How does black cohosh work to relieve menopause symptoms?

Black cohosh's exact mechanism remains under investigation, though it is believed to act on serotonin receptors rather than estrogen receptors. Research suggests compounds like triterpene glycosides may modulate neurotransmitters involved in thermoregulation. Unlike phytoestrogens, it does not appear to stimulate breast tissue, making it distinct from hormonal therapies (Evidence Level: B).

Can black cohosh interact with medications or hormone therapy?

Black cohosh may interact with hormone-sensitive conditions and medications metabolized by the liver. It is contraindicated for patients with hormone-sensitive cancers or those taking CYP450 substrates due to potential liver enzyme interactions. Patients on anticoagulants or hormone replacement therapy should consult a physician before use (Evidence Level: C/D).

What is the recommended dosage for black cohosh extract?

The standard adult dosage for black cohosh is 20 to 40 mg of a standardized extract (containing triterpene glycosides) taken twice daily. Clinical studies often utilize specific extracts like Remifemin. Users should not exceed recommended durations without medical supervision, typically limiting use to six months (Evidence Level: B).

Is black cohosh safe to take during pregnancy or breastfeeding?

Black cohosh is considered unsafe during pregnancy because it can stimulate uterine contractions and induce labor. While traditionally used for this purpose near term, it should be avoided earlier in pregnancy to prevent miscarriage. It is also not recommended during breastfeeding due to insufficient safety data and potential toxicity to the infant (Evidence Level: C/D).

Is black cohosh effective for treating hot flashes and night sweats?

Clinical studies suggest black cohosh may reduce the frequency and severity of hot flashes and night sweats associated with menopause (Evidence Level: B). While results have been mixed, meta-analyses often show modest benefits compared to placebo. It is considered one of the most researched herbs for menopausal symptom management, though individual responses vary significantly.

Black Cohosh (Actaea racemosa)

Qu'est-ce qu'une interaction plante-médicament ?

Une interaction plante-médicament se produit lorsqu'une plante ou un complément modifie l'action d'un médicament dans votre organisme — en le rendant plus puissant, moins efficace, ou plus susceptible de provoquer des effets nocifs. Les plantes contiennent des composés actifs qui peuvent accélérer ou ralentir les enzymes et transporteurs utilisés pour métaboliser les médicaments.

Pourquoi c'est important

Millepertuis peut rendre la contraception, les antidépresseurs et les anticoagulants moins efficaces.

Ail peut augmenter le risque de saignement avec la warfarine et autres anticoagulants (aussi ginkgo, gingembre et curcuma).

Kava peut amplifier la sédation avec les médicaments contre l'anxiété ou le sommeil (aussi la valériane).

Le risque est plus élevé chez les personnes âgées, ceux qui prennent plusieurs médicaments et les personnes atteintes de maladies chroniques.

Indiquez toujours à votre médecin et à votre pharmacien toutes les plantes et compléments que vous prenez — et vérifiez ci-dessous avant toute association.

Interactions Médicamenteuses Connues (2)

2 Modéré

Médicament	Sévérité	Description
Tamoxifen	Modéré	L'ajoigneau peut interagir avec la tamoxifène en conditions hormonales sensibles.
Hepatotoxic medications (general)	Modéré	Le black cohosh a été associé à des cas rares de dommage hépatique. La combinaison avec d'autres médicaments hépatotoxiques peut augmenter le risque de lésion hépatique.

Cette liste reflète un sous-ensemble sélectionné d'interactions documentées et n'est pas exhaustive. L'absence d'un médicament ici ne prouve pas qu'il est sans danger à combiner. Confirmez toujours auprès d'un pharmacien ou d'un professionnel de santé.

Fiche d'information compilée à partir de PubMed

Cette fiche a été compilée à partir de résumés PubMed (NIH) avec l'assistance d'une IA. Chaque affirmation factuelle est citée par un article PubMed réel (voir la liste des sources). Elle n'a pas encore été révisée par un humain — confirmez auprès d'un professionnel de santé avant utilisation.

