Black Cohosh
Research reviewed: Up until 03/2026
Black Cohosh (Actaea racemosa (Cimicifuga racemosa)) is a dietary supplement with 12 published peer-reviewed studies involving 4,008 participants, researched for Menopausal Symptoms, Hot Flushes, Mood & Sleep in Menopause and 3 more areas.
Evidence at a Glance
Strength is scored by study design, sample size, study type, and outcomes
Menopausal Symptoms
WeakHot Flushes
ModerateMood & Sleep in Menopause
ModerateBone Health
WeakSystematic reviews
WeakClinical trials
ModerateResearch Visualised
Visual breakdown of the clinical data.
Study Quality Breakdown
What types of studies were conducted
Participants Per Study
Larger samples = more reliable results
Research Timeline
When the studies were published
All Studies
Detailed breakdown of each trial. Click to expand.
Menopausal Symptoms
To evaluate the efficacy of black cohosh in relieving menopausal symptoms.
Study Type
Cochrane systematic review
Purpose
To evaluate the efficacy of black cohosh in relieving menopausal symptoms.
Dose
Various standardised preparations
Participants
Cochrane systematic review of RCTs
Duration
3–6 months
Results
Evidence from RCTs does not consistently demonstrate significant reduction in hot flush frequency. Some trials show modest beneficial effects on menopausal symptom scores. The evidence base is limited by methodological heterogeneity.
How They Measured It
Kupperman Menopausal Index, hot flush frequency, sleep quality
To update the Spanish Menopause Society position statement on black cohosh for menopausal symptoms.
Study Type
Systematic review of clinical evidence
Purpose
To update the Spanish Menopause Society position statement on black cohosh for menopausal symptoms.
Dose
Various (iCR extracts, typically 40 mg/day)
Participants
Expert panel review of clinical evidence 1997–2021
Duration
Various
Results
Current evidence indicates black cohosh has modest efficacy for menopausal symptoms, particularly hot flushes, in peri-menopausal women. Standardised iCR preparations have the best evidence. Safety profile is acceptable.
How They Measured It
Hot flash frequency and severity, Kuppermann index, MRS, safety data
To systematically review efficacy of black cohosh for menopausal symptoms across clinical trials.
Study Type
Systematic review
Purpose
To systematically review efficacy of black cohosh for menopausal symptoms across clinical trials.
Dose
Various
Participants
Systematic review of 16 clinical studies
Duration
Various
Results
Nine of the 16 studies reported a statistically significant reduction in menopausal symptoms. Black cohosh may provide modest benefit especially for peri-menopausal women; a beneficial effect cannot be excluded despite inconsistent evidence.
How They Measured It
Hot flush reduction, Kuppermann index, menopausal rating scales
Hot Flushes
To evaluate the effect of black cohosh on vasomotor symptoms (hot flushes, night sweats) in postmenopausal women.
Study Type
Randomised, double-blind, placebo-controlled
Purpose
To evaluate the effect of black cohosh on vasomotor symptoms (hot flushes, night sweats) in postmenopausal women.
Dose
40 mg/day black cohosh extract
Participants
80 postmenopausal women
Duration
8 weeks
Results
Black cohosh significantly reduced hot flush frequency and severity compared to placebo. Kuppermann index scores improved significantly in the treatment group. Treatment was well tolerated.
How They Measured It
Hot flush frequency and severity (VAS), Kuppermann Index
To assess the efficacy of isopropanolic black cohosh extract (iCR) on menopausal hot flushes with updated evidence.
Study Type
Meta-analysis
Purpose
To assess the efficacy of isopropanolic black cohosh extract (iCR) on menopausal hot flushes with updated evidence.
Dose
40 mg/day iCR extract
Participants
Meta-analysis of RCTs
Duration
3–6 months
Results
iCR extract demonstrated significant and clinically meaningful reduction in hot flush frequency and menopausal symptom scores. Evidence supports its use particularly in peri-menopausal women as an alternative to HRT.
How They Measured It
Hot flush frequency, severity, and composite symptom scores
Mood & Sleep in Menopause
To assess the effects of black cohosh on mood, sleep, and quality of life during menopause transition.
Study Type
Randomised, double-blind, placebo-controlled
Purpose
To assess the effects of black cohosh on mood, sleep, and quality of life during menopause transition.
Dose
40 mg/day black cohosh extract
Participants
76 peri-menopausal women
Duration
12 weeks
Results
Black cohosh significantly improved sleep quality and mood scores compared to placebo. Reductions in depression and anxiety subscales of the menopausal rating scale were observed.
How They Measured It
Beck Depression Inventory, Pittsburgh Sleep Quality Index, MRS
Bone Health
To investigate the effects of Cimicifuga racemosa on bone density in ovariectomised rats.
Study Type
Animal study
Purpose
To investigate the effects of Cimicifuga racemosa on bone density in ovariectomised rats.
