Black Cohosh

31 research sources Also known as: black cohosh root extract black cohosh root actaea racemosa cimicifuga racemosa
160 Products on Market
80.0 mg Median Dose
🟢 98/100 Market Safety Score
31 Research Sources
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Product Forms

Capsule 56% Liquid 21% Tablet or Pill 11% Powder 8% Softgel Capsule 2% Other (e.g. tea bag) 1% Lozenge 1% Gummy or Jelly 1%

Dose Distribution

1-5 mg 3 10-25 mg 9 100-250 mg 39 25-50 mg 28 250-500 mg 7 5-10 mg 1 50-100 mg 28 500-1000 mg 14 <1 mg 5 >1000 mg 2

Top Brands

TerraVita 11 TerraVita Premium Collection 9 Nature's Way 7 Earth Friend Herb Co. 7 Estroven 6 BulkSupplements.com 6 Planetary Herbals 5 DC 5 Wonder Laboratories 5 Gaia Herbs 4 NOW 3 Source Naturals 3

Claims on Labels

All Other 99% Structure/Function 79% Nutrient 2% No Claim 1%

Top-Rated Black Cohosh Products

Menopause Support With Isoflavones And Black Cohosh Martin Avenue Pharmacy
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Evidence Summary

Black cohosh is a botanical supplement primarily researched for its use in managing menopausal symptoms, particularly vasomotor symptoms. While numerous systematic reviews and meta-analyses exist, evidence regarding its efficacy and safety varies across different studies.

Evidence by Condition

Menopausal Symptoms (Vasomotor) Moderate

Multiple meta-analyses suggest potential efficacy for managing vasomotor symptoms, though results across Cochrane and other reviews show varying levels of certainty.

Endometriosis-induced Low Estrogen Moderate

Black cohosh extracts may help improve low estrogen status in patients following GnRHa treatment for endometriosis.

Depression and Anxiety Insufficient

Black cohosh has been evaluated within broader systematic reviews of herbal medicines for depression and anxiety, but specific high-strength evidence is not detailed.

Effective Doses

Dose ranges are not specified in the provided research summaries.

Key Findings

  • No evidence of hepatotoxicity was found for isopropanolic black cohosh extract in meta-analysis of RCTs (PMID: 21228727).
  • Black cohosh extracts may improve low estrogen status induced by postoperative GnRHa treatment in endometriosis patients (PMID: 32762163).
  • Extensive meta-analyses have investigated the efficacy of black cohosh for menopausal symptoms (PMID: 22972105, 37192826).

Limitations

Research results for menopausal symptoms are inconsistent across different systematic reviews. There is also a lack of specific dosage-response data provided in the available studies.

Safety & Interactions

Meta-analysis indicates no evidence of hepatotoxicity for isopropanolic extracts (PMID: 21228727), though weight gain has been investigated as a potential adverse event (PMID: 34608830).

AI-generated summary from 31 peer-reviewed studies. Not medical advice. Always consult a healthcare provider.

