Written by Jianping Liu, Xun Li and the CAM-Cancer Consortium.
Updated August 14, 2009

Black cohosh

Abstract and key points

  • Black cohosh (Actaea racemosa) is a medicinal herb.
  • Evidence from three randomised clinical trials is not sufficient to support the use of black cohosh extracts for treatment of hot flushes in breast cancer patients undergoing chemotherapy or receiving tamoxifen.
  • Black cohosh appears to be relatively safe; but pre-existing liver damage is a contraindication.

Black cohosh (Actaea racemosa, synonym: Cimicifuga racemosa) is a medicinal herb traditionally used by native American Indians for menstrual, menopausal, and other conditions. In Germany, there is a pattern of traditional use for climacteric symptoms. Extracts of black cohosh have been recommended as an alternative to hormone replacement therapy for treatment of hot flushes in menopausal women.

Current evidence from three randomised clinical trials is not sufficient to support the use of black cohosh extracts for treatment of hot flushes in breast cancer patients undergoing chemotherapy or receiving tamoxifen. Black cohosh extracts do not work better than placebo; only one methodologically limited study showed a better improvement with black cohosh when used in combination with tamoxifen.

Reviews of preclinical and clinical studies suggest black cohosh to be relatively safe; but pre-existing liver damage is a contraindication.

Citation Jianping Liu, Xun Li, CAM-Cancer Consortium. Black cohosh [online document]. http://www.cam-cancer.org/CAM-Summaries/Biologically-Based-Practices/Black-cohosh. August 14, 2009.

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