About Black Cohosh
Black cohosh is used primarily for menopausal vasomotor symptoms. Meta-analysis of 22 RCTs (2,310 women) found 26% improvement in vasomotor symptoms vs placebo. Results are mixed — some trials show significant benefit, others no difference from placebo. Most positive evidence comes from the isopropanolic extract (Remifemin) at 40 mg/day. Not effective for anxiety or depressive symptoms per meta-analysis. Safety profile is favorable in clinical trials. Rare hepatotoxicity reports exist but causal link is unestablished. No established RDA/UL.
What Black Cohosh supports
- May reduce hot flash frequency and severity (meta-analysis of 22 RCTs, 2,310 women)
- 26% improvement in vasomotor symptoms vs placebo (95% CI: 11–40%)
How much Black Cohosh to take
Clinical studies typically use 20–160 mg of Black Cohosh. RCTs predominantly use 20–40 mg/day of standardized extract (2.5% triterpene glycosides). Cochrane review median dose: 40 mg/day across 22 trials. Raw root powder (300–540 mg) is common in commercial products but less studied; unstandardized root powder and standardized extract are not directly bioequivalent.
- Effective range
- 20–160 mg
Clinical evidence
Moderate clinical evidence. Meta-analysis of 22 trials (2,310 women) showed 26% improvement in menopausal hot flashes
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