Drug-Supplement Interactions

Antiarrhythmics 🔴 Critical
Mechanism: Black Cohosh is a weak inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of amiodarone (antiarrhythmics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of amiodarone. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Anticonvulsants 🔴 Critical
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of carbamazepine (anticonvulsants), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of carbamazepine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
GI Prokinetics 🔴 Critical
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of cisapride (gi-prokinetics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of cisapride. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Immunosuppressants 🔴 Critical
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of cyclosporine (immunosuppressants), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of cyclosporine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Theophylline 🔴 Critical
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of theophylline (theophylline), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of theophylline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Warfarin 🔴 Critical
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of warfarin (warfarin), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of warfarin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
ADHD Medications 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of atomoxetine (adhd-medications), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of atomoxetine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
ARB 🟡 Moderate
Mechanism: Black Cohosh is a weak inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of losartan (arb), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of losartan. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antibiotics 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of clarithromycin (antibiotics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of clarithromycin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antidiabetic Drugs 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of repaglinide (antidiabetic-drugs), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of repaglinide. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antiemetics 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of ondansetron (antiemetics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of ondansetron. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antifungals 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of fluconazole (antifungals), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of fluconazole. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antipsychotics 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of haloperidol (antipsychotics), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of haloperidol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Antitussives 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of dextromethorphan (antitussives), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of dextromethorphan. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Benzodiazepines 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of midazolam (benzodiazepines), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of midazolam. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Beta Blockers 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP2D6, which decreases metabolism of CYP2D6 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of metoprolol (beta-blockers), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of metoprolol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Beta-2 Agonists 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of salmeterol (beta2-agonists), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of salmeterol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
CFTR Modulators 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of ivacaftor (cftr-modulators), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of ivacaftor. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Calcium Channel Blockers 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of nifedipine (calcium-channel-blockers), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of nifedipine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Chemotherapy 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of doxorubicin (chemotherapy), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of doxorubicin. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Corticosteroids 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of prednisone (corticosteroids), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of prednisone. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Leukotriene Antagonists 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of montelukast (leukotriene-antagonists), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of montelukast. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
NSAIDs 🟡 Moderate
Mechanism: Black Cohosh is a weak inhibitor of CYP2C9, which decreases metabolism of CYP2C9 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of ibuprofen (nsaids), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of ibuprofen. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Opioids 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of methadone (opioids), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of methadone. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Oral Contraceptives 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of ethinylestradiol (oral-contraceptives), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of ethinylestradiol. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
PDE5 Inhibitors 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of sildenafil (pde5-inhibitors), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of sildenafil. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
PPIS 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of omeprazole (ppis), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of omeprazole. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
SNRI 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of venlafaxine (snri), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of venlafaxine. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
SSRI 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of sertraline (ssri), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of sertraline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred
Statins 🟡 Moderate
Mechanism: Black cohosh may inhibit CYP3A4, potentially increasing statin levels (especially simvastatin/atorvastatin).
Effect: Increased statin levels; possible myopathy risk
Management: Monitor for statin side effects (muscle pain). Consider pravastatin as alternative.
Evidence: possible
Tricyclic Antidepressants 🟡 Moderate
Mechanism: Black Cohosh is a moderate inhibitor of CYP3A4, which decreases metabolism of CYP3A4 substrates, potentially increasing their plasma concentrations and risk of adverse effects.
Effect: Increased plasma levels of amitriptyline (tricyclic-antidepressants), potentially leading to toxicity or enhanced adverse effects.
Management: Monitor for increased adverse effects of amitriptyline. Dose reduction may be necessary. Consider alternative supplement or consult healthcare provider.
Evidence: cyp-inferred

⚠️ This information is for educational purposes only and does not constitute medical advice. Always consult your healthcare provider before combining supplements with medications.

Claims vs. Evidence

100% Evidence-Backed
0% Unsupported
79% Structure/Function
Claim Type% of ProductsEvidence RequiredStatus
All Other 99% Tier D (Unclassified) ✅ Supported
Structure/Function 79% Tier C (DSHEA Structure/Function (no pre-approval)) ✅ Supported
Nutrient 2% Tier D (Unknown) ✅ Supported
No Claim 1% Tier D (No claim on label) ✅ Supported

🏛️ NIH ODS Factsheet

Black Cohosh

Research by Topic

Black Cohosh 25 studies
SYS [Efficacy of black cohosh extracts for improving low estroge...
SYS Vasomotor symptoms resulting from natural menopause: a syste...
MET Suspected black cohosh hepatotoxicity: no evidence by meta-a...
+22 more
St. John'S Wort 3 studies
MET Review & meta-analysis: isopropanolic black cohosh extract i...
SYS Benefit-risk profile of black cohosh (isopropanolic Cimicifu...
SYS Efficacy of Cimicifuga racemosa, Hypericum perforatum and Ag...
Black Cohosh Menopause 2 studies
SYS Weight gain in menopause: systematic review of adverse event...
RCT Assessing the combined effects of Black Cohosh, Soy Isoflavo...
Cochrane Womens Health 1 studies
MET Black cohosh (Cimicifuga spp.) for menopausal symptoms

⚠️ FDA Safety Data

Adverse Event Profile: Black Cohosh

Research Evidence (31)

Systematic Review: 23 Meta Analysis: 5 Rct: 1 Openfda Safety: 1
B [Efficacy of black cohosh extracts for improving low estrogen status induced by postoperative GnRHa treatment in patients with endometriosis: a systematic review]
Systematic Review Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences 2020 n=745

**Peng et al., 2020** | Zhejiang Da Xue Xue Bao Yi Xue Ban | Systematic Review Peng Jie, Xu Wenfei, ... Wu Qiaoai. [Efficacy of black cohosh extracts for improving low estrogen status induced by postoperative GnRHa treatment in patients with endometr...

PubMed
B Black cohosh (Cimicifuga spp.) for menopausal symptoms
Meta Analysis The Cochrane database of systematic reviews 2012

**Leach et al., 2012** | Cochrane Database Syst Rev | Meta Analysis Leach Matthew J, Moore Vivienne. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012-Sep-12;2012(9):CD007244. doi:10.1002/14651858.CD007244.pub2 ...

