Black Cohosh: Characteristics, Uses, and Precautions

Black cohosh can relieve menopausal symptoms, increase fertility, and treat various gynecological problems. Discover more of its benefits as well as its possible adverse effects in this article!
Black Cohosh: Characteristics, Uses, and Precautions

Last update: 30 June, 2021

Black cohosh, or Actaea racemosa, is a plant with large leaves and tall clusters of white flowers native to North America. Both its flowers and roots were used by Native Americans in the treatment of gynecological, renal, and even mental problems.

Today Actaea racemosa serves as an active ingredient in supplements related to women’s health, especially those that relieve menopausal symptoms, increase fertility, and balance hormonal balance.

Find out everything you need to know about this plant in this article!

Uses and possible health benefits

As we mentioned previously, most of its benefits and uses have to do with women’s health. Let’s take a detailed look at how it can help, as well as its other attributed benefits.

1. Relieving menopausal symptoms

Most people use black cohosh to combat menopausal symptoms (fatigue, hot flashes, sweating, insomnia, mood swings, among others).

A study of 80 menopausal women with hot flashes showed that those who consumed 20 milligrams per day for 8 weeks experienced a decrease in the number and severity of hot flashes.

However, although other studies support these effects, we still need more research to certify cohosh as a palliative for menopausal symptoms.

A menopausal woman having a hot flash.
Hot flashes are annoying symptoms of menopause that many women try to eliminate in order to improve their quality of life.

Read also: Hormonal Changes in Menopause

2. May increase fertility

While it’s true that many sellers of this supplement claim that it can improve fertility, the scientific evidence is scanty.

According to research in Reproductive BioMedicine Online and Gynecological Endocrinology, black cohosh increases the effectiveness of clomiphene. This drug’s useful in treating infertility in women with ovulation problems, thus increasing their chances of becoming pregnant.

Studies also showed an improvement in pregnancy and ovulation rates in women with infertility who took black cohosh and clomiphene supplements. However, more research on these effects is still necessary.

3. Treating various gynecological problems

This medicinal plant’s also known to treat other ailments that afflict women. These include the following:

4. Reduces the risk of breast cancer

Because black cohosh behaves like the hormone estrogen, experts believe that it may worsen or increase the risk of breast cancer.

However, a study published in Integrative Cancer Therapies found that it doesn’t increase the likelihood of breast cancer. On the contrary, it was associated with a lower risk.

According to test-tube studies, black cohosh extract may act as an anti-estrogen and slow the spread of breast cancer cells. However, more research is still necessary.

5. May improve mental health

Experts also believe that black cohosh may improve mental health, especially in menopausal women. According to research in Post Reproductive Health, supplements do not affect anxiety. However, they may improve some psychological symptoms.

However, more studies are necessary to support this benefit of black cohosh supplements.

6. Improve sleep quality

A small study of 42 menopausal women suggested that black cohosh supplements may improve the duration and quality of sleep.

Likewise, research in Minerva Obstetrics and Gynecology found that combining black cohosh with other compounds (chaste berry, zinc, ginger, and hyaluronic acid) could improve hot flashes that cause anxiety and insomnia. However, it’s difficult to know if it was the compound that was behind these effects.

7. Stimulate weight loss

Menopausal women often gain weight, given the natural decrease in their estrogen levels. However, since there’s scientific evidence of the estrogenic effects of black cohosh, experts believe that it may help control weight at this stage.

Black cohosh care and side effects

Although black cohosh has side effects, they’re mostly mild. These include stomach upset, skin rashes, muscle pain, breast enlargement, and spotting or bleeding outside the period, among others.

Serious cases include aggravating liver damage. This is why people with these diseases or undergoing treatment should avoid this ingredient. Similarly, an animal study linked high doses to damage to red blood cells, leading to anemia. However, more research is necessary to look at these effects in humans.

At the same time, you should note that research on black cohosh is sparse, so there may be other adverse effects that we’re not aware of.

A woman with a rash all over her back.
Among the adverse reactions of the compound, we can mention urticaria and dermatological reactions.

Dosage and presentations of black cohosh

Black cohosh is available in various presentations, whether capsules, liquid extract, or tea. According to the dosages, these can vary depending on the brand. However, the general dosage is between 20 to 120 milligrams of extract or powder per day.

Experts believe that to treat menopausal symptoms, women must take at least 20 milligrams daily. However, some experts say that you shouldn’t take it for more than 6 months, given its potential to cause liver damage.

Supplements often come in forms that blend black cohosh with other components. For example, red clover, soy isoflavones, chaste berry, St. John’s wort, dong quai, and vitamin C.

