health program

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