Black cohosh is an herbal remedy that’s long been used by Native Americans to treat a variety of conditions.
Today, it’s used as a supplement to treat symptoms of menopause in older women, including hot flashes and excessive sweating, as well as some of the psychological symptoms that can be caused by menopause.
These include irritability, anxiety, and insomnia. Whether it’s for physical or psychological problems caused by menopause, black cohosh is a popular way to alleviate these problems.
Our research team has ranked and reviewed the ten best sources of black cohosh on the market.
1. Nature’s Way Standardized Black Cohosh
Nature’s Way Standardized Black Cohosh uses careful processing to ensure that each capsule contains 40 mg of black cohosh extract (not raw root material), and has a standardized diterpene content of 2.5%.
This makes it an excellent choice for those looking to mirror the clinical research on black cohosh as closely as possible—many of the studies that have found black cohosh to be an effective treatment for menopause use doses of 40 mg of standardized black cohosh extract.
Additionally, this supplement has no binders or fillers save for the cellulose that makes up the capsule. Thanks to all of these perks, it’s our top pick.
2. Nested Naturals Menopause Complete Natural Care
Nested Naturals Menopause Complete Natural Care is a good balance between pure black cohosh-only supplements and more comprehensive menopause supplements that include a long list of ingredients.
Nested Naturals Menopause Complete Natural Care focuses on four key herbal supplements to treat the symptoms of menopause: dong quai, chamomile, milk thistle, and of course black cohosh.
The black cohosh is standardized to 40 mg of extracted root material, of which 2.5% is diterpene glycosides. Nested Naturals is a great pick for all-around menopause symptom relief that still contains a clinically tested dosage of black cohosh.
3. Pure Encapsulations Black Cohosh 2.5
Pure Encapsulations Black Cohosh 2.5 is another supplement that uses a standardized extract of black cohosh instead of the raw plant root.
These capsules provide 250 mg of standardized extract, though, so it’s a good choice if you are aiming for the higher end of doses that have been tested in clinical settings. The supplement design is very clean, too—the vegan-friendly cellulose used to make up the capsule is the only additional ingredient.
4. Staying Cool Vitex and Black Cohosh
Staying Cool is an herbal blend from Eu Natural that’s specifically designed to fight hot flashes, headaches, and other symptoms of menopause. It uses a sophisticated combination of vitamins, minerals, and herbal extracts.
Chief among these herbal extracts is black cohosh, but you’ll also find chaste tree extract, ashwagandha, and St. John’s Wort, among other ingredients. If you are looking for a total nutritional solution for menopause, Staying Cool is the best choice you can make, but if you specifically want to harness the power of black cohosh along, there are better options on the market.
5. Solaray Black Cohosh
Solaray Black Cohosh is a very simple supplement that delivers 540 mg of raw black cohosh root, with only a vegetable-derived cellulose capsule and no binders or fillers.
It’s a good choice if you are specifically looking for raw plant material, and not a standardized extract. Among the black cohosh supplements that deliver raw materials, it’s the most pure.
6. Gaia Herbs Black Cohosh
Gaia Herbs Black Cohosh has a solid 400 mg dosage of black cohosh root extract, and comes in a vegan-friendly capsule.
It has no additional binders or fillers, making it an excellent choice for purists and those looking for a simple, straightforward product.
7. Nature’s Bounty Black Cohosh
Nature’s Bounty Black Cohosh is a high dose option that delivers 540 mg of black cohosh root in a gelatin capsule. It also contains silica and magnesium stearate to stabilize the capsule, and while it won’t be the favorite among purists, the higher dosage is a distinct appeal.
8. Amazing Formulas Black Cohosh
Amazing Formulas Black Cohosh has a higher than average dose of 540 mg of black cohosh and only a few binders, which includes silica and magnesium stearate.
It’s a good though not spectacular source of black cohosh, and will mostly appeal to people looking for a high dosage supplement.
9. Saz Products Limited Black Cohosh
Saz Products Limited Black Cohosh delivers 540 mg of raw black cohosh in a gelatin-based capsule.
The dose of raw plant material is solid, but the presence of other ingredients like silica and magnesium stearate detract from the purity and quality of this black cohosh supplement.
10. DrFormulas Menopause Support
DrFormulas Menopause Support is a multi-ingredient herbal supplement designed to treat menopause symptoms. It includes a high dose of black cohosh (160 mg standardized extract), but it also has high doses of other herbs like licorice, chasteberry, blessed thistle, and several others.
Some of these, like red clover, have also been researched for their ability to treat specific menopause symptoms, but the wide range of herbs included increases the likelihood of negative interactions or adverse effects.
Black cohosh benefits and side effects
Black cohosh is an herbal supplement that’s been heavily researched as a potential treatment for many of the symptoms of menopause, such as hot flashes, night sweats, anxiety, and irritability.
These symptoms are fundamentally rooted in your body’s decreased estrogen production as you age and enter menopause.
