Black Cohosh: Top benefits, dosage, side effects, and more!

Eu Natural
November 3, 2020
Fact checked
Dr. Stephanie Nichols, ND

Black cohosh is a member of the buttercup family, a flowering plant native to the Eastern side of the USA and Canada.

Also known as Actaea racemosa and cimicifuga racemosa, fairy candle, and black snakeroot, traditional Native American medicine has used plants for hundreds of years!

Unlike its name suggests, the Black cohosh produces small white flower clusters. A beauty to look at, but the medicinal properties lay in the roots and underground stems.

In this article, we’ll be running through the potential benefits of Black cohosh, supporting evidence, and how a daily supplement can fit into your life. 

How does black cohosh work?

The roots of black cohosh contain phytoestrogens, which are plant versions of estrogens and mimic estrogen’s actions in a woman’s body.

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black cohosh roots

Phytoestrogens bind to the hormone receptors in the breasts, uterus, and other parts of the body, reducing night sweats, hot flashes, mood swings, headaches, vaginal dryness, and other hormonal symptoms.

Methylserotonin is a chemical compound also found in black cohosh roots. The chemical has an activity similar to that of serotonin.

Serotonin levels directly impact our mood. Those with lower serotonin levels often experience lower moods, while those with higher serotonin levels experience a better mood.

What are the benefits of black cohosh?

bunch of black cohosh

There are several potential benefits of Black cohosh, which primarily relate to women’s health.

Due to its similarities to estrogen, it’s no surprise then that black cohosh is widely known and used for relieving symptoms of menopause. 

The benefits of the plant don’t end there! 

Studies support that black cohosh can also help with:

Some additional benefits that currently require more research include:

  • Heart disease
  • Menstrual cycle regulation
  • Migraines
  • Rheumatoid arthritis
  • Fever
  • Mosquito or snake bites
  • Sore throat

It sounds like an excellent plant to be familiar with, especially if you’re a woman! 

Studies into herbal supplements are becoming more and more popular as so let’s dive into each of the benefits and the findings of studies!

Bonus: Download This 21-Day Menopause Reset that will show you how to tackle your worst menopause symptoms quickly.

Black cohosh for menopause 

women with fan for menopause

A vast amount of research on black cohosh has been to identify its efficacy in relieving menopause symptoms. 

In 2018, a study set out to understand the impact black cohosh has on hot flashes caused by menopause.

Two groups, each of forty menopausal women, participated in the study. One group was to take 6.5mg dry extract of black cohosh each day for eight weeks. Compared to the first week, there was a significant reduction in hot flashes in the black cohosh group by week eight. 

The study results indicate that Black cohosh may improve the quality of life for those suffering from hot flashes by reducing the severity and the frequency.

These findings are consistent with several other studies that confirm black  cohosh helps relieve symptoms of menopause.

A 2003 review of nine trials concludes that in each of the nine trials, black cohosh had a positive effect on relieving symptoms of menopause.

Science strongly suggests that Black Cohosh may help to alleviate menopausal symptoms such as hot flashes, which can improve life quality for menopausal women. 

Black cohosh and fibroids

womb illustration

Fibroids are growths that can develop in or around the womb. While they’re not cancerous, they can cause uncomfortable symptoms such as:

  • Heavy periods
  • Lower back pain 
  • Pain during sex
  • Abdominal pain
  • Constipation

Two hundred forty-four women participated in a study to understand the effect black cohosh has on fibroids. After taking 40mg of black cohosh extract daily over three months, the results found that the fibroids decreased by as much as 30%.

While the study doesn’t indicate whether black cohosh can prevent fibroids, there is strong evidence that it can help reduce them if they develop.

Black cohosh and fertility

woman with pregnancy test

Access to infertility services has been declining year after year, and now, the option is only realistic for those who are financially fortunate. 

The cost of infertility service is just one reason why many studies have investigated the efficacy of Black Cohosh on fertility. The use of the plants for increasing fertility dates back to the 15th century, but does science support these claims?

It turns out; many studies are in favor of the use of black cohosh to increase the chance of fertility, specifically in women with Polycystic Ovarian Syndrome.

A higher pregnancy rate resulted from one study that divided a group of 100 into two groups. The women all had Polycystic Ovarian Syndrome, half the group took a black cohosh extract, and the second half took a different supplement. 

The study identified that black cohosh reduces luteinizing hormone levels, which is associated with better ovulation and implantation rates in women with POS.

As infertility services are not available to everyone, consider taking a black cohosh supplement if you’re struggling with fertility. While there are no guarantees, studies have had positive results.