PubMed DOI
B Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause
Systematic Review BJOG : an international journal of obstetrics and gynaecology 2017 n=8326

**Sarri et al., 2017** | BJOG | Systematic Review Sarri G, Pedder H, ... Lumsden M A. Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and C...

PubMed DOI
C Suspected black cohosh hepatotoxicity: no evidence by meta-analysis of randomized controlled clinical trials for isopropanolic black cohosh extract
Meta Analysis Menopause (New York, N.Y.) 2011 n=517

**Naser et al., 2011** | Menopause | Meta Analysis Naser Belal, Schnitker Jörg, ... Osmers Rüdiger. Suspected black cohosh hepatotoxicity: no evidence by meta-analysis of randomized controlled clinical trials for isopropanolic black cohosh extract. M...

PubMed DOI
C Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms - an update on the evidence
Meta Analysis Climacteric : the journal of the International Menopause Society 2021

**Castelo-Branco et al., 2021** | Climacteric | Meta Analysis Castelo-Branco C, Gambacciani M, ... Pickartz S. Review & meta-analysis: isopropanolic black cohosh extract iCR for menopausal symptoms - an update on the evidence. Climacteric. 2021-Apr;2...

PubMed DOI
C Menopausal symptoms
Systematic Review BMJ clinical evidence 2007

**Morris et al., 2007** | BMJ Clin Evid | Systematic Review Morris Edward P, Rymer Janice. Menopausal symptoms. BMJ Clin Evid. 2007-Sep-01;2007 INTRODUCTION: Menopause is a physiological event. In the UK, the median age for onset of menopausal sympto...

PubMed
C Menopausal symptoms
Systematic Review BMJ clinical evidence 2011

**Burbos et al., 2011** | BMJ Clin Evid | Systematic Review Burbos Nikolaos, Morris Edward P. Menopausal symptoms. BMJ Clin Evid. 2011-Jun-15;2011 INTRODUCTION: Menopause is a physiological event. In the UK, the median age for onset of menopausal sym...

PubMed
C Menopausal symptoms
Systematic Review BMJ clinical evidence 2010

**Morris et al., 2010** | BMJ Clin Evid | Systematic Review Morris Edward P, Burbos Nikolaos. Menopausal symptoms. BMJ Clin Evid. 2010-Feb-25;2010 INTRODUCTION: Menopause is a physiological event. In the UK, the median age for onset of menopausal sym...

PubMed
C Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis
Meta Analysis Menopause (New York, N.Y.) 2023

**Sadahiro et al., 2023** | Menopause | Meta Analysis Sadahiro Ryoichi, Matsuoka Lillian Nohara, ... Tseng Ping-Tao. Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis. Menopause. 2023-Jul-01;30(7):766-773. doi...

PubMed DOI
C Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis
Meta Analysis Alternative therapies in health and medicine 2010

**Shams et al., 2010** | Altern Ther Health Med | Meta Analysis Shams Taghreed, Setia Maninder Singh, ... Ciampi Antonio. Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis. Altern Ther Health Med. 2010;16(1):36-...

PubMed
C Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance
Systematic Review Phytotherapy research : PTR 2018

**Yeung et al., 2018** | Phytother Res | Systematic Review Yeung K Simon, Hernandez Marisol, ... Gubili Jyothirmai. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res...

PubMed DOI
C Pharmacological effects of Cimicifuga racemosa
Systematic Review Life sciences 2003

**Borrelli et al., 2003** | Life Sci | Systematic Review Borrelli F, Izzo A A, Ernst E. Pharmacological effects of Cimicifuga racemosa. Life Sci. 2003-Jul-25;73(10):1215-29 Cimicifuga racemosa is widely employed to relieve menopause symptoms for its ...

PubMed
C Impact of phytoestrogens on treatment of urogenital menopause symptoms: A systematic review of randomized clinical trials
Systematic Review European journal of obstetrics, gynecology, and reproductive biology 2021

**Abdi et al., 2021** | Eur J Obstet Gynecol Reprod Biol | Systematic Review Abdi Fatemeh, Rahnemaei Fatemeh Alsadat, ... Pakzad Reza. Impact of phytoestrogens on treatment of urogenital menopause symptoms: A systematic review of randomized clinical ...

PubMed DOI
C Phytochemistry and ethnopharmacological studies of genus Cimicifuga: A systematic and comprehensive review
Systematic Review Fitoterapia 2024

**Fatima et al., 2024** | Fitoterapia | Systematic Review Fatima Shireen, Verma Mahima, Ansari Irfan Ahmad. Phytochemistry and ethnopharmacological studies of genus Cimicifuga: A systematic and comprehensive review. Fitoterapia. 2024-Jan;172:105767. ...

