Nutritional Supplement

Black Cohosh

Parts Used & Where Grown

Black cohosh is a shrub-like plant native to the eastern deciduous forests of North America, ranging from southern Ontario to Georgia, north to Wisconsin and west to Arkansas. The dried root and rhizome are used medicinally.1 When harvested from the wild, the root is black in color. Cohosh, an Algonquin Indian word meaning “rough,” refers to the plants gnarly root structure.2

How It Works

Black cohosh contains several ingredients, including triterpene glycosides (for example, acetin and 27-deoxyactein) and isoflavones (for example, formononetin). Other constituents include aromatic acids, tannins, resins, fatty acids, starches, and sugars. As a woman approaches menopause, the signals between the ovaries and pituitary gland diminish, slowing down estrogen production and increasing luteinizing hormone (LH) secretions. Hot flashes can result from these hormonal changes. Earlier animal studies3,4 and a human clinical trial5 suggested that black cohosh had some estrogen activity in the body and also decreased LH secretions. However, more recent animal studies6 and a clinical trial7 have found no estrogen activity for black cohosh extracts. Further clinical trials are needed to determine whether black cohosh has significant estrogenic actions in the body.

Small German clinical trials support the usefulness of black cohosh for women with hot flashes associated with menopause.8,9 A review of eight clinical trials found black cohosh to be both safe and effective for symptomatic relief of menopausal hot flashes.5 Other symptoms which improved included night sweats, insomnia, nervousness, and irritability. A clinical trial compared the effects of 40 mg versus 130 mg of black cohosh in menopausal women with complaints of hot flashes.11 While hot flashes were reduced equally at both amounts, there was no evidence of any estrogenic effect in any of the women. Although further trials are needed, this trial suggests that black cohosh is best reserved only for the symptomatic treatment of hot flashes associated with menopause and is not thought to be a substitute for hormone replacement therapy in menopausal and postmenopausal women.

A recent study suggests black cohosh may protect animals from osteoporosis.12 Human studies have not confirmed this action.

References

1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996, 88-9.

2. Castleman M. The Healing Herbs. Emmaus, PA: Rodale Press, 1991, 75-8.

3. Jarry H, Harnischfeger G, Düker E. Studies on endocrine effects of the contents of Cimicifuga racemosa. 2. In vitro binding of compounds to estrogen receptors. Planta Medica 1985;51:316-9.

4. Jarry H, Harnischfeger G. Studies on endocrine effects of the contents of Cimicifuga racemosa. 1. Influence on the serum concentration of pituitary hormones in ovariectomized rats. Planta Medica 1985;51:46-9.

5. Düker EM, Kopanski L, Jarry H, Wuttke W. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Medica 1991;57:420-4.

6. Einer-Jensen N, Zhao J, Andersen KP, Kristoffersen K. Cimicifuga and Melbrosia lack estrogenic effects in mice and rats. Maturitas 1996;25:149-53.

7. Liske E, Wüstenberg P, Boblitz N. Human pharmacological investigations during treatment of climacteric complaints with Cimicifuga racemosa (Remifemin®): No estrogen-like effects [Poster presentation]. 2nd International Congress on Phytomedicine, London, October 15-16, 1998.

8. Stoll W. Phytopharmaceutical influences atrophic vaginal epithelium. Double-blind study on Cimicifuga versus an estrogen preparation. Therapeutikon 1987;1:23-32.

9. Warnecke G. Using phyto-treatment to influence menopause symptoms. Med Welt 1985;36:871-4.

10. Liske E, Wüstenberg P. Therapy of climacteric complaints with Cimicifuga racemosa: a herbal medicine with clinically proven evidence [Abstract #98.0020]. Poster Presentation, 9th Annual Meeting of the North American Menopause Society, Toronto, Canada, September 16-9, 1998.

11. Kadota S, Li JX, Li HY, et al. Effects of cimicifugae rhizome on serum calcium and phosphate levels in low calcium dietary rats and on bone mineral density in ovariectomized rats. Phytomed 1996/97;3(4):379-85.

12. Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecological disorders. Advances Therapy 1998;15:45-53.

13. Nappi RE, Malavasi B, Brundu B, Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 2005;20:30-5.

14. Lieberman S. A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause. J Womens Health 1998;7:525-9.

15. Newton KM, Reed SD, LaCroix AZ, et al. Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med 2006;145:869-79.

16. Uebelhack R, Blohmer JU, Graubaum HJ, et al. Black cohosh and St. John's wort for climacteric complaints: a randomized trial. Obstet Gynecol 2006;107:247-55.

17. Uebelhack R, Blohmer JU, Graubaum HJ, et al. Black cohosh and St. John's wort for climacteric complaints: a randomized trial. Obstet Gynecol 2006;107:247-55.

18. Blumenthal M, Busse WR, Goldberg A, et al., eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 90.

19. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995, 376.

20. Bradley PR, ed. British Herbal Compendium, vol 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992, 34-6.

21. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 90.

22. Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecological disorders. Advances Therapy 1998;15:45-53.

23. Nappi RE, Malavasi B, Brundu B, Facchinetti F. Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol. Gynecol Endocrinol 2005;20:30-5.

24. Lieberman S. A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause. J Womens Health 1998;7:525-9.

25. Newton KM, Reed SD, LaCroix AZ, et al. Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med 2006;145:869-79.

26. Uebelhack R, Blohmer JU, Graubaum HJ, et al. Black cohosh and St. John's wort for climacteric complaints: a randomized trial. Obstet Gynecol 2006;107:247-55.

27. Uebelhack R, Blohmer JU, Graubaum HJ, et al. Black cohosh and St. John's wort for climacteric complaints: a randomized trial. Obstet Gynecol 2006;107:247-55.

28. Blumenthal M, Busse WR, Goldberg A, et al., eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 90.

29. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995, 376.

30. Bradley PR, ed. British Herbal Compendium, vol 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992, 34-6.

31. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 90.

32. Kadota S, Li JX, Li HY, et al. Effects of cimicifugae rhizome on serum calcium and phosphate levels in low calcium dietary rats and on bone mineral density in ovariectomized rats. Phytomed 1996/97;3(4):379-85.

33. Foster S. Herbs for Your Health. Loveland, CO: Interweave Press, 1996, 12-3.

34. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995, 376.

35. Bradley PR, ed. British Herbal Compendium, vol 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992, 34-6.

36. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 90.

37. Gruenwald J. Standardized black cohosh (Cimicifuga) extract clinical monograph. Quart Rev Nat Med 1998;Summer:117-25.

38. Cohen SM, O'Connor AM, Hart J, et al. Autoimmune hepatitis associated with the use of black cohosh: a case study. Menopause 2004;11:575-7.

39. Levitsky J, Alli TA, Wisecarver J, Sorrell MF. Fulminant liver failure associated with the use of black cohosh. Dig Dis Sci 2005;50:538-9.

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2025.