Black cohosh - also known as Cimicifuga racemosa, Black snakeroot, Bugbane, Macrotys or Squaw root - is a traditional herbal medicine product used for the relief of symptoms associated with the menopause. These include hot flushes, night sweats, poor sleep, mood changes and irritability.
It is a popular herbal ingredient in the UK.
Black cohosh is registered with the UK medicines regulator MHRA under the Traditional Herbal Registration (THR) scheme. This does not mean the regulator has tested products which contain it to prove it works or that claims about it have been verified by clinical studies. However, it does mean black cohosh has been confirmed as being used as a traditional medicine for at least 30 years - and 15 years in the EU. Registration also confirms that the manufacturer of product is meeting established standards of safety and quality.
Some studies have found evidence that black cohosh does help with menopause symptoms. However, many experts consider the evidence unclear and say that we need more research.
Black cohosh warnings
Women using black cohosh are warned to ensure they use effective contraception while taking it. It should not be taken by women who are breastfeeding or attempting to get pregnant.
If menopause symptoms do not improve after three months, they should consult a doctor. It should not be taken by anyone with a sensitivity to black cohosh, women with an oestrogen dependent tumour or anyone with current or past liver disease.
In autumn 2012, the MHRA issued a reminder about the risk of liver problems following a case of liver failure resulting in a liver transplant suspected to have been caused by a herbal product containing black cohosh.
The MHRA recommends always reading the patient information to check for the correct way to take any medicine, supplement or herbal product. The leaflet should also list potential side effects as well as any possible interactions with other medication.
Anyone experiencing signs of liver problems - including jaundice, dark urine or fatigue - while taking black cohosh should stop taking it immediately and seek medical advice.