PubMed DOI
C Weight gain in menopause: systematic review of adverse events in women treated with black cohosh
Systematic Review Climacteric : the journal of the International Menopause Society 2022

**Naser et al., 2022** | Climacteric | Systematic Review Naser B, Castelo-Branco C, ... Pickartz S. Weight gain in menopause: systematic review of adverse events in women treated with black cohosh. Climacteric. 2022-Jun;25(3):220-227. doi:10.1080/136...

PubMed DOI
C Black cohosh (Cimicifuga racemosa) for menopausal symptoms: a systematic review of its efficacy
Systematic Review Pharmacological research 2008

**Borrelli et al., 2008** | Pharmacol Res | Systematic Review Borrelli Francesca, Ernst Edzard. Black cohosh (Cimicifuga racemosa) for menopausal symptoms: a systematic review of its efficacy. Pharmacol Res. 2008-Jul;58(1):8-14. doi:10.1016/j.phrs.20...

PubMed DOI
C Benefit-risk profile of black cohosh (isopropanolic Cimicifuga racemosa extract) with and without St John's wort in breast cancer patients
Systematic Review Climacteric : the journal of the International Menopause Society 2019

**Ruan et al., 2019** | Climacteric | Systematic Review Ruan X, Mueck A O, ... Pickartz S. Benefit-risk profile of black cohosh (isopropanolic Cimicifuga racemosa extract) with and without St John's wort in breast cancer patients. Climacteric. 2019-A...

PubMed DOI
C Black cohosh (Cimicifuga racemosa): a systematic review of adverse events
Systematic Review American journal of obstetrics and gynecology 2008

**Borrelli et al., 2008** | Am J Obstet Gynecol | Systematic Review Borrelli Francesca, Ernst Edzard. Black cohosh (Cimicifuga racemosa): a systematic review of adverse events. Am J Obstet Gynecol. 2008-Nov;199(5):455-66. doi:10.1016/j.ajog.2008.05.0...

PubMed DOI
C Black cohosh and breast cancer: a systematic review
Systematic Review Integrative cancer therapies 2014 n=26

**Fritz et al., 2014** | Integr Cancer Ther | Systematic Review Fritz Heidi, Seely Dugald, ... Fergusson Dean. Black cohosh and breast cancer: a systematic review. Integr Cancer Ther. 2014-Jan;13(1):12-29. doi:10.1177/1534735413477191 BACKGROUND: Man...

PubMed DOI
C Hormone Therapy and Other Treatments for Symptoms of Menopause
Systematic Review American family physician 2016

**Hill et al., 2016** | Am Fam Physician | Systematic Review Hill D Ashley, Crider Mark, Hill Susan R. Hormone Therapy and Other Treatments for Symptoms of Menopause. Am Fam Physician. 2016-Dec-01;94(11):884-889 The results of large clinical trials h...

PubMed
C Systematic Review of Black Cohosh (Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility
Systematic Review Journal of pharmacy practice 2022

**Fan et al., 2022** | J Pharm Pract | Systematic Review Fan Chi Wai, Cieri-Hutcherson Nicole E, Hutcherson Timothy C. Systematic Review of Black Cohosh (Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility. J Pharm Pr...

PubMed DOI
C Efficacy of Cimicifuga racemosa, Hypericum perforatum and Agnus castus in the treatment of climacteric complaints: a systematic review
Systematic Review Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 2012

**Laakmann et al., 2012** | Gynecol Endocrinol | Systematic Review Laakmann Elena, Grajecki Donata, ... Buhling Kai J. Efficacy of Cimicifuga racemosa, Hypericum perforatum and Agnus castus in the treatment of climacteric complaints: a systematic rev...

PubMed DOI
C Assessing the combined effects of Black Cohosh, Soy Isoflavones, and SDG Lignans on menopausal symptoms: a randomized, double-blind, placebo-controlled clinical trial.
Rct European journal of nutrition

OBJECTIVE: This randomized, double-blind, parallel-group clinical trial aimed to evaluate the efficacy of Black Cohosh, Soy Isoflavones, and SDG Lignans in alleviating menopausal symptoms compared to a placebo. METHODS: Ninety-six postmenopausal wome...

PubMed DOI
C Black cohosh for the management of menopausal symptoms : a systematic review of clinical trials
Systematic Review Drugs & aging 2009 n=16

**Palacio et al., 2009** | Drugs Aging | Systematic Review Palacio Carlos, Masri Ghania, Mooradian Arshag D. Black cohosh for the management of menopausal symptoms : a systematic review of clinical trials. Drugs Aging. 2009;26(1):23-36. doi:10.2165/0...

