Natural Medical SolutionsBlack cohosh is a plant from North America, in the buttercup family. The root is used. Today it is mostly taken as a supplement for menopause symptoms, and hot flashes in particular.
What is black cohosh?
Black cohosh grows in North America. It belongs to the buttercup family. The part used is the root, or the underground stem.
Native Americans used it for kidney trouble, malaria, sore throats and period cramps. It has been used as a medicine in Germany for well over a century.
Today it is sold mainly for menopause symptoms. It is also promoted for period cramps, for premenstrual syndrome, and to bring on labor.
What are the benefits of black cohosh?
Menopause is where the research is. A good number of studies in people have looked at it. Much less work has been done on anything else.
A 2023 review pulled together 22 studies. It found black cohosh products were possibly helpful for menopause symptoms overall.
Looking at single symptoms, the picture was narrower:
- Hot flashes. Improved.
- Anxiety. No improvement found.
- Low mood. No improvement found.
So the evidence points at hot flashes, not at mood.
For hot flashes linked to breast cancer care, it is not clear whether it helps. For other uses, there is not enough reliable data to say.
What are the side effects of black cohosh?
Black cohosh has been used safely in studies that ran as long as a year. Most people tolerate it well.
The concern that gets raised is the liver. Cases of liver damage have been reported in people taking products labeled as black cohosh, and some were very serious.
Two things are worth being clear about. These cases are rare. And it is not known whether black cohosh actually caused them.
There may be another explanation. Some products sold as black cohosh have been found to contain the wrong herb, or a mix of herbs not listed on the label. Those stowaways might be responsible. That is possible, but unproven.
Call your doctor if you take black cohosh and notice dark urine or unusual tiredness. Those can be signs of liver trouble.
Is blue cohosh the same thing?
No. They are different plants with similar names, and the difference matters.
Blue cohosh can cause high blood pressure, high blood sugar and chest pain.
Using blue cohosh to bring on labor has been linked to life-threatening problems in the baby, including seizures.
Check the label carefully. If it says blue cohosh, it is not what this page is about.
Who should not take black cohosh?
Talk to your doctor first if any of these apply:
- You are pregnant or breastfeeding. It may not be safe.
- You have had a hormone-sensitive condition, such as breast or uterine cancer. Whether black cohosh is safe in that situation is uncertain.
- You have liver problems.
- You take any prescription medicine.
Common questions about black cohosh
Does black cohosh help hot flashes?
Can black cohosh damage your liver?
How long can you take black cohosh?
Is black cohosh safe if I have had breast cancer?
Related on this site
Where this information comes from
Written from NCCIH (National Center for Complementary and Integrative Health), a public-domain resource from the U.S. National Institutes of Health. Information retrieved 2026-08-21.
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