Overview

What is black cohosh?

What are black cohosh’s main benefits?

What are black cohosh’s main drawbacks?

How does black cohosh work?

Dosage information

If using an isopropanolic extract (usually sold under the brand name of Remifemin), 20-40mg daily is used in doses of 20mg; taking 20mg results in a once daily dosing, whereas taking 40mg is twice daily dosing of the 20mg. This dosage (20-40mg) confers 1-2mg of triterpenoid glycosides.

If using an aqueous:ethanolic extract of black cohosh root (ie. not Remifemin) then doses range from 64-128mg daily which are usually taken in two divided doses. This contributed about the same amount of triterpenoid glycosides.

It is not known whether or not black cohosh needs to be taken with food, although it is sometimes recommended to do so out of prudency.

Examine Database: Black Cohosh

Show Conditions

Health Condition/Goal	Health Outcome	Evidence
Menopause	4 Outcomes	9 Studies
General Cardiovascular Health	6 Outcomes	6 Studies
High Cholesterol	5 Outcomes	5 Studies
General Liver Health	4 Outcomes	4 Studies
Breast Cancer	2 Outcomes	3 Studies
Cognitive Improvement	2 Outcomes	2 Studies
Dyslipidemia	2 Outcomes	2 Studies
Metabolic Health	2 Outcomes	2 Studies
Anxiety	1 Outcome	1 Study
Bone Health	1 Outcome	1 Study

Menopause

4 Outcomes

9 Studies

General Cardiovascular Health

6 Outcomes

6 Studies

High Cholesterol

5 Outcomes

5 Studies

General Liver Health

4 Outcomes

4 Studies

Breast Cancer

2 Outcomes

3 Studies

Cognitive Improvement

2 Outcomes

2 Studies

Dyslipidemia

2 Outcomes

2 Studies

Metabolic Health

2 Outcomes

2 Studies

Anxiety

1 Outcome

1 Study

Bone Health

1 Outcome

1 Study

Menopause

General Cardiovascular Health

High Cholesterol

General Liver Health

Breast Cancer

Cognitive Improvement

Research FeedRead all studies

Plant-derived supplements for menopausal symptoms

In this meta-analysis of randomized controlled trials in perimenopausal or postmenopausal women, supplementation with isoflavones, soy, and other herbal products improved hot flash frequency and menopausal symptoms overall.

How does black cohosh compare with HRT for menopausal symptoms?

Frequently asked questions

What is the etymology of black cohosh?

How was black cohosh used by indigenous North Americans?

Does black cohosh improve bone density?

Can black cohosh be taken with St. John’s wort?

Can black cohosh be used instead of HRT for symptoms of menopause?

