Last verified: 17 days ago
Black Cohosh Root
Also known as: Actaea racemosa, Cimicifuga racemosa, Black Snakeroot, Bugbane, Rattleroot, Cr 99, isopropanolic black cohosh extract
Evidence under review. — Not yet rated
Herbal root extract with moderate evidence for reducing hot flashes and menopause symptoms.
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What it does
Black cohosh is a flowering plant native to North America, long used to ease menopause-related symptoms. Clinical trials show that standardized extracts (40 mg/day) can meaningfully reduce hot...
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Evidence quality
Evidence base hasn't been formally rated yet. See research below.
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Clinical dose
40 mg daily (standardized extract) based on clinical trials
What the Science Says
Black cohosh is a flowering plant native to North America, long used to ease menopause-related symptoms. Clinical trials show that standardized extracts (40 mg/day) can meaningfully reduce hot flashes, night sweats, and other climacteric complaints, particularly in women in the early stages of menopause. Benefits appear most pronounced in women with moderate-to-severe symptoms, with effects comparable in scale to some hormone replacement therapy studies.
What It Doesn't Do
Not a hormone replacement — it does not contain estrogen. No evidence it helps with PMS, fertility, or labor induction based on the provided studies. Does not work equally well for all women — those in late menopause or with mild symptoms may see little benefit. Not proven to prevent osteoporosis or cardiovascular disease.
Evidence-Based Benefits
Reduces hot flash frequency and severity in menopausal women, especially those with moderate-to-severe symptoms.
Moderate EvidenceEffective at: 40 mg/day standardized extract
Supporting studies (click to view on PubMed):
Improves overall menopause symptom scores, including mood and sleep disturbances, in early climacteric women.
Moderate EvidenceEffective at: 40 mg/day standardized extract
Supporting studies (click to view on PubMed):
Absorption & Bioavailability
Unknown — no pharmacokinetic data provided in the reviewed studies. Active constituents (triterpene glycosides, phenolic acids) have been identified but absorption data is not established from these papers.
Red Flags to Watch For
- Liver safety concerns: rare case reports of hepatotoxicity exist, though structured causality analysis found no confirmed causal link in reviewed cases — still warrants caution and monitoring
- Long-term safety is not fully established — the National Toxicology Program conducted 2-year carcinogenicity studies in animals, results of which are still being evaluated
- Product quality varies widely — adulteration with other Actaea species is a known issue; look for standardized, authenticated extracts
- Safety during pregnancy and lactation is largely unknown — avoid use without medical supervision
- Efficacy is inconsistent across the full population — one large trial showed no benefit in the overall group, only in women with more severe symptoms
Frequently Asked Questions
What does Black Cohosh Root do?
Herbal root extract with moderate evidence for reducing hot flashes and menopause symptoms.
What is the effective dose of Black Cohosh Root?
40 mg daily (standardized extract) based on clinical trials
Is Black Cohosh Root safe?
Liver safety concerns: rare case reports of hepatotoxicity exist, though structured causality analysis found no confirmed causal link in reviewed cases — still warrants caution and monitoring
What doesn't Black Cohosh Root do?
Not a hormone replacement — it does not contain estrogen.
Research Sources
- PubMed
- NIH DSLD
This information is for educational purposes only and is not medical advice. Always consult a healthcare professional before starting any supplement regimen. Last updated: 2026-05-25