Black Cohosh

Black cohosh is an herb that is used to help alleviate the symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness. Although it is not clear as to how exactly black cohosh works, it is thought that it has estrogen-like effects. Some of the possible side effects of black cohosh include headaches, weight gain, and an upset stomach.

 

What Is Black Cohosh?

Black cohosh (Actaea racemosa, Cimicifuga racemosa) is an herbal supplement often used for natural menopause relief. Specifically, it is frequently used to help alleviate the symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness.
 
(Click Benefits of Black Cohosh for more information on what black cohosh is used for.)
 

How Does Black Cohosh Work?

It is not clear how exactly black cohosh works. Black cohosh contains several different active compounds. Because black cohosh is most often used for menopause symptoms, it is thought that its activity is related to estrogen. While black cohosh seems to work like estrogen (it has many actions similar to estrogen), research suggests that black cohosh does not bind to estrogen receptors and does not increase the number of estrogen receptors. Therefore, it is not known how or why black cohosh has estrogen-like effects.
 

Is Black Cohosh Effective?

Many studies have evaluated the effectiveness of black cohosh for treating the symptoms of menopause, and the results have been mixed. Some studies indicated that black cohosh worked well, while other studies suggested that black cohosh was no more effective than a placebo (a "sugar pill" that does not contain any active ingredients).
 
There is not enough evidence to evaluate the effectiveness of black cohosh for any other use.
 
(Click Does Black Cohosh Work? for more information.)
 

Black Cohosh Dosing Information

Even though there is little information available about the best way to dose herbal supplements (compared to prescription or non-prescription medications), many studies of black cohosh for treating menopause symptoms have used similar doses.
 
(Click Black Cohosh Dosage for more information.)
 

Side Effects of Black Cohosh

Many people believe that "natural" products, such as black cohosh, do not have any side effects. However, many natural products cause side effects, some of which can be quite serious. Black cohosh can cause side effects, such as:
 
  • Headaches
  • An upset stomach
  • Weight gain
  • Breast tenderness.
     
(Click Black Cohosh Side Effects to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
 

Drug Interactions With Black Cohosh

Black cohosh may interact with a few other medications or supplements (see Black Cohosh Drug Interactions).
 

Is Black Cohosh Safe?

In reasonable doses and for short periods of time, black cohosh is probably safe for many people. However, some people may be more likely than others to experience problems due to black cohosh. Therefore, you should talk with your healthcare provider before taking black cohosh if you have:
 
  • Cancer (or a history of cancer)
  • Endometriosis
  • Uterine fibroids
  • Had a kidney transplant
  • Liver disease, including liver failure, hepatitis, or cirrhosis
  • A blood clotting disorder
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
Make sure to tell your healthcare provider about any other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 
(Click Black Cohosh Safety for more information, including any available black cohosh warnings and precautions.)
 

What If I Take a Black Cohosh Overdose?

It is not known what exactly to expect from a black cohosh overdose. If you think you may have taken too much black cohosh, seek immediate medical attention.
 
(Click Black Cohosh Overdose for more information.)
 

Black Cohosh: Storage Methods

Refer to the label of your individual black cohosh product for information on how best to store black cohosh. Keep black cohosh and all other medications or supplements out of the reach of children.
 
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;