Black cohosh and menopause
What 4 graded rows on black cohosh agree on for menopause, and where they differ. Counted side by side, never averaged.
Consensus finder Rows from the Black cohosh page, reviewed Oct 21, 2026 How it decides
What the rows agree on
Each block and row is one graded row from the Black cohosh page, with its PubMed record.
Your question
Black cohosh and menopause
4 rows · 4,777 peopleMostly no difference: 3 of 4 rows, and most of the people. 1 found an improvement.
- CGrade C× 1
- ∅No effect× 3
- Rows
- 4
- Trials
- 40
- People
- 4,777
- Pooled reviews may count some twice
Where they differ
From the rowsThe best-graded row, grade C, is a meta-analysis of 2,310 people (2023) and found an improvement. 3 rows are graded No effect, our grade for adequately powered trials that found no effect.
The row that found an improvement was larger: 2,310 people, against a median of 351 people for the 3 rows that found no difference.
The row that found an improvement is newer (2023) than the 3 rows that found no difference (2006 to 2012).
The rows
1 improved · 3 no difference- ∅No effectHot flash frequency and menopausal symptom scores · No difference
Systematic review, 16 studies · n 2,027 · 2012 · Perimenopausal and postmenopausal women in 16 RCTs
Median 40 mg/day (8–160 mg/day) · Mean 23 weeks
No difference vs placebo in daily hot flushes (MD 0.07 per day; 3 trials, 393 women) or symptom scores (4 trials, 357 women). Hormone therapy did better than black cohosh. Authors found insufficient evidence to support or oppose use.
Row on the Black cohosh page · PubMed 22972105 (opens PubMed)
- ∅No effectHot flashes and night sweats · No difference
RCT · n 351 · 2006 · Women aged 45–55 with 2 or more hot flashes or night sweats a day (Washington State)
160 mg/day · 12 months
Hot flashes and night sweats per day and their intensity did not differ from placebo at 3, 6 or 12 months; hormone therapy cut about 4 symptoms per day vs placebo.
Row on the Black cohosh page · PubMed 17179056 (opens PubMed)
- ∅No effectHot flashes and night sweats · No difference
RCT · n 89 · 2009 · Perimenopausal and postmenopausal women with 35 or more hot flashes and night sweats a week
128 mg/day · 12 months
Symptoms fell in all groups, but black cohosh and red clover did not differ from placebo; symptom intensity was worse with black cohosh at 6 and 9 months.
Row on the Black cohosh page · PubMed 19609225 (opens PubMed)
- CGrade COverall menopausal symptoms and hot flashes (extracts alone or combined) · Improved
Meta-analysis, 22 studies · n 2,310 · 2023 · Menopausal women in 22 randomized trial reports
Not stated in the abstract · Not stated in the abstract
Overall menopausal symptoms (Hedges' g 0.575), hot flashes (g 0.315) and somatic symptoms (g 0.418) improved versus placebo; anxiety and depressive symptoms did not. Dropout rates were similar to placebo.
Row on the Black cohosh page · PubMed 37192826 (opens PubMed)