Black Cohosh Benefits, Dose, Side Effects, and More

Medically Reviewed on 7/13/2022
Black Cohosh
Black cohosh is a powerful herb that provides the following nine benefits and potential side effects.

Black cohosh is a powerful herb that has been used for centuries in traditional medicine to treat a variety of ailments. Actaea raemosa and Cimicifuga racemosa are the scientific names for this perennial flowering plant that belongs to the buttercup family.

  • Native to North America, this herb is also referred to by common names such as snakeroot, black bugbane, rattleweed, macrotys, baneberry, rheumatic weed, and fairy candle.
  • This medicinal plant has been used since ancient times for treating a variety of illnesses, including musculoskeletal discomfort, arthritis, fever, cough, pneumonia, and menstrual irregularities.
  • According to various studies, it is one of the supplements with the highest popularity and sales in the Western world (10th rank in 2008).

What is the correct dose of black cohosh?

Most investigations on black cohosh have used the Remifemin extract, which is standardized to have 1 mg of terpene glycosides per 20-mg tablet. Two 20-mg tablets taken two times daily is the most common Remifemin dose.

  • The peak effect usually occurs between four and eight weeks.
  • Black cohosh extract is offered as a tincture, with a recommended dose of 2 mL two times daily of a 1:1 tincture in 90 percent alcohol.
  • Consult your doctor so that they may guide you with a safe dose according to your health concern.

What are the side effects of black cohosh?

In clinical studies, stomach discomfort was the only adverse effect that was consistently recorded.

  • Black cohosh can result in nausea, vomiting, headaches, giddiness, and dizziness in higher doses.
  • There have been rare cases where black cohosh users may have experienced liver issues; the specifics of these cases are still under investigation.
  • However, people who already have liver issues or those who take any other drugs or substances that affect the liver should avoid using black cohosh or consult a doctor.

9 benefits of black cohosh

Nine benefits of black cohosh include:

  1. Treats menopausal symptoms: According to reports, black cohosh possesses direct estrogenic activity. Menopausal women frequently use it because it has traits that are comparable to those of estrogen, such as easing hot flashes, lowering depression, and preventing bone loss. It, however, should not be considered an estrogen substitute because it may increase estrogen activity in some parts of the body and decrease it in others. 
    • Black cohosh extract contains a substance called phytoestrogen, which is thought to be the source of its estrogenic activity.
    • Neurotransmitter-like substances found in black cohosh extract help reduce postmenopausal syndrome symptoms. It contributes to the thermoregulation process by attaching to serotonergic receptors in the hypothalamus (temperature regulation).
    • As a result of this thermoregulation mechanism, black cohosh extract reduces postmenopausal hot flashes.
  2. Promotes brain health: By acting on the opiate receptor, the black cohosh rhizome extract produces a numbing effect on rats. Studies on animals report that black cohosh extract has antidepressant properties.
  3. May reduce osteoporosis (bone loss): Black cohosh extract can treat postmenopausal osteoporosis. In an osteoporosis rat model, the bone structure was preserved by reducing bone reabsorption and preventing bone loss.
    • Triterpenoids in black cohosh reduced the development of osteoclast-like cells and their resorbing activity, preventing osteoclastic bone resorption in an animal model and increasing bone mineral density.
    • In people with osteoporosis, the glycoside (actein) defends the bone by limiting oxidative damage to osteoblasts (bone-forming cells), and deoxyactein significantly boosts cell proliferation, and collagen content, alkaline phosphatase activity, and mineralization in the cells, defending bone density.
  4. Potent anti-inflammatory effects: Inflammation in rats was reduced by the black cohosh rhizome extract. When ferulic acid and isoferulic acid (present in black cohosh) are given to virus-infected mice, interleukin levels, and neutrophils in the bronchoalveolar lavage process are decreased.
  5. Role in cancer: Studies in the lab have reported that black cohosh extracts prevent the growth of both estrogen-positive and estrogen-negative human breast cancer cells.
    • Black cohosh extract has cytotoxic and apoptotic (cell self-destruction) effects on prostate cancer cells that were androgen-dependent and independent. 
    • Some lab studies have reported the inhibitory effect of black cohosh extract on breast cancer cells.
  6. Helps treat diabetes: By activating certain protein kinase enzymes, black cohosh extract has antidiabetic effects. Black cohosh extracts significantly reduced body weight in diabetic mice, boosted glucose metabolism, and enhanced insulin sensitivity.
  7. Antiallergic action: Black cohosh extract inhibits the immunoglobulin E-induced anaphylaxis reaction (an acute and severe allergic reaction to an antigen). Additionally, it suppresses the cytokine mRNA, indicating an antiallergic action.
  8. Controls polycystic ovary syndrome (PCOS): Women of reproductive age frequently experience PCOS which causes hormonal imbalance, weight gain, and irregular menstrual cycles.
    • Black cohosh is a strong ayurvedic supplement that supports blood flow regulation, cycle maintenance, and hormone balance.
    • Supplementing with black cohosh helps reduce the size of uterine fibroids. Hence, it is used in treating uterine fibroids.
  9. Encourages sleep: Black cohosh provides a one-stop solution for improving sleep and may help minimize hot flash-related symptoms that are disturbing your sleep. When consumed before bed, black cohosh nourishes the brain cells and enhances sleep patterns, promoting a comfortable night's rest.


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Medically Reviewed on 7/13/2022
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