There is conflicting evidence regarding the use of this herb for effective management of menopausal symptoms or for any of its other claimed uses.
Long-term side effects of this product beyond 6 months of use are unknown.
When taken by mouth, black cohosh may cause breast tenderness, dizziness, headache, irritability, rash, unusual tiredness, or upset stomach. Rarely reported side effect of black cohosh includes abnormal growth of the uterus lining (endometrial hyperplasia) and liver damage.
Black cohosh can interact with some medications. When taken with a cholesterol medication called atorvastatin, it may increase liver enzyme levels. It may also reduce the efficacy of a cisplatin, a medication commonly used to treat cancers.
Black cohosh may reduce the rate at which the liver breaks down certain medications which can increase the risk of liver damage. If you are taking any medications or herbal products, talk to your health care provider before using black cohosh.
If you have a liver disorder, speak to your health care provider before using this product. If you develop symptoms of liver problems (e.g., abdominal pain, dark urine, jaundice), immediately stop use of this product and seek medical help from a health care provider. There have been reports of liver failure and hepatitis in women using this herb.
Black cohosh is also not recommended for people who:
- are breast-feeding
- are pregnant
- have a history of hormone-related cancers or conditions such as breast cancer, ovarian cancer, or uterine cancer
Black cohosh should not be confused with blue cohosh (Caulophyllum thalictroides). The use and side effects of blue cohosh are different than those of black cohosh.
Before taking any new medications, including natural health products, speak to your physician, pharmacist, or other health care provider. Tell your health care provider about any natural health products you may be taking.