Combining black cohosh with each of these could help boost its role in alleviating menopausal symptoms. However, we still need more studies to support such hypotheses.

Black cohosh: An ally for menopausal symptoms

Black cohosh is a North American medicinal plant. Ancient Native Americans used it to treat conditions that afflicted women, as well as other ailments such as sore throat, kidney problems, and even depression.

Today, its uses haven’t changed much. It’s mainly used to alleviate menopausal symptoms, increase fertility, and treat various gynecological problems, such as fibroids, polycystic ovary syndrome, and premenstrual syndrome.

Although most of its adverse effects are mild, you should note that it may worsen liver damage, as well as affect red blood cells, causing anemia.

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  • Mehrpooya, M., Rabiee, S., Larki-Harchegani, A., Fallahian, A. M., Moradi, A., Ataei, S., & Javad, M. T. (2018). A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes. Journal of education and health promotion, 7, 36. https://doi.org/10.4103/jehp.jehp_81_17
  • Friederichsen, L., Nebel, S., Zahner, C., Bütikofer, L., & Stute, P. (2020). Effect of CIMicifuga racemosa on metaBOLIC parameters in women with menopausal symptoms: a retrospective observational study (CIMBOLIC). Archives of gynecology and obstetrics, 301(2), 517–523. https://doi.org/10.1007/s00404-019-05366-8
  • Shahin, A. Y., Ismail, A. M., & Shaaban, O. M. (2009). Supplementation of clomiphene citrate cycles with Cimicifuga racemosa or ethinyl oestradiol–a randomized trial. Reproductive biomedicine online, 19(4), 501–507. https://doi.org/10.1016/j.rbmo.2009.06.007
  • Shahin, A. Y., & Mohammed, S. A. (2014). 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. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 30(7), 505–510. https://doi.org/10.3109/09513590.2014.895983
  • Kamel H. H. (2013). Role of phyto-oestrogens in ovulation induction in women with polycystic ovarian syndrome. European journal of obstetrics, gynecology, and reproductive biology, 168(1), 60–63. https://doi.org/10.1016/j.ejogrb.2012.12.025
  • Xi, S., Liske, E., Wang, S., Liu, J., Zhang, Z., Geng, L., Hu, L., Jiao, C., Zheng, S., Zepelin, H. H., & Bai, W. (2014). 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. Evidence-based complementary and alternative medicine : eCAM, 2014, 717686. https://doi.org/10.1155/2014/717686
  • Fritz, H., Seely, D., McGowan, J., Skidmore, B., Fernandes, R., Kennedy, D. A., Cooley, K., Wong, R., Sagar, S., Balneaves, L. G., & Fergusson, D. (2014). Black cohosh and breast cancer: a systematic review. Integrative cancer therapies, 13(1), 12–29. https://doi.org/10.1177/1534735413477191
  • Huyen, C., Luyen, B., Khan, G. J., Oanh, H. V., Hung, T. M., Li, H. J., & Li, P. (2018). Chemical Constituents from Cimicifuga dahurica and Their Anti-Proliferative Effects on MCF-7 Breast Cancer Cells. Molecules (Basel, Switzerland), 23(5), 1083. https://doi.org/10.3390/molecules23051083
  • Shahmohammadi, A., Ramezanpour, N., Mahdavi Siuki, M., Dizavandi, F., Ghazanfarpour, M., Rahmani, Y., Tahajjodi, R., & Babakhanian, M. (2019). The efficacy of herbal medicines on anxiety and depression in peri- and postmenopausal women: A systematic review and meta-analysis. Post reproductive health, 25(3), 131–141. https://doi.org/10.1177/2053369119841166
  • Jiang, K., Jin, Y., Huang, L., Feng, S., Hou, X., Du, B., Zheng, J., & Li, L. (2015). Black cohosh improves objective sleep in postmenopausal women with sleep disturbance. Climacteric : the journal of the International Menopause Society, 18(4), 559–567. https://doi.org/10.3109/13697137.2015.1042450
  • Cappelli, V., Morgante, G., Di Sabatino, A., Massaro, M. G., & De Leo, V. (2015). Valutazione dell’efficacia di un nuovo preparato nutraceutico nel trattamento dei disturbi delle donne in postmenopausal [Evaluation of the efficacy of a new nutraceutical product in the treatment of postmenopausal symptoms]. Minerva ginecologica, 67(6), 515–521.
  • Martin B. R. (2019). Complementary Medicine Therapies That May Assist With Weight Loss: A Narrative Review. Journal of chiropractic medicine, 18(2), 115–126. https://doi.org/10.1016/j.jcm.2018.10.004