Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Black cohosh (Actaea racemosa), a perennial plant native to North America, has a long history of use by Native American communities and later by European settlers for treating various women's health issues, particularly menopausal symptoms such as hot flashes and night sweats. Its modern use as a dietary supplement for menopause is widespread, and numerous clinical trials have investigated its efficacy. However, the scientific evidence is mixed. Some randomized controlled trials and meta-analyses suggest black cohosh may offer modest relief from menopausal symptoms, especially vasomotor symptoms like hot flashes. Proposed mechanisms include interaction with serotonin receptors rather than estrogenic activity, as initially thought. Yet, other studies have shown no significant benefit compared to placebo, and methodological limitations are common (e.g., small sample sizes, short duration, variability in preparations). Major health organizations, such as the North American Menopause Society, conclude that black cohosh may be an option for some women but emphasize the inconsistent evidence and recommend caution. Importantly, black cohosh appears relatively safe for short-term use, but long-term safety data are lacking, and rare cases of liver toxicity have been reported. In summary, while black cohosh is justified by both tradition and some scientific support, the overall strength of the scientific evidence is moderate to low.

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Products containing black cohosh

Vitabase Active Woman's Multi
Pure Encapsulations Black Cohosh 2.5
Metagenics Black Cohosh Plus®
Metagenics Chasteberry Plus
Designs For Health FemGuard+Balance™
Thorne Meta-Balance
Vitabase Women's Support