Though many of these symptoms of menopause were historically treated using hormone replacement therapy, concerns about the health risks associated with hormone therapy led health and nutrition researchers to seek out other ways to either address the decrease in estrogen associated with menopause or modify the body’s reaction to this decrease in estrogen.
Black cohosh could reduce the incidence or severity of hot flashes. One of the most aggravating effects of menopause is hot flashes, which are sudden surges of feeling hot, sweaty, and feverish.
These seem to be related to changes in your body’s thermoregulation process that accompany the changes in hormone levels that coincides with menopause. Black cohosh has been researched extensively for use as an herbal remedy to reduce the severity or incidence of hot flashes.
According to the Office of Dietary Supplements at the National Institutes of Health, the precise mechanism of action of black cohosh is still up for debate (1). Some researchers believe that it affects estrogen levels, or the biological activity of estrogen, while others believe its effects are concentrated in the brain.
Regardless, several studies have indicated that black cohosh may help control hot flashes that are associated with menopause.
A systematic review article by Francesca Borrelli and Edzard Ernst published in 2008 cited multiple randomized controlled trials that found a beneficial effect of black cohosh, though other studies they cited found no benefits (2).
The authors concluded that black cohosh may exert beneficial effects on hot flashes, and recommended additional research.
Black cohosh may be able to improve anxiety and sexual dysfunction as well. Hot flashes and night sweats are not the only symptoms of menopause that black cohosh addresses—other research has focused on its ability to address some of the other problems that accompany the transition away from regular ovulation.
Much like decreases in testosterone can cause sexual dysfunction in men, the decreases in estrogen that accompany menopause seem to be associated with sexual dysfunction in women.
One such study was published in 2013 in the journal Chinese Medicine compared the effects of a black cohosh supplement to a placebo (3).
However, unlike previous work, this study included measurements on sexual dysfunction as well as anxiety and other psychological symptoms.
After eight weeks of taking the black cohosh supplement or the placebo, the researchers found that the people taking the real supplement experienced significant improvements in both anxiety and sexual function compared to the placebo group.
These findings make the case that black cohosh does not exert effects on just heat regulation, but addresses several of the overlapping effects of menopause.
When it comes to dosage, more black cohosh may not be better. One of the reasons why it’s been difficult for researchers to definitively establish how much of a benefit you can derive from black cohosh for menopause symptoms has to do with differences across various studies with respect to dosage.
Black cohosh is, of course, a plant, and so herbal preparations derived from its roots will vary in the concentration of the biologically active compounds that the roots contain.
Scientists have tried to combat this inherent variability by using standardized preparations of black cohosh extract.
Even then, the precise dosage used from one study to the next varies. One study published in in 2002 in the Journal of Women’s Health & Gender-Based Medicine directly addressed this issue by testing a 39 mg dose of standardized black cohosh extract with a 127 mg dose among a sample of women with menopause (4).
After following both the low dose and high dose black cohosh groups for six months, the researchers found that both treatments were equally effective.
These results suggest that a lower dose of about 40 mg of standardized black cohosh per day, which is the most commonly studied dosage in clinical research, is adequate to get the benefits of black cohosh, and that a higher dose may not be automatically better when it comes to relieving menopause symptoms.
In large controlled trials, black cohosh is generally well-tolerated, though some studies have reported side effects of gastrointestinal problems and rashes (5).
One limitation of these studies is that their follow-up time has been fairly short; they are almost always less than a year in length.
Some case studies have indicated that there are more serious side effects of black cohosh related to liver function. One paper published in 2002 by a team of doctors in Australia described two patients who were taking black cohosh supplements who developed symptoms of serious liver dysfunction; one of these patients needed a liver transplant (6).
While these case reports are isolated, they do suggest that you should exercise caution with black cohosh, and realize that there is some risk of the supplement affecting your liver.
Further, people with a history of liver problems should definitely not use black cohosh without talking to their doctor first.
While research to date has used a wide range of doses of black cohosh to treat menopause, several studies have converged on a dosage of 40 mg of standardized black cohosh root extract per day.
Further, one study even compared a daily dosage of 39 mg head to head with a daily dosage of 127 mg, and found no significant difference between these two protocols (7).
This makes the case for trying a moderate dosage of 40 mg of black cohosh, at least to start with, since higher doses don’t seem to be related to better outcomes.
Black cohosh is an herbal remedy that’s been extensively researched as a treatment for the symptoms of menopause. While there is conflicting evidence, some research suggests that it could be an effective way to treat night sweats and hot flashes that accompany menopause.
A dosage of 40 mg of standardized black cohosh extract per day is the best-supported dosage that’s been researched, though several studies have explored larger or smaller doses with varying success.
Side effects may include gastrointestinal problems and rashes, and their have been rare reports of serious liver problems associated with black cohosh usage.
For this reason, it’s a good idea to talk to your doctor first if you have concerns about the potential effects of black cohosh on your liver.
Still, black cohosh does show promise when it comes to treating hot flashes, night sweats, sexual dysfunction, and anxiety, so black cohosh might be a good solution to many of the troublesome symptoms of menopause.