Black Cohosh

Menopause symptom support is mixed; some reviews suggest potential benefit for overall symptoms, but results are inconsistent and product variability is high.

womens-healthmenopausesleepstress-anxiety

Dosing model

FLATFixed dose (no body-weight scaling).

Min dose

20 mg

Max dose

80 mg

Rounding

5 mg

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Evidence

2 records

Menopausal symptom relief

Peri-/postmenopausal women • Systematic review

Low

Review summaries suggest potential benefit for overall menopause symptoms, but uncertainty remains due to heterogeneity and product differences.

Dose: 40 mg • Duration: 4–12 weeks (typical study windows)

Citation: NCCIH – Black Cohosh: Usefulness and Safety

Menopausal symptoms including hot flashes and somatic symptoms

Peri-/postmenopausal women • Meta-analysis of RCTs

Moderate

Updated pairwise meta-analysis of 22 RCTs (n=2,310) found black cohosh extracts significantly improved overall menopausal symptoms (Hedges' g=0.575), hot flashes (g=0.315), and somatic symptoms (g=0.418) vs placebo. Anxiety and depressive symptoms were not significantly improved. Dropout rates were similar to placebo.

Dose: 40 mg • Duration: Varies (pooled)

Citation: Shahnazi M, et al. Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis. Menopause. 2023;30(8):866-875.

Forms

Capsule

Extract-standardization varies