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Black Cohosh

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

womens healthmenopausesleepstress anxiety

Evidence last reviewed: 04 Apr 2026

Evidence
2 records
2 recordsBest grade:Moderate
Biomarkers
Anxiety

The evidence for black cohosh includes a systematic review and a meta-analysis of randomized controlled trials, indicating moderate support for symptom relief in menopausal women. However, variability in product quality and individual responses presents gaps in the overall effectiveness.

Menopausal symptom relief
Peri-/postmenopausal women · Systematic review
Low

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

Dose: 40 mgDuration: 4–12 weeks (typical study windows)
Menopausal symptoms including hot flashes & 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), & somatic symptoms (g=0.418) vs placebo. Anxiety & depressive symptoms were not significantly improved. Dropout rates were similar to placebo.

Dose: 40 mgDuration: Varies (pooled)
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How to take it

Take 20-40 mg of standardized extract daily, preferably with food.

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