Actaea racemosa (formerly Cimicifuga racemosa). A North American root traditionally used for women’s complaints, now the most popular herbal remedy for hot flashes. Despite marketing, it is not a plant estrogen.
What the research supports
Very little. A 2012 Cochrane review of 16 randomized trials with 2,027 women found no significant difference from placebo in hot flash frequency, and the year-long HALT trial found the same. The Menopause Society does not recommend it for hot flashes. Some women report relief, which may partly reflect the strong placebo response hot flashes show.
The dose that was actually studied
Trials used standardized root extracts at widely varying doses, from about 40 mg a day to 160 mg a day in the year-long HALT trial. Studies lasted from a few weeks to 12 months.
What to look for on a label
- The root or rhizome named as the plant part
- The full Latin name, Actaea racemosa, because Asian Cimicifuga species have been substituted in some products
- A cautionary statement about liver risk, as recommended by the U.S. Pharmacopeia
- Third-party testing for identity and contamination
Who should not take it
- Anyone with liver disease, or who notices dark urine, yellow skin or eyes, or unusual fatigue while taking it
- Pregnant or breastfeeding women
- Women with a history of breast or other hormone-sensitive cancer, unless their oncologist approves
- Anyone on prescription medication without checking with a pharmacist first
Read the full guide: Black Cohosh for Hot Flashes: What the Menopause Research Really Shows.
This profile is for general education and is not medical advice. Talk to your doctor or pharmacist before starting a supplement, especially if you take medication or have a health condition.
