Detailed definition
Black cohosh is a North American flowering plant whose root has been used for menopausal symptoms for decades. Mechanism is not fully established and may not involve direct estrogen receptor binding. Multiple RCTs have produced mixed results: some show modest reductions in hot flash frequency vs. placebo, others show no benefit. NAMS does not endorse black cohosh as a recommended treatment but acknowledges that some women report benefit. Rare reports of hepatotoxicity have led to label warnings; baseline and monitoring liver function may be reasonable for women using it long-term. Quality of commercial products varies (the supplement market is unregulated), so standardized extracts from reputable manufacturers are preferred when used.
Why it matters in menopause
Black cohosh occupies a "may help, won't reliably hurt" niche for women who prefer supplements over prescriptions and have mild-to-moderate symptoms. For severe vasomotor symptoms, prescription options (HRT, fezolinetant, venlafaxine) have stronger evidence.
Related terms
Sources
External references: Wikipedia.