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evidence · mechanism · dose
Supplements/Herb

Black Cohosh

aka Actaea racemosa

Standardized extract for menopausal vasomotor symptoms.

Women's Health

Overview

Standardized extract for menopausal vasomotor symptoms.

Natural sources
  • Actaea racemosa root
Common forms
  • Remifemin standardized

Mechanism of action

Non-estrogenic; possibly modulates serotonin and dopamine receptors.

Pathways
  • · Serotonergic

Effects on the body

Decreases
Hot flashes

Organ system effects

Reproductive

Reduces menopausal hot flashes.

Evidence-based benefits

Reduces menopausal hot flashes

Moderate evidence

Potential side effects

Common
  • · GI upset
Rare
  • · Headache
Serious
  • · Hepatotoxicity (rare case reports)

Drug interactions

Hepatotoxic drugs
Caution.
moderate
Tamoxifen
Uncertain interaction.
moderate

Safety & non-supplemental interactions

Educational summary — always confirm with your clinician or pharmacist before starting, stopping, or combining with prescription therapy.

Avoid if you are
  • ·Pregnant or breastfeeding (insufficient safety data)
  • ·Children under 18 (unless directed by a clinician)
  • ·Pregnant (uterine stimulant)
  • ·Breastfeeding
Avoid with these conditions
  • ·Active or history of liver disease
  • ·Hormone-sensitive cancers
Avoid / monitor with these medications
  • ·Hepatotoxic drugs
  • ·Statins
  • ·Tamoxifen

Supplement interactions

Pairs well with

None listed.

Avoid combining with
  • Liver disease
    Hepatotoxicity reports.

Dosing & bioavailability

Typical dose
20–40 mg Remifemin × 2/d

Where to buy

Affiliate-style search links to reputable retailers. We don't endorse specific brands — verify third-party testing (USP, NSF, Informed Sport) before purchase.

Herb
Black Cohosh
Amazon
Wide selection · fast shipping
Herb
Black Cohosh
iHerb
Global delivery · curated brands
Herb
Black Cohosh
Thorne
Practitioner-grade · NSF tested

Scientific evidence (8)

Meta-analysisCochrane Database · 2012

Black cohosh for menopausal symptoms

Leach MJ, Moore V

Cochrane review of 16 RCTs.

Key findings

Insufficient evidence to support routine use.

Open study
Systematic reviewPubMed (NLM) · 1970

PubMed: Black Cohosh — Reduces menopausal hot flashes

Live PubMed search

Live results for "Black Cohosh Reduces menopausal hot flashes" across the PubMed/MEDLINE peer-reviewed index.

Key findings

Opens current human and preclinical literature matching Black Cohosh and "Reduces menopausal hot flashes". Filter by RCT, meta-analysis, or year on the results page.

Open study
Systematic reviewPubMed (NLM) · 1970

PubMed: Black Cohosh — randomized controlled trial

Live PubMed search

Live results for "Black Cohosh randomized controlled trial" across the PubMed/MEDLINE peer-reviewed index.

Key findings

Opens current human and preclinical literature matching Black Cohosh and "randomized controlled trial". Filter by RCT, meta-analysis, or year on the results page.

Open study
Systematic reviewPubMed (NLM) · 1970

PubMed: Black Cohosh — meta-analysis

Live PubMed search

Live results for "Black Cohosh meta-analysis" across the PubMed/MEDLINE peer-reviewed index.

Key findings

Opens current human and preclinical literature matching Black Cohosh and "meta-analysis". Filter by RCT, meta-analysis, or year on the results page.

Open study
Systematic reviewPubMed (NLM) · 1970

PubMed: Black Cohosh — pharmacokinetics

Live PubMed search

Live results for "Black Cohosh pharmacokinetics" across the PubMed/MEDLINE peer-reviewed index.

Key findings

Opens current human and preclinical literature matching Black Cohosh and "pharmacokinetics". Filter by RCT, meta-analysis, or year on the results page.

Open study
Systematic reviewPubMed (NLM) · 1970

PubMed: Black Cohosh — safety adverse events

Live PubMed search

Live results for "Black Cohosh safety adverse events" across the PubMed/MEDLINE peer-reviewed index.

Key findings

Opens current human and preclinical literature matching Black Cohosh and "safety adverse events". Filter by RCT, meta-analysis, or year on the results page.

Open study
Systematic reviewPubMed (NLM) · 1970

PubMed: Black Cohosh — dose response

Live PubMed search

Live results for "Black Cohosh dose response" across the PubMed/MEDLINE peer-reviewed index.

Key findings

Opens current human and preclinical literature matching Black Cohosh and "dose response". Filter by RCT, meta-analysis, or year on the results page.

Open study
Systematic reviewGoogle Scholar · 1970

Google Scholar: Black Cohosh — clinical evidence

Live Scholar search

Cross-database citation index for Black Cohosh as it relates to "clinical evidence".

Key findings

Includes preprints, theses, and journal articles. Useful for tracking citation counts and follow-on work.

Open study
Educational use only. This profile is not medical advice. Consult a qualified healthcare professional before starting any supplement, especially if you take prescription medication or have a chronic condition.