Black Cohosh For Women’s Health: Friend Or Foe

With its soothing and fertility-boosting properties, this herb is a woman's best friend.

Reviewed by Mayuri Aavula, MSc (Nutrition)
By Varsha Patnaik, MSc (Biotechnology), Certified Diet & Nutrition Coach

Have you ever heard of a herb that can ease you into menopause? Black cohosh is a flowering plant known for its beneficial effects during and after menopause. Native to eastern North America and a perennial herb of the buttercup family, it is also known as bugbane, rattleweed, and black snakeroot. Apparently, Native Americans have been using this herb for centuries to regularize the menstrual cycle and ease menopause and childbirth.In this article, we shall understand how science and studies back these black cohosh benefits and if there are any potential risks involved as well.

Stylecraze Trivia
Black cohosh was used in the 19th century to treat snakebites and inflamed lungs and to reduce pain during childbirth.

What Is Black Cohosh?

Black cohosh, scientifically known as Actaea racemose or Cimicifuga racemosa, is a perennial herb primarily used to treat menopause symptoms (1). Native Americans traditionally used black cohosh roots and flowers to treat menopause symptoms. Today, it is used in popular women’s health supplements to help regulate the monthly cycle, ease menopause discomforts, and fertility concerns (2).

Most women have to deal with hot flashes, excessive sweating, headaches, anxiety, mood swings, and vaginal dryness for about 3-4 years during their menopause. Black cohosh seems to act similar to the hormone estrogen and has pain-relieving effects that help alleviate these symptoms (2),(3). Going further, let’s understand these beneficial effects of black cohosh in detail.

Stylecraze Trivia
Black cohosh was also used topically to treat acne or for the removal of moles and warts.

Health Benefits Of Black Cohosh

Black cohosh has several potential benefits when it comes to hormonal balance and women’s health. However, apart from its effects in easing menopausal symptoms, all other benefits need more research to be established.

  • May Help With Menopause
Woman undergoing menopause may benefit from black cohosh


The primary benefit of black cohosh is its alleviating effects of menopausal pain and other symptoms. This is also strongly backed by many studies (4).

A study on menopausal women reported a significant reduction in hot flashes on a daily supplementation of 20 mg of black cohosh for 8 weeks (5). Another review of studies on menopausal women concluded a 26% reduction in hot flashes and night sweats on black cohosh supplementation in combination with other substances like St John’s wort, red clover flower extract, ginseng, soy extract, vitamin D, primrose oil, calcium, etc (6).

Black cohosh may provide pain-relief effects by binding to the body’s opioid receptors (7). Therefore it might be effective in reducing body pain and muscle aches during and after menopause.

  • May Help Improve Fertility

Although there’s not much evidence to support this, black cohosh may help improve your fertility. Especially for women with PCOS, black cohosh seems to improve the efficacy of the fertility drug Clomid (clomiphene citrate) increasing their chances to conceive. A few human studies suggest an improvement in ovulation and chances of conception in women struggling with infertility on supplementation of black cohosh alongside Clomid (8), (9). Although, more research is needed to confirm this effect.

  • May Help With Uterine Fibroids

Along with helping regulate your menstrual cycle and improving your chances of conceiving, black cohosh might also help improve the conditions of uterine fibroids. A 3-month study on postmenopausal women who took 40 mg of black cohosh daily, reported a 30% decrease in the size of their uterine fibroids (12).

  • Might Help Decrease The Risks Of Cancer

Studies show that black cohosh may help decrease the risks of breast cancer (13). This is interesting since black cohosh behaves similar to the hormone estrogen (which may potentially increase your risk of breast cancer). Few test-tube studies also suggest that black cohosh may help restrict the spread of cancerous cells (14). Further research is warranted to establish the same.

  • May Help Improve Mental Health
Woman with mental issues may benefit from black cohosh


According to a review of studies on the effects of herbal supplementation in menopausal women, black cohosh might help menopausal women deal with mental health concerns better. They reported significant improvements in their psychological symptoms (15). However, more research is needed to confirm the same.

