Black cohosh is full of surprises. For one thing, the name doesn’t match the curtains – black cohosh produces white flowers from its green stem. Other names for black cohosh include snakeroot and beetlewort – let’s just say we appreciate the non-literal approach.
Black cohosh is something of a celebrity supplement. According to the latest National Health and Nutrition Examination Survey, an estimated 1.2 million Americans consumed black cohosh products, one of the most popular dietary supplements in the world, in the past 30 days.
If you spend your days and nights trying to figure out how to stop experiencing hot flashes, you may have heard of black cohosh as an alternative treatment for vasomotor symptoms (VMS) during menopause.
Black cohosh is definitely on everyone’s lips – but does it work? Here’s everything you need to know and some surprising facts about the popular supplement.
What is Black Cohosh?
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Black cohosh originally comes from North America and belongs to the buttercup family. (Adorable, right?)
The root and rhizome (underground stem) of the plant are used in herbal supplements, typically sold as liquid extracts or dried extracts in pill form.
Medicinal black cohosh has been around for centuries and has deep roots in traditional Native American medicine. Black cohosh is said to treat a wide range of women’s symptoms and health concerns, including VMS.
For a long time it was believed that black cohosh was a phytoestrogen – a plant substance that has an estrogen-like effect on the body. However, a growing body of research suggests that black cohosh may not be a phytoestrogen, but still has the ability to act like estrogen in certain parts of the body, including the brain, vagina, and bones.
Read: Should you take menopause supplements? >>
Can taking black cohosh improve menopause symptoms?
Because of its potential estrogen-like effects, black cohosh is marketed as an herbal therapy for menopausal symptoms.
Potential benefits of taking the supplement include relief from hot flashes, night sweats, and vaginal dryness.
There is some research to support VMS’s claims: A 2023 analysis of 22 studies involving more than 2,300 women found that taking black cohosh significantly improved common menopausal symptoms, hot flashes, and genitourinary syndrome of menopause (GSM) compared to those women who did not take black cohosh.
In addition to relieving VMS, black cohosh can also help relieve period cramps and PMS and induce labor in pregnant women. However, it is important to note that research on black cohosh and health conditions outside of VMS is very limited.
What are the possible side effects of black cohosh?
The risk of side effects from black cohosh is low and most people tolerate the supplement without any problems. However, if there are any side effects from taking black cohosh they may include:
- Gastrointestinal problems
- Headache
- Pain in the musculoskeletal system
- Uterine bleeding
- rash
- Chest pain
- Increased liver enzymes
- Liver failure
Although rare, severe liver damage has been reported in some people who took black cohosh. In 2023, 83 cases of liver damage were reported worldwide.
Who shouldn’t take black cohosh?
Because black cohosh can affect the liver, people with liver disease should avoid taking the supplement. Pregnant or breastfeeding people should also avoid black cohosh, as there is limited research on the supplement’s safety during pregnancy and breastfeeding, and as previously mentioned, black cohosh could induce labor.
Because black cohosh may have estrogen-like effects, it is especially important for people with hormone-positive conditions such as some breast cancers, benign breast lumps, fibrocystic breast lesions, fibroids, and endometriosis to speak to their doctor before taking black cohosh.
The supplement may also interact with certain medications, including some cancer treatments. Therefore, make sure your doctor has a complete list of all medications and supplements you are taking before deciding to take black cohosh.
Is black cohosh safe?
Black cohosh is relatively safe for most people. However, it is important to note that black cohosh products – like all dietary supplements – are not approved or regulated by the Food and Drug Administration (FDA) before being sold to the public. This means the product you purchased may contain the wrong herb or unknown ingredients that could be harmful to your health.
A recent study of 320 black cohosh brands found that nearly half of the products sold were adulterated or mislabeled. Dietary supplements with a US Pharmacopoeial (USP) Convention Dietary Supplement Verification Program or ConsumerLab.com verification on the label mean that the supplements are of high quality and are not adulterated with other ingredients.
Talk to your doctor before taking any supplements
If you are interested in taking black cohosh, the first step is to talk to your doctor about the benefits, harms, and possible drug interactions. When it comes to your health, you don’t want any surprises.
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