Identity & origin
BOTANICAL IDENTITY
The right name is the first step.
The results concern certain dry extracts used in adult women, not every preparation of the plant.
Also known as: Cimicifuga racemosa, Actaea racemosa, black cohosh
The botanical name, part and preparation must match. A photograph is not enough for identification intended for consumption.
An illustration is not enough to identify a plant for consumption. Do not forage for a species based solely on this profile.
Uses & evidence
UNDERSTANDING THE USES
Properties & uses.
Menopausal symptoms
Well-established use of certain extracts for hot flushes and excessive sweating.
EMA status applies only to the described preparation and indication, not every form of the plant.
Read the sourceThe traditional uses described are not clinical proof of effectiveness. Evidence for one preparation cannot automatically be applied to another.
Precautions before use
BEFORE ANY USE
Precautions & contraindications.
This guidance does not cover every individual situation. Missing information is not a guarantee of safety.
Contraindications & precautions
- Source-listed contraindicationFood supplements: ANSES advises against use with hormone-dependent cancer or liver/biliary disease.Source
- PrecautionStop and seek prompt care for jaundice, dark urine, appetite loss, unusual fatigue or upper abdominal pain with nausea/vomiting.Source
Medicine interactions
- Possible interactionANSES warns about interactions with oestrogen/progestogen therapies and anti-oestrogens, including tamoxifen. Prescriber review is needed; do not present every product interaction as certain.Source
Other retained warnings · review incomplete
These existing warnings remain relevant to consult. Their exhaustive reassessment is outside this targeted review.
Restrictions and precautions
- Supplements: hormone-dependent cancer or liver/biliary disease.
Medicine interactions
- Have hormonal treatments and antiestrogens, including tamoxifen, checked.
Pregnancy, breastfeeding and children
Pregnancy and breastfeeding: avoid. Women who may be pregnant: medical approval is essential.
For adult women only; no paediatric use.
“Reported” does not prove causality; “possible” may reflect indirect evidence. “None reported” means none in the cited source, not that all combinations have been studied. Do not stop a prescribed treatment based on this profile.
Adverse effects
- Liver injury, allergic skin reactions, swelling and digestive symptoms reported; frequency unknown.
Pregnancy & breastfeeding
Food supplements: pregnancy/breastfeeding contraindicated according to ANSES. Women who could become pregnant should avoid these supplements and have hormonal medicines reviewed.
SourceChildren & adolescents
No paediatric indication: the preparations concern adult women.
SourceIf symptoms persist, worsen or are unusual, consult a healthcare professional. In an emergency, contact the emergency services.
Forms & how they are used
DOCUMENTED FORMS
One plant, several preparations.
Only forms documented in this profile’s sources are presented.
Dry extractRhizome · Route: oral
Medicine containing a precisely identified extract.
Please note: Do not use the root in homemade preparations.
Read the sourceUnderstanding the plant’s actions
EXPLORE THE EVIDENCE
How does the plant act?
Certain black cohosh rhizome extracts have well-established medicinal use for menopausal symptoms, including hot flashes and sweating. This does not justify calling the plant a natural estrogen. The European report explains that neither the exact mechanism nor the constituents responsible for clinical improvement have been conclusively determined.
Menopausal symptoms
The indication concerns defined extracts; it does not extend to every powder, herbal tea or combination sold for “hormonal comfort”.
EMA status applies only to the described preparation and indication, not every form of the plant.
Read the referenceNeural pathways studied
Serotonergic and dopaminergic effects have been observed in the laboratory and partly in animals. These remain possible explanations, without a complete demonstration of the mechanism in women.
Laboratory or animal observation. A human benefit cannot be inferred from this finding alone.
Read the referenceEstrogenic hypothesis
The initial observations of receptor binding are not consistently confirmed by the more recent data examined in the report.
The references do not establish a benefit. Lack of evidence is not assurance of safety.
Read the referenceWhat this means for preparation.
Compare the definition of the extract with that of the documented medicine. Unexplained bleeding or liver symptoms should lead to an assessment, not self-directed adjustment.
Studies, findings & limitations
THE RESEARCH
What the research shows.
A laboratory or animal result alone does not demonstrate a benefit in humans. Each result must be read alongside the preparation studied and its limitations.
Observed efficacy, mechanism still uncertain
EMA status applies only to the described preparation and indication, not every form of the plant.
- Type of research
- EMA assessment of rhizome preparations.
- Preparation concerned
- Specific extracts, distinguished by solvent and manufacturing process.
- Observed results
- A benefit for the specified symptoms can be recognized without identifying a single active ingredient.
- Limitations to consider
- The results do not validate treatment of osteoporosis, cancer prevention or equivalence to hormone therapy.
What can we take from this?
Experimental studies on hormone-dependent tissues are inconsistent; they do not prove safety in all people with a history of cancer. Liver precautions remain essential.
Documentary review dated 09/10/2026. The references remain available to check the context.
Sources & last review
CHECKING REFERENCES
Sources for this profile.
- EMA — Cimicifugae rhizoma: official dossierAccessed on 09/10/2026
- ANSES — precautions for plants in food supplements, June 2023 summaryAccessed on 09/10/2026
- EMA — Assessment report on Cimicifuga racemosa (L.) Nutt. (rhizome)Accessed on 09/10/2026
Image: H. Zell · CC BY-SA 3.0. View the original image and its licence. Image resized and converted to WebP.
