Black Cohosh – Cimicifuga racemosa

Breast Health

  • For preventing breast cancer – Black Cohosh may have anti-estrogenic properties and prevent the development of breast cancer. More studies are needed on this. Int J Cancer. 2007;120:1523-1528
  • Breast Cells – there have been concerns about the effect Black Cohosh might have on women’s breast cells. This six month study, using an alcohol extract of Black Cohosh, showed no adverse effects on breast or endometrial tissue. Menopause. 2007 Jan-Feb;14(1):8-96
  • With Breast Cancer Treatment – when used in women suffering from hot flashes due to treatment with tamoxifen, in pre-menopausal breast cancer survivors, women experienced significant reduction in hot flashes. Maturitas 2003 Mar 14;44 Suppl 1:S59-65.

Drug / Herb Interactions & Safety

  • Effect on the liver – in a 12 month study of women taking Black Cohosh, with no preexisting liver conditions, no liver issues were reported Fertil Steril. 2009 Nov;92(5):1780-2.
  • Compared to Conventional – an alcohol extract of Black Cohosh was compared to the hormone drug tibolone. Black Cohosh was as effective and was more safe than the drug. Maturitas 2007 Sep 20;58(1):31-41.
  • in a comparison with the drug fluoxetine, postmenopausal women experienced improvement of hot flashes and night sweats, but didn’t find it helped with mood improvement. Adv Ther 2007 Mar-Apr;24(2):448-61.
  • compared to hormone replacement, Black Cohosh stimulated the activity of osteoblasts and had weak estrogen activity. The hormone replacement inhibited the activity of osteoclasts and had strong estrogen effects on vaginal tissue. This demonstrates that it may have valuable benefit for bone integrity, but without the adverse affects that are commonly a concern with hormone replacement. Menopause 2006 Mar-Apr;13(2):185-96
  • compared with estradiol, Black Cohosh was just as effective for menopausal symptoms. There were differences in the effect on lipids, with Black Cohosh increasing HDL and lowering LDL. Gynecol Endocrinol. 2005 Jan;20(1):30-5.
  • No Cell Proliferation – using a special extract of Black Cohosh (BNO 1055) a group of women were studied for one year. Of note was no proliferation of endometrial cells and few side effects. It was also effective for menopausal symptoms. Menopause. 2006 Jul-Aug;13(4):678-91.
  • Effects on Pathways of Metabolism – in this study there was no clinical affect on the CYP3A pathway. J Clin Pharmacol. 2006 Feb;46(2):201-13.
    Weakly inhibited CYP2D6. Clin Pharmacol Ther 2005 May;77(5):415-26.
  • Digoxin – showed no interference with digoxin. Drug Metab Dispos. 2006 Jan;34(1):69-74.
  • Cardiovascular effects – in a study on menopausal women there were no adverse cardiovascular risks associated with taking Black Cohosh and soy isoflavones. Fertil Steril 2007 Apr;87(4):849-57
  • Side Effects – demonstrated a reduction in hot flashes with few side effects. in fact no patents stopped treatment due to side effects. Cancer Invest 2004;22(4):515-21.


  • Infertility of unknown cause – in combination with clomiphene citrate, Black Cohosh was beneficial for increasing pregnancy rate for couples with unexplained infertility. Reprod Biomed, Online 2008 Apr;16(4):580-8.


  • Symptoms of menopause – many studies show that Black Cohosh is effective for menopausal symptoms, including hot flashes. Gynecol Endocrinol. 2009 Jan;25(1):21-6.
  • a dry extract of Black Cohosh demonstrated benefits for menopausal symptoms. Ginekol Pol 2006 Sep;77(9):678-83.
  • alcohol extract of Black Cohosh was found to be effective in hot flashes, sweating, insomnia, and anxiety. Adv Ther 2005 Mar-Apr;22(2):148-54.
  • Black Cohosh & St John’s Wort – effective for menopausal symptoms, and more effective together where there were mood symptoms. Maturitas 2007 Aug 20;57(4):405-14.
  • the combination showed improvement and possible benefits in lipid profiles. Yonsei Med J. 2007 Apr 30;48(2):28-94
  • significant improvement and was much better than placebo. Obstet Gynecol 2006 Feb;107(2 Pt 1):247-55.
  • Stages of Menopause – women who used Black Cohosh in the earlier stages of menopause had better benefits than women who used it in later stages. Obstet Gynecol 2005 May;105(5 Pt 1):1074-83.