Root of a North American woodland plant.
Why it’s used: Traditionally used to support women through the menopause.
Black cohosh (Actaea racemosa, formerly Cimicifuga racemosa) is a tall flowering plant that grows in the woodlands of eastern North America. It is the root and rhizome, the underground stem, that is dried and used. Native American communities used it long before it arrived in European herbal practice, and today it is one of the most familiar herbs on menopause shelves.
In supplements you will usually see it listed as black cohosh root extract, sometimes standardised to triterpene glycosides, the group of compounds researchers have focused on. It appears on its own in capsules and tablets, and alongside other botanicals such as red clover, sage or soy isoflavones in blends designed for women in midlife.
Black cohosh is traditionally used to support women through the menopause. Researchers have studied it in a number of trials, and a 2023 review of 22 studies noted possible benefits for overall menopause symptoms, though results across the wider research have been mixed. It is worth knowing that black cohosh is a different plant from blue cohosh, which has a separate and less reassuring safety profile.
3 findings behind this ingredient. Hover a card for the detail and the source.
Meta-analysis of randomised controlled trials covering 2,310 menopausal women. Black cohosh improved overall symptoms (Hedges' g 0.575), hot flushes and somatic symptoms versus placebo, with dropout rates similar to placebo; anxiety and depressive symptoms did not change significantly.
Review and meta-analysis of 35 clinical studies and one meta-analysis covering 43,759 women, 13,096 of whom took the extract. It outperformed placebo (SMD -0.694) and was comparable to low-dose transdermal oestradiol or tibolone.
Meta-analysis of nine randomised placebo-controlled trials, seven pooled for vasomotor symptoms. Six trials showed a significant benefit, and the pooled improvement was 26% (95% CI 11–40%), with significant heterogeneity between trials.
Can't see yours? Ask our team, answered within a working day.
No. They are different plants. Black cohosh (Actaea racemosa) is the one used in menopause supplements. Blue cohosh (Caulophyllum thalictroides) has been linked to side effects such as raised blood pressure and should not be confused with it.
Research studies have used black cohosh for up to 12 months without serious side effects. If you plan to take it longer, or you have any health conditions, it is sensible to talk it through with your GP or pharmacist.
Most people tolerate it well, but rare cases of liver damage have been reported in people taking black cohosh products. It is not certain the herb was the cause. Avoid it if you have liver problems, and stop and seek advice if you notice dark urine or yellowing skin.
Information only, not medical advice. If you take medication, are pregnant or breastfeeding, speak to your GP or pharmacist first.
Six quick questions match you to the products in our range that fit your goal, with the reasons why.
