What does Black Cohosh do for your body? (dosage, side effects)

What does Black Cohosh do for your body

Black Cohosh (Cimicifuga racemosa) is a herb, member of the buttercup family. It’s used to treat women’s reproductive health:

  • Menopause symptoms (hot flashes, night sweats, trouble sleeping, vaginal dryness, heart palpitations, tinnitus, vertigo, nervousness, mood swings, irritability, anxiety)
  • Premenstrual syndrome (PMS)
  • Dysmenorrhea (period pain)
  • It raises low estrogen levels in menopausal women
  • Might help the immune system
  • Might help to reduce inflammation
  • Might help the nerves and brain
  • Might help weak and brittle bones (osteoporosis)

In the video below, Dr. Meschino explains the studies showing the efficacy of black cohosh in the management of menopausal symptoms and other female health problems.

What are Black Cohosh root’s side effects?

  • Stomach upset and cramping, and weight gain
  • Rash
  • A feeling of heaviness or blood clots (especially in the legs)
  • Vaginal spotting, bleeding, or stimulation of menstrual flow 
  • Liver damage
  • Abnormal or increased vaginal discharge
  • Abnormal heartbeat or altered blood pressure (typically lowered)
  • Breast cancer recurrence
  • Fluid buildup
  • Headache

Black Cohosh Menopause dosage

In tablet form

  • 20 to 80 mg once or twice daily for 12 weeks (and up to 6 months).
  • 40 to 160 mg daily, with a average dose of 40 mg/day.

Effects generally begin after 2 weeks of treatment, with maximum effects usually occurring within 8 weeks.

Teas or Powders

  • 1-2 g three times daily (for less easily absorbed forms).

Liquid or tinctures

  • 0.4-2 milliliters of a 60% ethanol mixture. 
  • 40 drops of herb mixture taken orally once or twice daily for up to 24 weeks.

Dried herb form

The British Herbal Compendium recommends taking 40-200 mg, spread out in 3 equal daily doses.


  • More than 900 mg a day of black cohosh is considered an overdose.
  • Don’t take black cohosh for more than six months at a time.

How much Black Cohosh should I take for hot flashes?

You should take 20 mg of black cohosh daily for 8 weeks for fewer and less severe hot flashes. See details in study below:

Study Title

A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes.

Hot flashes are considered to be a common experience for menopausal women and they can compromise the quality of life.

The objective of this study is to assess the efficacy of Black Cohosh in comparison with evening primrose oil (EPO) in postmenopausal women with menopause-related symptoms.

Subject Information

  • Number of Subjects: 80 
  • Gender of Subjects: female
  • Health Status: postmenopausal with hot flashes.

Method Used

  • The participants were randomly divided into two groups.
  • The participants of one group received black cohosh.
  • The other group received EPO for 8 weeks.
  • The severity and number of hot flashes and quality of life were measured, 1st, 4th, and 8th weeks after treatment.


  • Average severity of hot flashes in both groups and number of hot flashes in black cohosh group in 8th week were significantly lower than 1st week.
  • Number of hot flashes in primrose oil group in 8th week showed no significant differences.
  • The number of hot flashes and quality of life score in black cohosh compared to EPO showed a significant decrease in the 8th week .
  • All scores were significantly improved in two groups.
  • The percentage of improvement in black cohosh was significantly superior to EPO group.


Both herbs were effective in reduction of severity of hot flashes and improvement of the quality of life, but it seems that black cohosh is more effective than primrose oil because it was able to reduce the number of hot flashes too.

Want to know more?

Click the links below to access the individual topic pages:


This article makes use of information from the U.S. National Library of Medicine under the terms of the Creative Commons Attribution 4.0 International License.

  1. Mehrpooya M, Rabiee S, Larki-Harchegani A, Fallahian AM, Moradi A, Ataei S, Javad MT. A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes. J Educ Health Promot. 2018 Mar 1;7:36. doi: 10.4103/jehp.jehp_81_17. PMID: 29619387; PMCID: PMC5868221.
  2. Franco OH, Chowdhury R, Troup J, Voortman T, Kunutsor S, Kavousi M, Oliver-Williams C, Muka T. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016 Jun 21;315(23):2554-63. doi: 10.1001/jama.2016.8012. PMID: 27327802.
  3. Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012 Sep 12;2012(9):CD007244. doi: 10.1002/14651858.CD007244.pub2. PMID: 22972105; PMCID: PMC6599854.
  4. Geller SE, Shulman LP, van Breemen RB, Banuvar S, Zhou Y, Epstein G, Hedayat S, Nikolic D, Krause EC, Piersen CE, Bolton JL, Pauli GF, Farnsworth NR. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial. Menopause. 2009 Nov-Dec;16(6):1156-66. doi: 10.1097/gme.0b013e3181ace49b. PMID: 19609225; PMCID: PMC2783540.
  5. Newton KM, Reed SD, LaCroix AZ, Grothaus LC, Ehrlich K, Guiltinan J. Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med. 2006 Dec 19;145(12):869-79. doi: 10.7326/0003-4819-145-12-200612190-00003. PMID: 17179056.

What does Black Cohosh do for your body? (dosage, side effects)
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