  • May Help You Sleep Better

Black cohosh supplementation may help improve the duration and quality of sleep in menopausal women (16). As per a study, black cohosh in combination with other compounds like ginger, zinc, hyaluronic acid, and chaste berry might help improve hot flashes associated with anxiety and insomnia (17). However, it is not clear whether it is only because of black cohosh or any of the other ingredients involved.

  • May Aid Weight Loss
Black cohosh may aid in weight loss


Women nearing menopause tend to gain weight with a natural decrease in their estrogen levels. Black cohosh, with its estrogen-like effects, may have a slightly beneficial effect in managing and maintaining their weight (18). However, further human studies are needed to establish this.

People should exercise caution when considering or using black cohosh supplements. Studies on the risks of using it are limited even if numerous side effects have been associated with it.

Did You Know?
Black cohosh is also used to ease rheumatism, arthritis, and joint pain because of the presence of salicylic acid, which acts as an anti inflammatory component.

Dosage And How To Take Black Cohosh?

Black cohosh roots and underground stems are commonly prepared and sold as capsules, ground powder, or liquid extracts. While there are no fixed dosage recommendations, they may vary between 20-120 mg based on different brands and varying health concerns (19).

Additionally, black cohosh is used as an herbal supplement in combination with red clover, soy isoflavones, St. John’s wort, and chaste berry (20), (21), (22), (23).

Since black cohosh seems to have potential effects on your hormones, you might experience changes in your menstrual cycle when you stop taking it. You should consult your doctor for any such concerns.

As the Food and Drug Administration (FDA) does not regulate supplements, the quality, strength, and amount of active ingredients in the product may vary from brand to brand. You should hence look for black cohosh supplements tested and approved by third-party testing organizations like United States Pharmacopeia (USP), NSF International, and ConsumerLab.

Some health professionals claim you should not take black cohosh for longer than 6 months to 1 year because of its potential long-term risks (19). Let’s have a detailed understanding below.

Side Effects Of Black Cohosh

Black cohosh may trigger nausea


Black cohosh has some potentially mild side effects. They may include nausea, digestive issues, infection, skin rashes, muscle pain, breast pain or enlargement, and bleeding or spotting outside your regular menstrual cycle (19). A long-term intake of black cohosh could lead to a few of the more pronounced risks discussed below.

  • Might Lead To Liver Damage

Long-term use of black cohosh may lead to severe liver damage. In case you are having pre-existing liver conditions or are taking any medications or supplements for the same, you should avoid taking black cohosh (19).

  • Might Lead To Anemia

According to an animal study, high doses of black cohosh intake might be related to red blood cell damage, resulting in anemia. Further research is needed to confirm the same for humans (24).

  • May Worsen Prior Health Concerns

People with certain previous health concerns might be at a greater risk of developing complications on using black cohosh. Because of its blood-thinning and hormonal effects, black cohosh might aggravate certain health issues in people with prior hormonal replacement therapy, breast or uterine cancers, endometriosis, liver disease, etc. (25).

  • May Have Drug Interactions

There are few medications that might increase the chances of complications and adverse drug interactions adding to the potential side effects of black cohosh (26).

As black cohosh preparations are not regulated by the FDA, there is also a chance that products may contain other botanical or chemical ingredients that could cause harm.

  • May Trigger Allergies
Black cohosh may trigger some allergies


Some people might have certain allergic reactions to black cohosh. The herb may also contain small levels of salicylic acid, the active component in aspirin (27). People with aspirin intolerance or allergies should avoid it.

To Sum Up

Black cohosh is a perennial plant known for its remedial effects on women’s health. With its estrogen-like properties, it is used in modern health supplements for women to ease menstrual discomfort and treat menopausal symptoms. Though it has been in use traditionally, it is not regulated by the FDC, and hence should not be taken in large doses without consulting a health practitioner.

Frequently Asked Questions

Does black cohosh give you energy?

Yes, black cohosh may help reduce the fatigue experienced by women going through menopause (28).

Does black cohosh cause water retention?

Yes, some people may experience water retention as a side effect of using black cohosh (29).

Is black cohosh anti-inflammatory?

Yes, black cohosh contains saponins which may play a vital role in inflammatory pathways of neurodegenerative diseases like Alzheimer’s disease (30).

