Black Cohosh
Hormone Support
Also known as: Actaea racemosa, Cimicifuga racemosa, Black snakeroot, Bugbane, Remifemin
A
Grade A💊 20-40mg standardized extract (often Remifemin) daily🎯 9 primary uses🔗 3 synergies⚠️ Review warnings
Levels upStress & Mood+50 pts
Overview
Black cohosh is a traditional herbal remedy primarily used for menopausal symptom relief, with moderate clinical evidence supporting its efficacy for hot flashes and night sweats. Its mechanisms likely involve phytoestrogen activity and serotonergic pathways, though the active constituents remain incompletely characterized.
Primary Uses
Hot flashesMenopause symptomsMood (menopause)Night sweatsMenopause moodVasomotor symptomsMenopausal hot flashesMenopause-related mood changesVaginal dryness
Frequently Asked About Black Cohosh
How much Black Cohosh should I take?
The typical effective range is 20-40mg standardized extract (often Remifemin) daily. Individual needs vary based on age, body weight, diet, and goals — start at the lower end and adjust based on response. Always consult a healthcare provider before starting a new supplement.
When is the best time to take Black Cohosh?
Divided doses. Consistency matters more than perfect timing — pick a daily anchor (e.g. with breakfast or before bed) and stick with it.
Should I take Black Cohosh with food?
Either way.
Does Black Cohosh interact with medications?
Yes — known interactions include Hepatotoxic drugs, Statins, and Tamoxifen (unclear). If you take any prescription medication, talk to your doctor or pharmacist before starting Black Cohosh.
What does Black Cohosh pair well with?
Black Cohosh stacks well with St. John's Wort, Red Clover, and Maca — these combinations either improve absorption or work synergistically toward common goals.
Who should not take Black Cohosh?
Black Cohosh should be avoided or used with caution by people with Liver disease and Hormone-sensitive cancers (caution). Pregnant or breastfeeding women should consult a healthcare provider before use.
What are the side effects of Black Cohosh?
Most people tolerate Black Cohosh well. The most commonly reported side effects are GI upset, Headache, and Dizziness. Side effects are usually dose-dependent — lowering the dose often resolves them.
Dosage
Typical range
20-40mg standardized extract (often Remifemin) daily
Timing
Divided doses
With food
Either way
Duration
Up to 6 months, reassess
Special Populations
Menopausal and perimenopausal women
Research & Studies
Search the literature now
We haven’t curated landmark studies for Black Cohoshyet — one-click into the primary literature here. PubMed (RCTs) is usually the highest-signal starting point.
Mechanism of Action
- • Modulates serotonin receptors
- • Does not act as estrogen
- • Reduces vasomotor symptoms
- • Mood support
Evidence Quality
Evidence Grade A
Strong evidence for hot flashes and menopause symptoms
Safety & Contraindications
Serious Warnings
- • Rare liver toxicity reports - monitor
- • Seek care if jaundice/abdominal pain
Contraindications
- • Liver disease
- • Hormone-sensitive cancers (caution)
Common Side Effects
- • GI upset
- • Headache
- • Dizziness
- • Weight gain (rare)
Pregnancy & Breastfeeding
Avoid
Liver & Kidney Notes
Monitor liver function, rare hepatotoxicity reported
Interactions
💊 Medications
- • Hepatotoxic drugs
- • Statins
- • Tamoxifen (unclear)
🧪 Supplements
- • Often combined with St. John's Wort
🍽️ Food & Alcohol
- • Either way
Stacking & Synergies
Pairs Well With
Avoid Combining With
Hepatotoxic medications
Best Goal Synergies
Hot flashesMenopause symptoms
Buying Guide
What to Look For
- • Authentic Actaea racemosa
- • Standardized extract
- • Remifemin studied
Standardization Markers
Triterpene glycosides 2.5%
Adulteration risk
Moderate (species substitution)
Practical Notes
- • Does NOT act as estrogen
- • Monitor liver with long-term use
- • Remifemin most studied brand
- • Remifemin most studied
Tags
menopausehot-flasheswomen's-healthmoodbotanicalvasomotor symptomsphytoestrogenwomen's healthtraditional medicine
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Related Guides
In-depth guides covering Black Cohosh — protocols, comparisons, and use cases.
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Last reviewed: September 2026 by the Formulate Research Team. Sources cited above; methodology and scoring criteria published here.
Cite this page
Formulate Research Team. (2026, September). Black Cohosh — Evidence-Based Supplement Guide. Formulate Supplement Encyclopedia. https://app.formulate-health.app/learning/supplements/black-cohosh
Educational content based on published research and our scoring methodology. Not medical advice — consult a qualified healthcare provider before starting, stopping, or changing supplements, especially if you take medications, are pregnant, or have a medical condition.