It’s one of the most-studied natural remedies for menopause symptoms. But what exactly is black cohosh and would it be helpful for you?


What is black cohosh?

Native to north America, this plant is actually a member of the buttercup family. It has a long use in traditional medicine among native Americans, who used it to treat a wide range of conditions, from musculoskeletal pain to fever and menstrual irregularities. Evidence suggests that when the colonial settlers arrived, they used it to support women’s wellbeing. Nowadays, it’s best known for helping to ease menopause symptoms. So, could black cohosh work for you?

Turning down the heat

Black cohosh may help with the classic vasomotor symptoms of menopause – hot flushes and night sweats. There’s some evidence to support its use for these issues. In 2010, a review of studies found black cohosh reduced hot flushes and night sweats by up to 26%.[1] More recently, in 2018, a study compared black cohosh with evening primrose oil for treating hot flushes and found that while menopause-related quality of life improved in both groups, the number and severity of hot flushes significantly decreased in the group taking black cohosh.[2] It’s important to note that some other studies haven’t had the same results so the evidence is mixed. And it’s unclear why black cohosh can have some positive effects – it may function as a plant oestrogen, helping to gently rebalance hormones – or it may work in some other way. Regardless, many women swear by it, for example our online menopause community member Mila says she really relies on the herb.

Boosting mood

There’s some limited research to suggest black cohosh may help with mood issues related to menopause. One analysis found it significantly eased psychological symptoms, which include feeling low and agitated.[3] Having said that, the review also noted that one of the studies in the analysis showed the herb had little effect on anxiety. Again, anecdotal evidence suggests some women find it very helpful, even though the research isn’t robust.

Supporting sleep

It’s common for menopause to knock your sleep for six, and for lots of women this issue can persist into the postmenopausal phase. A study found that black cohosh may help with this symptom, improving sleep quality and efficiency and reducing waking in the early hours [4]. The research suggests it may be helpful chiefly for its role in easing night sweats. Another study looked at a preparation including black cohosh and found it helped in another sleep-related way, by improving hot flushes aggravated by anxiety and insomnia.

How do I take it?

Often found in capsule or tincture form, black cohosh is easy to get hold of as it’s widely available in health stores. It’s often combined with other herbs, such as red clover and soy isoflavones, to help with menopause symptoms. Usually, 20mg of black cohosh daily is recommended or you could visit a herbal medicine practitioner for a tailored prescription.

Stay safe!

Black cohosh is considered safe for most people. There have been some reports of adverse effects on the liver, although it’s not clear whether these were connected with the herb itself, or with impurities in particular products. Regardless, if you have any liver problems, you should check with your doctor before you take it. Otherwise, the usual rules apply – always speak to your GP or pharmacist before trying black cohosh if you’re pregnant, have a health condition or take any regular medication, including HRT, as there’s potential for it to affect hormones.




Research References