Key Takeaways

  • Scientifically called Actaea racemose or Cimicifuga racemosa, black cohosh is a perennial herb mainly used to treat menopause symptoms.
  • It may also enhance fertility and help you with uterine fibroids.
  • However, it might cause liver damage and anemia.


Articles on StyleCraze are backed by verified information from peer-reviewed and academic research papers, reputed organizations, research institutions, and medical associations to ensure accuracy and relevance. Read our editorial policy to learn more.

  1. Black Cohosh – StatPearls – NCBI Bookshelf
  2. Black cohosh: efficacy safety and use in clinical and preclinical applications
  3. Current Treatment Options: Headache Related to Menopause-Diagnosis and Management
  4. Effect of CIMicifuga racemosa on metaBOLIC parameters in women with menopausal symptoms: a retrospective observational study (CIMBOLIC)
  5. A comparative study on the effect of ”black cohosh” and ”evening primrose oil” on menopausal hot flashes
  6. Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis – Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews – NCBI Bookshelf
  7. Black Cohosh has Central Opioid Activity in Postmenopausal Women: Evidence from Naloxone Blockade and PET Neuroimaging Studies
  8. Supplementation of clomiphene citrate cycles with Cimicifuga racemosa or ethinyl oestradiol–a randomized trial
  9. Adding phytoestrogens to clomiphene induction in unexplained infertility patients–a randomized trial
  10. Adding the phytoestrogen Cimicifugae Racemosae to clomiphene induction cycles with timed intercourse in polycystic ovary syndrome improves cycle outcomes and pregnancy rates – a randomized trial
  11. Role of phyto-oestrogens in ovulation induction in women with polycystic ovarian syndrome
  12. Effect of Isopropanolic Cimicifuga racemosa Extract on Uterine Fibroids in Comparison with Tibolone among Patients of a Recent Randomized Double Blind Parallel-Controlled Study in Chinese Women with Menopausal Symptoms
  13. Black cohosh and breast cancer: a systematic review
  14. Chemical Constituents from Cimicifuga dahurica and Their Anti-Proliferative Effects on MCF-7 Breast Cancer Cells
  15. The efficacy of herbal medicines on anxiety and depression in peri- and postmenopausal women: A systematic review and meta-analysis
  16. Black cohosh improves objective sleep in postmenopausal women with sleep disturbance
  17. [Evaluation of the efficacy of a new nutraceutical product in the treatment of postmenopausal symptoms]
  18. Complementary Medicine Therapies That May Assist With Weight Loss: A Narrative Review
  19. Black Cohosh – Health Professional Fact Sheet
  20. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial
  21. Vaginal endometrial and reproductive hormone findings: randomized placebo-controlled trial of black cohosh multibotanical herbs and dietary soy for vasomotor symptoms: the Herbal Alternatives for Menopause (HALT) Study
  22. Black cohosh and St. John\’s wort (GYNO-Plus) for climacteric symptoms
  23. Efficacy of Cimicifuga racemosa Hypericum perforatum and Agnus castus in the treatment of climacteric complaints: a systematic review
  24. Black cohosh extracts and powders induce micronuclei a biomarker of genetic damage in human cells
  25. Herb-Drug Interactions: What the Science Says | NCCIH
  26. Analysis of spontaneous adverse drug reactions to echinacea valerian black cohosh and ginkgo in Australia from 2000 to 2015
  27. Black Cohosh (Cimicifuga Racemosa) as Treatment of Menopause-Related Symptoms: A Mini Review
  28. Black Cohosh and Climacteric Symptoms: Growing Knowledge about the Efficacy and Safety
  29. Coagulation activation and fluid retention associated with the use of black cohosh: a case study,the%20use%20of%20black%20cohosh.
  30. Black Cohosh: Insights into its Mechanism(s) of Action
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Varsha holds a master's degree in biotechnology from Ravenshaw University, Cuttack, and is a certified diet and nutrition coach. She... more

Mayuri Aavula

(MSc (Dietetics))
Mayuri Aavula is one of the top nutritionists in Hyderabad, India, and has won several awards and accolades. She started... more