Black Cohosh: Uses, Benefits, & Side Effects

If you’ve found yourself looking for natural ways to ease menopause symptoms like hot flushes or night sweats, you may have come across black cohosh. It’s often mentioned in conversations about herbal remedies for women’s health, especially around midlife. But what exactly is black cohosh, what does it do to the female body, and are there any side effects or risks you should know about?

This blog post examines black cohosh as a herbal remedy, covering its uses, benefits, and potential side effects.

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your GP or a qualified healthcare professional before starting any new herbal remedies, especially if you are pregnant, breastfeeding, taking medication, or managing a health condition.

Jump to:

Black cohosh is a herb derived from the root of the Actaea racemosa plant, which is native to North America. The black cohosh root has been used for centuries in traditional medicine, particularly by Native American communities, to support women’s health.

Today, it’s commonly used as a supplement for hot flashes, night sweats, and other symptoms associated with menopause or hormonal imbalances. You’ll often find it in capsule form, tinctures, or tablets.

The definition of black cohosh might vary slightly depending on the form it's in, but essentially, it’s a herbal supplement believed to support hormonal balance, especially during perimenopause and menopause.

Black cohosh is widely used for supporting women’s health during menopause, thanks to its gentle effects on hormones and the nervous system. While research continues, five key benefits are consistently reported:

Black cohosh is often used to reduce the frequency and intensity of hot flushes and night sweats. Some studies suggest it may lightly mimic oestrogen in the body, making it a helpful natural option for menopausal symptom relief without hormone therapy.

Several users report an improved mood and reduced irritability after taking black cohosh regularly. Some even say it gives them a mild energy boost, helping them feel more emotionally balanced and less fatigued throughout the day.

Because black cohosh may help reduce night sweats and anxiety, many women find that it improves their sleep quality. When taken in the evening, it may promote a calmer, more restful night.

Black cohosh is thought to influence neurotransmitters linked to anxiety. While research is limited, some women use it to help manage hormonal anxiety or emotional changes during menopause.

Black cohosh contains plant compounds that may have mild anti-inflammatory effects. These, combined with its hormone-balancing properties, may help soothe physical and emotional discomfort linked to hormonal fluctuations.

Black cohosh is available in a range of forms, allowing you to choose what fits best with your routine and preferences:

The ideal dose of black cohosh depends on the form you’re using and your reasons for taking it. Always check the label instructions, and start with the lowest effective dose if you're new to it.

The best time to take black cohosh depends on your symptoms and how your body responds. For hot flushes, mood swings, or night sweats, many people find evening use helpful, especially if symptoms worsen at night. If you're looking to support daytime energy or reduce anxiety, a morning dose may work better.

If using black cohosh to ease sleep disruption, taking it 30–60 minutes before bed may be most effective. It’s also wise to take it at the same time each day to support consistent effects.

As with many supplements, it’s recommended to leave a gap of at least two hours if you’re taking medications or other herbs, as black cohosh may affect absorption. Always speak to a healthcare provider before starting regular use, especially if you're combining it with other treatments.

Black cohosh is generally well-tolerated when used as directed, but like all supplements, it can cause side effects in some people, especially at higher doses or with long-term use. Side effects are usually mild, but it’s still important to be aware of how your body responds. Reported side effects may include:

Black cohosh may also interact with other medications or supplements, particularly those processed by the liver or affecting hormone levels. To avoid interactions, it’s best to take black cohosh supplements separately from prescription medicines and consult a healthcare provider beforehand. Starting with a low dose and observing how you feel can help reduce the chance of side effects.

Black cohosh isn’t suitable for everyone. You should avoid it if you:

It’s always best to speak with a healthcare professional before starting any new supplement, especially if you’re on medication.

Black cohosh is typically considered safe for short-term use, usually up to six months. This recommendation is based on current research, which hasn’t fully assessed the long-term impact of daily use.

To ensure safety and maintain effectiveness, many herbalists suggest using black cohosh in cycles, such as taking it for a few months, followed by a short break. This approach may also help prevent your body from becoming too accustomed to the herb, allowing it to remain effective when symptoms flare.

If you’re considering using black cohosh for an extended period, it’s best to do so under the guidance of a healthcare provider, particularly if you're managing ongoing hormonal or liver-related health concerns.

Black cohosh may help balance hormones, ease hot flushes, improve mood, and support better sleep. Some women also report more stable emotional wellbeing during hormonal shifts.

Black cohosh is not a hormone, but it may act similarly to oestrogen in the body, which is why it’s often used for menopause. This makes it appealing to those avoiding synthetic hormone therapy.

Some women do use both, especially if one helps with hot flushes and the other supports skin or mood. Taking them together may offer broader support for different menopause symptoms.

There’s no evidence to support black cohosh increasing hair growth, although hormone balancing may help with hair thinning in some cases. If hair loss is due to hormonal changes, black cohosh may offer indirect help.

Some people report bloating or water retention when taking black cohosh, though it’s not a universal side effect. Staying hydrated and monitoring sodium intake may reduce this effect.

Black cohosh has mild anti-inflammatory properties, but it’s not a substitute for other treatments. It may support joint or muscle comfort when paired with other lifestyle changes.

Some doctors recommend black cohosh, especially those who take an integrative or holistic approach. However, recommendations often depend on your health history and symptom severity.

There are no known major interactions, but combining supplements should be done carefully. Both may complement each other’s anti-inflammatory and hormone-supporting effects.

While it’s most often used for menopause, some use black cohosh for PMS or hormonal imbalances. It’s important to monitor your body’s response and adjust as needed.

If you’ve found yourself fascinated by the potential of black cohosh and other natural remedies, why not deepen your understanding? Whether you're a beginner or looking to expand your knowledge, Centre of Excellence offers a comprehensive Master Herbalist Diploma Course, designed for people of all levels. 

The course covers everything from herb identification and preparation to building herbal blends for specific emotional and physical needs. Follow the link to access the course for just £29!