How Much Do We Know about Black Cohosh?

What is that?

Black cohosh (Actaea racemose) is a woodland herb native to North America. The root is used as medicine and is often used for estrogen-related conditions. In some parts of the body, black cohosh might increase the effects of estrogen. In other parts of the body, black cohosh might decrease the effects of estrogen. Black cohosh should not be thought of as an "herbal estrogen" or a substitute for estrogen.

People commonly use black cohosh for symptoms of menopause, premenstrual syndrome (PMS), painful menstruation, weak and brittle bones, and many other conditions, there is no good scientific evidence to support most of these uses.

Don't confuse black cohosh with blue cohosh or white cohosh. These are unrelated plants.

Benefits and uses

Black cohosh has a number of potential benefits — most of them related to women’s health or hormonal balance. Yet, with the exception of menopause symptoms, there is little evidence to support its use for any of these conditions.

Menopause and menopause symptoms

Alleviating menopause symptoms is the reason most people use black cohosh, and it’s one of the uses that has the most compelling evidence to support it.

In a 2018 studyTrusted Source of 80 menopausal women who were experiencing hot flashes, those who supplemented with 20 milligrams (mg) of black cohosh daily for 8 weeks reported significantly fewer and less severe hot flashes than before they started the supplement.

What’s more, other human studies have confirmed similar findings. Though larger studies are needed, black cohosh appearsTrusted Source to be beneficial for alleviating menopause symptoms.

• Women’s health

Black cohosh is also used for a number of other purposes related to women’s health. However, the evidence supporting these benefits is not as strong as the evidence supporting its benefits for menopause and fertility.

Here are a few more reasons women may use black cohosh to support hormonal balance:

Fertility: Some older, smaller studiesTrusted Source have found taking black cohosh in combination with clomiphene citrate (Clomid) may help those with unexplained infertilityTrusted Source or fertility issues related to polycystic ovarian syndrome (PCOS)Trusted Source increase their chances of ovulating and becoming pregnant. However, newerTrusted Source research hasn’t found any evidence to support these claims.

Menstrual cycle regulation: These studies also found that black cohosh may help women with or without PCOS who are receiving fertility treatments like Clomid regulate their menstrual cycle. But more research is needed to support this.

Fibroids: One 3-month studyTrusted Source in 244 postmenopausal women found that supplementing daily with 40 mg of black cohosh may decrease the size of uterine fibroids by up to 30%.

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD): Though there are some claims online that black cohosh can help with PMS or PMDD, there’s no substantial evidence to support this.

Cancer Black cohosh has some potentially estrogenic activity, meaning it behaves like the hormone estrogen, which may worsen breast cancer or increase your breast cancer risk. However, most studies show that black cohosh does not affect your breast cancer risk. In fact, research has shown that taking black cohosh was associated with a decreased risk of breast cancer. One studyTrusted Source has also shown that black cohosh extract exhibited anti-estrogen activity and helped slow the spread of breast cancer cells. Still, more research needs to be done to understand the link between breast cancer and black cohosh.

• Mental health

Black cohosh may have some beneficial effects on mental health, particularly in menopausal women.

One review of studiesTrusted Source investigated the use of herbal supplements for anxiety and depression in menopausal women. Researchers found that supplementing with black cohosh had no effect on anxiety, but it was linked to significant improvements in psychological symptoms.

Yet, more research is needed before the effect of black cohosh on mental health is fully understood.

• Sleep

Although there’s little evidence that black cohosh can improve sleep, it may help reduce symptoms that are causing sleep disturbances in menopausal women, such as hot flashes.

However, a 2015 studyTrusted Source in 42 menopausal women found that supplementing with black cohosh seemed to improve sleep duration and quality.

Another studyTrusted Source noted that a combination of black cohosh and other compounds — including chasteberry, zinc, ginger, and hyaluronic acid — helped improve hot flashes that were associated with insomnia and anxiety.

Still, it’s hard to say whether black cohosh or one of the other ingredients was the beneficial compound in this mixture.

• Weight loss

Menopausal women may be at an increased riskTrusted Source of unwanted weight gain, as their estrogen levels naturally decrease.

Theoretically, because black cohosh may exhibit estrogenic effects, it may have a small beneficial effect on weight management in menopausal women.

However, the evidence to support this is minimal. More and larger human studies are needed to understand the link, if any, between black cohosh and weight management.

Side effects and precautions

Black cohosh has some potential side effects, but they’re typically mild. They includeTrusted Source:

• digestive upset
• skin rashes
• infection
• muscle pain
• breast pain or enlargement
• spotting or bleeding outside of your menstrual cycle

Dosage and how to take

Black cohosh is available in capsule, liquid extract, or tea form. Dosage recommendations vary widely between black cohosh brands. Typical doses are anywhere from 8–160 mgTrusted Source of standardized black cohosh extract or powder daily. Some healthcare professionals claim you should not take black cohosh for longer than 6 months to 1 year because of its slight potential to cause liver damage.

Additionally, black cohosh is often sold in blends containing other herbal supplements, including:

• Red clover: Research from 2009Trusted Sourcesuggests that black cohosh and red clover can be taken together to help manage menopause symptoms. But there’s no evidence that they’re more effective than a placebo.
• Soy isoflavones: Like black cohosh, soy contains phytoestrogens that may help improve hormonal issues or menopause symptoms. However, there’s little current evidenceTrusted Sourceto support these potential effects.
• John’s wort: In combination with black cohosh, St. John’s wort appearsTrusted Sourceto have some beneficial effects on menopause symptoms.
• Chasteberry: Chasteberry and black cohosh supplements are sold for menopause symptom relief, but there’s little evidenceTrusted Sourcethat they’re more effective than a placebo.
• Dong quai: Black cohosh and dong quaiare claimed to reduce menopause symptoms and possibly induce labor in pregnant women, but there’s no evidence to support this.
• Vitamin C: Vitamin C is recommended online alongside black cohosh to help induce miscarriage or abortion in the case of an unwanted pregnancy. However, there’s no evidence to support this use.

In conclusion, Black cohosh has great potential and is constantly being explored for its numerous health benefits.  Aogubio's commitment to developing nutraceuticals, supplements and products for various industries using Black cohosh underscores the company's commitment to harnessing the power of natural substances to improve human health. As research and understanding of Black cohosh continues to evolve, it’s clear that powerful Black cohosh holds great promise for the future of natural health.

Article writing:Miranda Zhang