Hormone Support
Black Cohosh
Also known as: Actaea racemosa, Cimicifuga racemosa, Black snakeroot, Bugbane
Black cohosh is a traditional herbal remedy primarily used for menopausal symptom relief, with moderate clinical evidence supporting its efficacy for hot flashes and night sweats. Its mechanisms likely involve phytoestrogen activity and serotonergic pathways, though the active constituents remain incompletely characterized.
Last reviewed June 2026 · Evidence graded from peer-reviewed research, not editorial opinion. Educational only — not medical advice.
Every Black Cohosh product we have scored
| # | Product | Score | Per serving |
|---|---|---|---|
| 1 | Pure Encapsulations Black Cohosh 2.5 | 92 A | $0.44 |
| 2 | Thorne Meta-Balance™ | 90 A | $1.60 |
| 3 | Bluebonnet Nutrition BLACK COHOSH ROOT EXTRACT | 85 A- | $0.43 |
| 4 | Vital Nutrients Black Cohosh Extract 250mg | 85 A- | $0.42 |
| 5 | Nature's Way Black Cohosh Root | 84 A- | $0.15 |
| 6 | Natural Factors Black Cohosh Extract | 83 A- | $0.14 |
| 7 | Pure Encapsulations PhytoBalance II | 82 A- | $0.47 |
| 8 | Nutricost Black Cohosh Capsules | 79 B+ | $0.08 |
| 9 | NOW Foods Female Balance | 77 B+ | $0.18 |
| 10 | Country Life DHEA Complex For Women | 77 B+ | $0.31 |
| 11 | Gaia Herbs Black Cohosh | 76 B+ | $0.49 |
| 12 | NOW Foods Black Cohosh Root | 76 B+ | $0.12 |
Scored on dose accuracy, form, label transparency and third-party testing. Per-serving cost is list price divided by servings per container. No brand pays to be listed or ranked.
Common questions
How much Black Cohosh should I take?
The typical range is 20-40mg standardized extract (often Remifemin) daily. Up to 6 months, reassess
When should I take Black Cohosh?
Divided doses. Either way.
Which form of Black Cohosh is best?
Standardized extract — Triterpene glycosides. Other forms in the catalog: Tincture, Remifemin, Capsule, Tablet, Liquid extract, Dried root powder.
Is Black Cohosh safe?
Commonly reported: GI upset, Headache, Dizziness, Weight gain (rare). Serious warnings: Rare liver toxicity reports - monitor, Seek care if jaundice/abdominal pain. Monitor liver function, rare hepatotoxicity reported
Which Black Cohosh supplement scores highest?
Pure Encapsulations Black Cohosh 2.5, at 92/100. Scored on dose accuracy, form, label transparency and third-party testing — no brand pays to be listed or ranked.
Primary uses
- Hot flashes
- Menopause symptoms
- Mood (menopause)
- Night sweats
- Menopause mood
- Vasomotor symptoms
- Menopausal hot flashes
- Menopause-related mood changes
- Vaginal dryness
What systematic reviews concluded
Outcomes that systematic reviews of Black Cohosh reached a verdict on: 2 with no effect, 1 unclear. Each is quoted from a review and linked to it on PubMed. How these were read.
Reviews found no effect (2)
“The two RCTs using black cohosh and dong quai found no measurable effects.” PMID 42451042
“There is no highquality, consistent evidence that yoga, paced respiration, acupuncture, exercise, stress reduction, relaxation therapy, and alternative therapies such as black cohosh, botanical products, omega-3 fatty acid supplements, and dietary Chinese herbs benefit patients more than placebo.” PMID 27929271
Not enough to say: hpa-axis activity.
How it works
- Modulates serotonin receptors
- Does not act as estrogen
- Reduces vasomotor symptoms
- Mood support
Dosage
- Typical range
- 20-40mg standardized extract (often Remifemin) daily
- Timing
- Divided doses
- With food
- Either way
- Duration
- Up to 6 months, reassess
- Special populations
- Menopausal and perimenopausal women
Forms
- Standardized extract
- Tincture
- Remifemin
- Capsule· 70/100
- Tablet· 70/100
- Liquid extract· 70/100
- Dried root powder· 70/100
Safety
Common side effects
- GI upset
- Headache
- Dizziness
- Weight gain (rare)
Contraindications
- Liver disease
- Hormone-sensitive cancers (caution)
Products containing Black Cohosh
Top-scoring supplements in our catalog that list Black Cohosh on the label. Each product is graded on Formulate's ingredient-level rubric — dose accuracy, form, transparency, and third-party testing.
Evidence notes
Strong evidence for hot flashes and menopause symptoms
Grade A: Multiple well-designed human trials support the main claims.
Related in Hormone Support
Check a full stack
Formulate's free interaction checker lets you paste in any combination of supplements and medications at once — every pairing flags severity, timing, and cited evidence.
Open the checkerWhere does Black Cohosh fit in your stack?
Answer two questions and get a stack graded on research — every ingredient scored on the evidence behind it, not the marketing.
Build my stack2 questions · free · no account needed to start
Also on iPhone — get the free app
Evidence-based supplement guides, no spam
We send a short digest when new guides drop — nothing else. No affiliate pushes, no sponsored content, unsubscribe anytime.
Medical disclaimer. This page is educational and does not replace advice from a qualified healthcare provider. Individual needs and risks vary — consult a professional before starting, stopping, or combining supplements, especially if you are pregnant or nursing, taking medication, or managing a health condition.