PubMed DOI
C Safety of alternative treatments for menopausal symptoms after breast cancer: a qualitative systematic review
Systematic Review Climacteric : the journal of the International Menopause Society 2007

**Antoine et al., 2007** | Climacteric | Systematic Review Antoine C, Liebens F, ... Rozenberg S. Safety of alternative treatments for menopausal symptoms after breast cancer: a qualitative systematic review. Climacteric. 2007-Feb;10(1):23-6 AIM: Thi...

PubMed
C Black cohosh (Cimicifuga racemosa [L.] Nutt.): safety and efficacy for cancer patients
Systematic Review Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2007 n=5

**Walji et al., 2007** | Support Care Cancer | Systematic Review Walji Rishma, Boon Heather, ... Younus Jawaid. Black cohosh (Cimicifuga racemosa [L.] Nutt.): safety and efficacy for cancer patients. Support Care Cancer. 2007-Aug;15(8):913-21 GOALS O...

PubMed
C Nonestrogen treatment modalities for vasomotor symptoms associated with menopause
Systematic Review The Annals of pharmacotherapy 2004

**Fugate et al., 2004** | Ann Pharmacother | Systematic Review Fugate Susan E, Church Chelsea O. Nonestrogen treatment modalities for vasomotor symptoms associated with menopause. Ann Pharmacother. 2004-Sep;38(9):1482-99 OBJECTIVE: To systematically ...

PubMed
C Cimicifuga racemosa: a systematic review of its clinical efficacy
Systematic Review European journal of clinical pharmacology 2002

**Borrelli et al., 2002** | Eur J Clin Pharmacol | Systematic Review Borrelli Francesca, Ernst Edzard. Cimicifuga racemosa: a systematic review of its clinical efficacy. Eur J Clin Pharmacol. 2002-Jul;58(4):235-41 BACKGROUND: Cimicifuga racemosa has ...

PubMed
C A systematic review of the safety of black cohosh
Systematic Review Menopause (New York, N.Y.) 2003

**Huntley et al., 2003** | Menopause | Systematic Review Huntley Alyson, Ernst Edzard. A systematic review of the safety of black cohosh. Menopause. 2003;10(1):58-64 OBJECTIVE: To systematically review the available data relating to the safety of med...

PubMed
D Black Cohosh

**Source:** [Office of Dietary Supplements, NIH](https://ods.od.nih.gov:443/factsheets/BlackCohosh-HealthProfessional/) **Reading Level:** Health Professional This fact sheet from the NIH Office of Dietary Supplements provides evidence-based informat...

D Adverse Event Profile: Black Cohosh
Openfda Safety FDA CAERS

**Source**: FDA Center for Food Safety and Applied Nutrition (CFSAN) Adverse Event Reporting System **Total Events**: 3 **Serious Events**: 1 **Date Range**: 20040205 to 20210629 - **GAMMA-GLUTAMYLTRANSFERASE INCREASED**: 1

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Frequently Asked Questions

What is Black Cohosh and what is it used for?

Black cohosh is a botanical supplement primarily used to manage menopausal symptoms, particularly vasomotor symptoms like hot flashes. There is moderate evidence regarding its use for these symptoms.

Does Black Cohosh work for menopause symptoms?

There is moderate evidence suggesting that black cohosh may help manage vasomotor symptoms during menopause. However, different scientific reviews show varying levels of certainty regarding its effectiveness.

Can Black Cohosh help with endometriosis?

There is moderate evidence that black cohosh extracts may help improve low estrogen levels in patients following GnRHa treatment for endometriosis. This specifically applies to managing estrogen deficiency induced by certain treatments.

Is Black Cohosh effective for treating anxiety or depression?

There is currently insufficient evidence to confirm if black cohosh is effective for treating depression or anxiety. While it has been studied within broader herbal medicine reviews, specific high-strength evidence is not available.

What is the recommended dose of Black Cohosh?

The provided research does not specify an effective or recommended dose range for black cohosh. You should consult a healthcare professional for personalized dosing advice.

Is Black Cohosh safe to take and are there side effects?

Meta-analyses have found no evidence of liver toxicity for isopropanolic black cohosh extracts. However, researchers have investigated weight gain as a potential adverse event.

Are there any drug interactions or people who should avoid Black Cohosh?

There are currently no documented drug interactions for black cohosh. While the research does not specify particular groups who should avoid it, you should always consult a doctor before starting a new supplement.

Answers generated from research evidence. Not medical advice.