Black cohosh, anxiety and depression in menopausal women

Severe mood swings, anxiety, and depression often go hand in hand with menopause and result from the fluctuating levels of ovarian hormones.

An analysis of herbal remedies suggests that black cohosh is worthy of consideration in treating depression and anxiety for those who prefer to take a natural supplement.

In 2007, a clinical trial analyzed the effect black cohosh had on menopausal women with anxiety and depression. One hundred twenty women were split into two groups, with one group to take black cohosh and the second group to take a well known antidepressant medication; fluoxetine. 

After three months of observation, symptoms of anxiety and depression had significantly reduced in both groups; however, the black cohosh being superior as it had also reduced other menopausal symptoms. The study concludes that black cohosh improved all parameters of health-related quality of life, except pain.

Black cohosh could be a natural alternative for those not wishing to seek medication for depression and anxiety.

Black cohosh and osteoporosis

arm with osteoporosis

Osteoporosis is one of the most common complications associated with menopause that weakens bones and makes them more susceptible to fracture as a woman ages.

According to the National Osteoporosis Foundation, women tend to experience rapid bone loss during their premenopausal stage.

Black cohosh contains phytoestrogens, a plant-based compound that protects against bone loss, therefore possibly preventing bone loss during menopause.

Research on the effect of phytoestrogens on osteoporosis so far has been limited to animal models. However, the results of one study currently suggest that black cohosh can have a significant impact on bone formation.

As black cohosh contains phytoestrogens, it could help prevent bone loss, especially in menopausal women. 

What dosage of black cohosh should I take?

tablets in hand with water

If you are considering using black cohosh for menopause symptom relief, a 20mg dose has been successful.

Current studies suggest to take black cohosh for a short period, as long term use might harm the liver.

As natural supplements don’t need to be approved by the FDA, make sure to look for a black cohosh supplement that has been supported by a well known third party evaluation program.

Black cohosh is available as a supplement, powder, tea, or liquid extract. If using a liquid extract, add this to a glass of water.

If you are thinking about trying black cohosh, speak with a medical healthcare professional to determine the length of time and the right amount of dose for you. 

FAQs

How should I store black cohosh?

Store black cohosh in a sealed container at room temperature. It’s always best to check the expiry date on the label and not consume after this time.

Are there any side effects of black cohosh?

Side effects of black cohosh are uncommon. However, one report suggested a side effect of black cohosh when used in regular doses is stomach discomfort.

There have been claims that black cohosh can cause damage to the liver. However, there have not been enough studies to understand the potential impact; therefore, avoid using black cohosh if you have liver issues. Research has also only looked at the short term effect of black cohosh, and more research is also required to understand the impact of long-term use.

There is limited research on the effect black cohosh has on children and pregnant or breastfeeding women, and therefore it’s best to avoid.

Does black cohosh interact with other medications?

There are some reports that black cohosh can react with specific medication, this includes:

Atorvastatin - used to prevent cardiovascular disease and treat abnormal lipid levels.
Various liver medication
Cisplatin - used to treat several different cancers.

Resist using black cohosh if you are taking any of the above medications, as it could negatively interfere with them.

Will I get withdrawal when I stop taking black cohosh? 

If you decide to stop taking a black cohosh supplement, there is currently no evidence that withdrawal symptoms will occur.

How should I store black cohosh?

Store black cohosh in a sealed container at room temperature. It’s always best to check the expiry date on the label and not consume after this time.

Are there any side effects of black cohosh?

Side effects of black cohosh are uncommon. However, one report suggested a side effect of black cohosh when used in regular doses is stomach discomfort. 

There have been claims that black cohosh can cause damage to the liver. However, there have not been enough studies to understand the potential impact; therefore, avoid using black cohosh if you have liver issues. Research has also only looked at the short term effect of black cohosh, and more research is also required to understand the impact of long-term use.

There is limited research on the effect black cohosh has on children and pregnant or breastfeeding women, and therefore it’s best to avoid.

Does black cohosh interact with other medications?

There are some reports that black cohosh can react with specific medication, this including:

  • Atorvastatin - used to prevent cardiovascular disease and treat abnormal lipid levels.
  • Various liver medication 
  • Cisplatin - used to treat several different cancers.

Resist using black cohosh if you are taking any of the above medications, as it could negatively interfere with them.

Will I get withdrawal when I stop taking black cohosh? 

If you decide to stop taking a black cohosh supplement, there is currently no evidence that withdrawal symptoms will occur.

Wrapping up

While black cohosh potentially has many benefits, there is significant evidence that it is especially beneficial for women going through menopause. 

If you are going through perimenopause or menopause and looking for a natural way to help relieve symptoms, black cohosh could be the answer! 

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