Holistic Health Herbal Medicine The Health Benefits of Black Cohosh By Cathy Wong facebook twitter Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health. Learn about our editorial process Cathy Wong Medically reviewed by Medically reviewed by Arno Kroner, DAOM, LAc on June 12, 2020 facebook twitter linkedin Arno Kroner, DAOM, LAc, is a board-certified acupuncturist, herbalist, and integrative medicine doctor practicing in Santa Monica, California. Learn about our Medical Review Board Arno Kroner, DAOM, LAc Updated on June 16, 2020 Print Black cohosh (Cimicifuga racemosa) is a plant commonly used in herbal medicine for the relief of menopausal symptoms. A member of the buttercup family, it has a long history of use in the treatment of arthritis and muscle pain. A key component of black cohosh is fukinolic acid, a compound that has estrogen-like properties. Proponents suggest this may be beneficial to women as they experience age-related declines in estrogen levels, a key factor in the development of menopausal symptoms. Verywell / Gary Ferster Black cohosh is sometimes touted as a natural alternative to hormone replacement therapy. It is used as a natural remedy for a number of menopause-related symptoms, including hot flashes, night sweats, disturbances in mood, and vaginal dryness. In addition, black cohosh is sometimes used to treat menstrual irregularities and alleviate symptoms of premenstrual syndrome. Commonly Known As black cohoshblack cohosh root Health Benefits While black cohosh is among the most popular natural remedies for menopausal symptoms, studies testing its effectiveness have produced conflicting results. Here's a look at the science: Menopause Symptoms The most comprehensive research on black cohosh and menopausal symptoms include a report published in the Cochrane Database of Systematic Reviews in 2012. For this report, scientists looked at 16 previously published clinical trials (with a total of 2,027 women) that compared the effects of black cohosh to those of a placebo, hormone replacement therapy, red clover, and other interventions in the treatment of menopausal symptoms. In their analysis, the review's authors found no significant difference between black cohosh and placebo in the relief of hot flashes. What's more, hormone replacement therapy appeared to be more effective than black cohosh for hot flash relief. Due to insufficient data, no firm conclusions could be drawn as to black cohosh's effectiveness in treating symptoms such as vaginal dryness and night sweats. Since the reviewed studies were of "uncertain quality," the report's authors concluded that further research on the use of black cohosh in the treatment of menopausal symptoms is warranted. Possible Side Effects Side effects of black cohosh include headache, heaviness in the legs, indigestion, low blood pressure, nausea, perspiration, vomiting, and weight gain. In excessive doses, black cohosh may cause seizures, visual disturbances, and slow or irregular heartbeat. Discontinue the use of black cohosh and seek medical attention if you experience symptoms such as abdominal pain, dark urine, and jaundice. Contraindications If you have any of the following conditions, do not take black cohosh: Hormone-sensitive conditions, such as breast cancer, prostate cancer, endometriosis, or uterine fibroidsA history of blood clots, stroke, seizures, or liver diseaseAre taking medications for high blood pressureAre allergic to plants in the buttercup (Ranunculaceae) familyAre allergic to aspirin or salicylates, as black cohosh contains small amounts of salicylic acidAre pregnant as black cohosh may stimulate uterine contractions Interactions Due to its possible estrogen-like activity, black cohosh may interfere with the effectiveness of hormone replacement therapy or oral contraceptives. Black cohosh may interfere with the effectiveness of the chemotherapy drug cisplatin. Dosage and Preparation Black cohosh is sold as capsules, gel caps, and tinctures. There is no recommended daily allowance for black cohosh. What to Look For The part of the black cohosh plant used medicinally is the root and most preparations of it specify it is from the root. When selecting a brand of supplements, look for products that have been certified by Consumer Labs, The U.S. Pharmacopeial Convention, or NSF International. Other Questions Are there other natural remedies for menopause symptoms I could use? There's some evidence that alternative therapies like acupuncture may be of some benefit to women going through menopause. Studies from 2016 suggest that acupuncture may help reduce hot flashes and improve sleep quality in menopausal women. Natural remedies such as red clover, soy, St. John's wort, progesterone cream, and evening primrose oil also show promise in the treatment of menopause-related symptoms. However, as in the case of black cohosh, more research is needed to determine the effectiveness of these remedies. Is black cohosh the same as blue cohosh? No. Black cohosh should not be confused with the herb blue cohosh (Caulophyllum thalictroides), white cohosh, bugbane, Cimicifuga foetida, or white baneberry. These species have different effects, and blue cohosh and white cohosh, in particular, can be toxic. There is a case report of neurological complications in a post-term baby after labor induction with a herbal blend of black cohosh and blue cohosh. Should You Try Vitex for Hormonal Balance? Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Office of Dietary Supplements. Black Cohosh. Updated August 30, 2018. National Center for Complementary and Integrative Health. Black Cohosh. Updated September 2016. Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012;(9):CD007244. doi:10.1002/14651858.CD007244.pub2 Borrelli F, Ernst E. Black cohosh (Cimicifuga racemosa): a systematic review of adverse events. Am J Obstet Gynecol. 2008;199(5):455-66. doi:10.1016/j.ajog.2008.05.007 Szmyd M, Lloyd V, Hallman K, et al. The effects of black cohosh on the regulation of estrogen receptor (ERα) and progesterone receptor (PR) in breast cancer cells. Breast Cancer (Dove Med Press). 2018;10:1–11. doi:10.2147/BCTT.S144865 Avis NE, Coeytaux RR, Isom S, Prevette K, Morgan T. Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial. Menopause. 2016;23(6):626–637. doi:10.1097/GME.0000000000000597 Geller SE, Studee L. Botanical and dietary supplements for menopausal symptoms: what works, what does not. J Womens Health (Larchmt). 2005;14(7):634–649. doi:10.1089/jwh.2005.14.634