Black Cohosh
Black cohosh root extract for menopausal symptoms and secondary mood support, via a serotonergic mechanism.
Pharmacology
Contents
WHAT IS BLACK COHOSH?
Detailed overview
Black cohosh (Cimicifuga racemosa, also called Actaea racemosa) is a rhizome extract from a North American herb used mainly for menopausal symptoms such as hot flashes, night sweats and mood swings. Contrary to the old assumption, it is not a meaningful estrogen receptor agonist: current research suggests it acts through central nervous system serotonergic, dopaminergic and opioid signaling that influence thermoregulation and mood. It has been studied in numerous randomized controlled trials, though results are mixed. In several European countries it is registered as a traditional herbal medicine (e.g. Remifemin), while in the US it is sold as a dietary supplement. Its mood effect is secondary, arising from relief of menopausal symptoms.
Mechanism
Serotonergic / dopaminergic (not estrogenic)
Evidence
Multiple human RCTs, mixed results
Legal status
EU: medicine; US: dietary supplement
Receptor profile
- Serotonin receptors (5-HT1A / 5-HT7)Moderate
- Dopaminergic signalingWeak
- Estrogen receptors (no meaningful agonism)Weak
- Opioid (μ) signalingWeak
Safety
Side effects, stop signs, contraindications
Side effects · 5
- Mild stomach upset, nausea, digestive discomfort
- Headache and dizziness, usually transient
- Skin rash or allergic skin reaction, rarely
- Rare case reports of liver injury (causation unproven)
- Weight change and breast tenderness in some studies
Contraindications · 4
- Pregnancy and breastfeeding: safety not established, avoid
- Pre-existing liver disease or abnormal liver enzymes: avoid due to rare hepatotoxicity signals
- Estrogen-sensitive cancers (breast, uterus): medical consultation required given uncertain hormonal effect
- Concurrent hepatotoxic drugs: increased liver monitoring is warranted
Related Nootropics
Same therapeutic category
Studies
Related research and clinical findings
Assessing the combined effects of Black Cohosh, Soy Isoflavones, and SDG Lignans on menopausal symptoms: a randomized, double-blind, placebo-controlled clinical trial
Cimicifuga racemosa extract for relieving menopausal symptoms: a randomized controlled trial
Effect of cimicifuga racemosa on menopausal syndrome caused by LHRH-a in breast cancer
Botanical and dietary supplements for mood and anxiety in menopausal women
Complementary therapies for management of menopausal symptoms: a systematic review to inform the update of the International Menopause Society recommendations on women's midlife health
FAQ
FAQ
Black cohosh root extract for menopausal symptoms and secondary mood support, via a serotonergic mechanism.
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Structure & chemistry
The information here is strictly for educational and scientific purposes. It does not replace medical advice or clinical consultation, and it does not encourage illegal substance or pharmaceutical use. Data is sourced. When in doubt, consult your doctor.