Update History

New meta-analyses added
minor

Research written by

Giulia Guerrini

Reviewed by

Nick Milazzo

FAQs added and database updated
major

Research written by

Giulia Guerrini

Edited by

Natalka Roshak

Reviewed by

Nick Milazzo

Research Breakdown

References

Examine Database References

Menopausal Symptoms - Castelo-Branco C, Gambacciani M, Cano A, Minkin MJ, Rachoń D, Ruan X, Beer AM, Schnitker J, Henneicke-von Zepelin HH, Pickartz SReview & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms - an update on the evidence.Climacteric.(2021-Apr)
Menopausal Symptoms - Wen-pei Bai, Shu-yu Wang, Jian-li Liu, Li Geng, Li-na Hu, Zhong-lan Zhang, Shu-ling Chen, Shu-rong Zheng[Efficacy and safety of remifemin compared to tibolone for controlling of perimenopausal symptoms]Zhonghua Fu Chan Ke Za Zhi.(2009 Aug)
Menopausal Symptoms - Geller SE, Shulman LP, van Breemen RB, Banuvar S, Zhou Y, Epstein G, Hedayat S, Nikolic D, Krause EC, Piersen CE, Bolton JL, Pauli GF, Farnsworth NRSafety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trialMenopause.(2009 Nov-Dec)
Menopausal Symptoms - Karel Raus, Cosima Brucker, Christoph Gorkow, Wolfgang WuttkeFirst-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055Menopause.(Jul-Aug 2006)
Menopausal Symptoms - Shams T, Setia MS, Hemmings R, McCusker J, Sewitch M, Ciampi AEfficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysisAltern Ther Health Med.(2010 Jan-Feb)
Menopausal Symptoms - Briese V, Stammwitz U, Friede M, Henneicke-von Zepelin HHBlack cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational studyMaturitas.(2007 Aug 20)
Menopausal Symptoms - Ross SMMenopause: a standardized isopropanolic black cohosh extract (remifemin) is found to be safe and effective for menopausal symptomsHolist Nurs Pract.(2012 Jan-Feb)
Menopausal Symptoms - Newton KM, Reed SD, LaCroix AZ, Grothaus LC, Ehrlich K, Guiltinan JTreatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trialAnn Intern Med.(2006 Dec 19)
Menopausal Symptoms - Pockaj BA, Gallagher JG, Loprinzi CL, Stella PJ, Barton DL, Sloan JA, Lavasseur BI, Rao RM, Fitch TR, Rowland KM, Novotny PJ, Flynn PJ, Richelson E, Fauq AHPhase III double-blind, randomized, placebo-controlled crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1J Clin Oncol.(2006 Jun 20)
Estrogen - Liske E, Hänggi W, Henneicke-von Zepelin HH, Boblitz N, Wüstenberg P, Rahlfs VWPhysiological investigation of a unique extract of black cohosh (Cimicifugae racemosae rhizoma): a 6-month clinical study demonstrates no systemic estrogenic effectJ Womens Health Gend Based Med.(2002 Mar)
Anxiety Symptoms - Amsterdam JD, Yao Y, Mao JJ, Soeller I, Rockwell K, Shults JRandomized, double-blind, placebo-controlled trial of Cimicifuga racemosa (black cohosh) in women with anxiety disorder due to menopauseJ Clin Psychopharmacol.(2009 Oct)
Subjective Well-Being - Maria Dolores Juliá Mollá, Yolanda García-Sánchez, Alberto Romeu Sarri, Faustino R Pérez-lópezCimicifuga racemosa treatment and health related quality of life in post-menopausal Spanish womenGynecol Endocrinol.(2009 Jan)
Menopausal Symptoms - Ahmed Nasr, Hanan NafehInfluence of black cohosh (Cimicifuga racemosa) use by postmenopausal women on total hepatic perfusion and liver functionsFertil Steril.(2009 Nov)
Menopausal Symptoms - Jacobson JS, Troxel AB, Evans J, Klaus L, Vahdat L, Kinne D, Lo KM, Moore A, Rosenman PJ, Kaufman EL, Neugut AI, Grann VRRandomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancerJ Clin Oncol.(2001 May 15)
Menopausal Symptoms - Matthias Rostock, Julia Fischer, Andreas Mumm, Ute Stammwitz, Reinhard Saller, Hans Helge BartschBlack cohosh (Cimicifuga racemosa) in tamoxifen-treated breast cancer patients with climacteric complaints - a prospective observational studyGynecol Endocrinol.(2011 Oct)
Breast Density - E Lundström, A L Hirschberg, G SöderqvistDigitized assessment of mammographic breast density--effects of continuous combined hormone therapy, tibolone and black cohosh compared to placeboMaturitas.(2011 Dec)
Bone Mineral Density - Michael Bebenek, Wolfgang Kemmler, Simon von Stengel, Klaus Engelke, Willi A KalenderEffect of exercise and Cimicifuga racemosa (CR BNO 1055) on bone mineral density, 10-year coronary heart disease risk, and menopausal complaints: the randomized controlled Training and Cimicifuga racemosa Erlangen (TRACE) studyMenopause.(2010 Jul)
Blood glucose - Spangler L, Newton KM, Grothaus LC, Reed SD, Ehrlich K, LaCroix AZThe effects of black cohosh therapies on lipids, fibrinogen, glucose and insulinMaturitas.(2007 Jun 20)
C-Reactive Protein (CRP) - Verhoeven MO, Teerlink T, Kenemans P, Zuijdgeest-van Leeuwen SD, van der Mooren MJEffects of a supplement containing isoflavones and Actaea racemosa L. on asymmetric dimethylarginine, lipids, and C-reactive protein in menopausal womenFertil Steril.(2007 Apr)
Cognition - Maki PM, Rubin LH, Fornelli D, Drogos L, Banuvar S, Shulman LP, Geller SEEffects of botanicals and combined hormone therapy on cognition in postmenopausal womenMenopause.(2009 Nov-Dec)

Black Cohosh

Overview

What is black cohosh?

What are black cohosh’s main benefits?

What are black cohosh’s main drawbacks?

How does black cohosh work?

Dosage informationMedical disclaimer

Examine Database: Black Cohosh

Research FeedRead all studies

Frequently asked questions

What is the etymology of black cohosh?

How was black cohosh used by indigenous North Americans?

Does black cohosh improve bone density?

Can black cohosh be taken with St. John’s wort?

Can black cohosh be used instead of HRT for symptoms of menopause?

Update History

New meta-analyses addedminor

FAQs added and database updatedmajor

Research Breakdown

References

Examine Database References

Research FeedRead all studies

Examine Database References

Examine Database: Black Cohosh

Dosage information

New meta-analyses added
minor

FAQs added and database updated
major