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The black cohosh plant

Black cohosh: benefits, dosage & side-effects

23 Nov 2022 • 1 min read

Find out all about black cohosh, including what it does, the benefits to taking it and how much you might need

Written by Madeleine Bailey on December 9, 2018 Reviewed by Dr Sarah Schenker on December 18, 2018


What is black cohosh and what does it do?

Black cohosh, also known as Cimicifuga racemosa, is the root of a herb grown in the eastern United States and Canada. It was traditionally used by Native Americans for a range of complaints including:
  • kidney problems
  • rheumatism
  • gynaecological problems
  • childbirth
  • snake bites1
Today, black cohosh is mainly used to ease menopause symptoms, in particular:2,3
  • hot flushes
  • excessive sweating
  • sleep problems
  • poor mood
  • low libido
Black cohosh is available as capsules, tablets, tinctures and teas.

Benefits of black cohosh

What does black cohosh do in the body?

Black cohosh is most well-known for its effect on menopausal symptoms. A 2010 York University review of studies on 1,400 menopausal women concluded that black cohosh reduced hot flushes and sweating by 25% compared with a placebo,4 while a study by Chinese researchers in 2015 suggested that black cohosh can help with menopausal sleep problems, leading to more time spent asleep.5 However, results have been mixed in other menopausal studies, so more research is needed.6 It’s not yet fully understood how black cohosh has this effect. In a 2008 study by the University of Missouri-Columbia, USA, scientists suggested that black cohosh may change how the neurotransmitter serotonin behaves in the body.7 Other theories are that the herb may act on the brain in the same way as the hormone oestrogen, or that black cohosh may have anti-inflammatory properties.8


How much black cohosh is safe to take?

Typically, 20–40mg of black cohosh extract has been used for studies into menopausal symptoms.9 Avoid taking it for more than six months: most black cohosh studies have stopped at six months, which means there’s a lack of research into its long-term safety.


What are the side-effects of taking black cohosh?

Studies have observed some serious side-effects, including liver damage, although this is rare and it’s not clear that black cohosh was responsible. However, if you experience any symptoms of liver damage – for example yellowing of the skin or eyes, nausea, vomiting and dark urine – you should stop taking the herb and see a doctor urgently.10 More common side-effects of taking black cohosh include:
  • allergic skin rash
  • upset stomach
  • facial swelling
  • headaches and dizziness
  • low blood pressure
  • changes in heart rhythm11
Don’t take black cohosh if you:
  • under 18 years of agehave or have had liver problems
  • have or have had breast cancer – scientists are still not sure if black cohosh has an oestrogenic effect or not so it’s best to avoid it for now, just in case
  • are child bearing age and do not use contraception
  • are lactose intolerant
  • are allergic to any of the ingredients are pregnant or breastfeeding – it has not been proven safe for these women12
Shop Herbal Remedies Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies. Sources 1. European Medicines Agency. Assessment report on Cimicifuga racemosa(L.) Nutt., rhizome Final. 2. European Medicines Agency. Black cohosh. 3. Mohammad-Alizadeh-Charandabi S, et al. Efficacy of black cohosh (Cimicifuga racemosa L.) in treating early symptoms of menopause: a randomized clinical trial. 4. Shams T, et al. Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis. 5. Jiang K, et al. Black cohosh improves objective sleep in postmenopausal women with sleep disturbance. 6. National Center for Complementary and Integrative Health. Black cohosh. 7. Ruhlen RL, Sun GY, Sauter ER. Black Cohosh: Insights into its Mechanism(s) of Action. 8. As above 9. Rena Goldman. Healthline. Black cohosh: Uses, benefits and side effects. 10. As Source 5 11. As Source 7 12. As Source 5
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