Dose
Cimicifuga racemosa extract equivalent to 10 mg/kg
Participants
Ovariectomised Sprague-Dawley rats
Duration
3 months
Results
Black cohosh extract partially prevented bone loss in ovariectomised rats. BMD and trabecular bone volume were significantly higher in the treatment group compared to untreated ovariectomised controls.
How They Measured It
Bone mineral density (BMD), histomorphometry, bone strength testing
Systematic reviews
To investigate the effects of Black Cohosh in evening primrose oil for menopause hot flashes: systematic review and meta-analysis.
Study Type
Systematic review and meta-analysis
Purpose
To investigate the effects of Black Cohosh in evening primrose oil for menopause hot flashes: systematic review and meta-analysis.
Dose
Black Cohosh (dose not specified)
Participants
Participants not specified
Duration
4 weeks
Results
regarding the benefits of EPO in alleviating hot flashes. We hope that more research is conducted to provide sufficient evidence for menopausal women considering the use of EPO.
How They Measured It
See study for outcome measures
To investigate the effects of Black Cohosh in weight gain in menopause: systematic review of adverse events in women treated with black cohosh.
Study Type
Systematic review
Purpose
To investigate the effects of Black Cohosh in weight gain in menopause: systematic review of adverse events in women treated with black cohosh.
Dose
Black Cohosh (dose not specified)
Participants
1839 participants
Duration
Duration not specified
Results
, this study provides no scientific evidence that the use of Cimicifuga racemosa causes weight gain in menopausal women.
How They Measured It
See study for outcome measures
Clinical trials
To investigate the effects of Black Cohosh in efficacy and safety of nutraceutical on menopausal symptoms in post-menopausal women: a randomized, double-blind, placebo-controlled clinical trial.
Study Type
Randomized, double-blind, placebo-controlled
Purpose
To investigate the effects of Black Cohosh in efficacy and safety of nutraceutical on menopausal symptoms in post-menopausal women: a randomized, double-blind, placebo-controlled clinical trial.
Dose
Black Cohosh (dose not specified)
Participants
Participants not specified
Duration
Duration not specified
Results
Menopausal symptoms severely reduce the quality of life of post-menopausal women worldwide. Nutraceuticals are widely prescribed as a viable and safer alternative and complementary approach to standard therapies. The aim of this study was to evaluate the clinical efficacy and safety of a nutraceutical in post-menopausal women.
How They Measured It
See study for outcome measures
To investigate the effects of Black Cohosh in effects of a combination of botanical actives on skin health and antioxidant status in post-menopausal women: a randomized, double-blind, placebo-cont
Study Type
Randomized, double-blind, placebo-controlled
Purpose
To investigate the effects of Black Cohosh in effects of a combination of botanical actives on skin health and antioxidant status in post-menopausal women: a randomized, double-blind, placebo-cont
Dose
Black Cohosh (dose not specified)
Participants
Participants not specified
Duration
Duration not specified
Results
ng is one of the most concerning issues during the post-menopausal period. Despite the promising effects of hormonal therapy, there is still concerned about the long-term outcomes from the treatment. Therefore, nutraceuticals that contain estrogenic and antioxidative effects have gained a lot of attention as an alternative therapy for slowing down skin age-related changes in women after menopause.
How They Measured It
See study for outcome measures
To investigate the effects of Black Cohosh in assessing the combined effects of black cohosh, soy isoflavones, and sdg lignans on menopausal symptoms: a randomized, double-blind, placebo-controlle
Study Type
Randomized, double-blind, placebo-controlled
Purpose
To investigate the effects of Black Cohosh in assessing the combined effects of black cohosh, soy isoflavones, and sdg lignans on menopausal symptoms: a randomized, double-blind, placebo-controlle
Dose
Black Cohosh (dose not specified)
Participants
Participants not specified
Duration
Duration not specified
Results
This randomized, double-blind, parallel-group clinical trial aimed to evaluate the efficacy of Black Cohosh, Soy Isoflavones, and SDG Lignans in alleviating menopausal symptoms compared to a placebo.
How They Measured It
See study for outcome measures
Frequently Asked Questions
Common questions about Black Cohosh research
There are currently 12 peer-reviewed studies on Black Cohosh (Actaea racemosa (Cimicifuga racemosa)), involving 4,008 total participants. Research covers Menopausal Symptoms, Hot Flushes, Mood & Sleep in Menopause and 3 more areas. The overall evidence strength is rated as Strong.
The evidence is currently rated as "Strong Evidence". This rating is based on study design quality (randomisation, blinding, placebo controls), sample sizes, study types (5 human studies), and reported outcomes.
Black Cohosh has been researched for: Menopausal Symptoms, Hot Flushes, Mood & Sleep in Menopause, Bone Health, Systematic reviews, Clinical trials. Each area has its own body of evidence which you can explore in the study breakdowns above.
Yes, 5 out of 12 studies are human trials. Human trials carry more weight in our evidence scoring system.
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