Compilé à partir de 25 articles PubMed · modèle : gemma4:31b

Résumé

Black cohosh (Actaea racemosa) is a North American botanical supplement primarily used to manage menopausal symptoms [PMID:29261886, PMID:31643322].

Contexte

Black cohosh, also known as Cimicifuga racemosa, is a perennial dicot of the Buttercup (Ranunculaceae) family native to the Eastern United States and Canada [PMID:29261886, PMID:33861455]. It is also referred to as baneberry, black snakeroot, bug root, and bugbane [PMID:29261886].

Usages traditionnels

Historically, it has been used by indigenous populations for rheumatoid muscular pain, headache, inflammation, dysmenorrhea, premenstrual syndrome (PMS), and menstrual pain and cramping [PMID:33861455, PMID:22504147]. It has also been used to promote labor [PMID:30000840].

Composés actifs

The rootstock contains triterpene glycosides (including actein, cimicifugoside, and 27-deoxyactein), isoferulic acid, and alkaloids such as n-methylcytisine [PMID:30000840, PMID:18592868].

Mécanisme d'action

While historically thought to have estrogenic activity, recent studies suggest it does not bind to estrogen receptors and lacks estrogenic effects on mammary cancer cells in vitro or uterine histology in rats [PMID:30000840, PMID:23459142]. Some research suggests it may act as an antinociceptive agent [PMID:22504147].

Preuves cliniques

Preuve AMenopausal symptoms (neurovegetative and psychological)

Isopropanolic extract (iCR) was significantly superior to placebo and comparable in efficacy to low-dose transdermal estradiol or tibolone, with a better benefit-risk profile than tibolone [PMID:33021111].

Preuve BMenopausal symptoms (combined therapy)

A combination of Black Cohosh, Soy Isoflavones, and SDG Lignans showed significant improvements in somatic, psychological, and urogenital domains compared to placebo [PMID:40131516].

Preuve CClimacteric complaints

The extract CR BNO 1055 reduced major climacteric complaints as effectively as conjugated estrogens and significantly more than placebo [PMID:23459142].

Preuve AHot flashes in breast cancer patients

Research assessing efficacy for the treatment of hot flashes in women with breast cancer is inconclusive [PMID:17602247].

Sécurité et effets indésirables

General adverse reactions are low in frequency but may include dizziness, nausea, headache, rash, vomiting, mastalgia, and weight gain [PMID:30000840, PMID:15898823]. Rare but severe reports of acute liver injury, hepatitis, and allergic reactions have occurred [PMID:30000840, PMID:31643322].

Grossesse et allaitement

Historically used by Native American women as a galactogogue, but there is no current data on safety and efficacy in nursing mothers or infants; some sources recommend against use during breastfeeding due to lack of safety data [PMID:30000840].

Interactions médicamenteuses

Black cohosh is reported to have a low likelihood of drug interactions and can generally be safely taken with most medications [PMID:28762712].

Posologie et administration

One review notes a current recommended dosage of 40-80 mg/day for certain extracts [PMID:15898823]. No PubMed data available. Consult a healthcare provider.

Synthèse des preuves

Evidence for the treatment of menopausal symptoms is supported by meta-analyses and RCTs, though some reviews describe findings as inconsistent or methodology as poor. Safety is generally high for short-term use, though rare hepatotoxicity is noted.

Sources PubMed

1.PMID: 28762712 (2017) — Common Herbal Dietary Supplement-Drug Interactions. · American family physician
2.PMID: 39477563 (2024) — Complementary and Alternative Medicine for Menopause. · The Nursing clinics of North America
3.PMID: 30000840 (2006) — Exploring the Efficacy and Safety of Black Cohosh (Cimicifuga racemosa) in Menopausal Symptom Management. · Journal of mid-life health
4.PMID: 31643322 (2012) — Botanicals and Their Bioactive Phytochemicals for Women's Health. · CITED REFERENCES
5.PMID: 29261886 (2026) — Black cohosh. · American family physician

Black Cohosh

Sources et citations

Dong Quai

Red Clover

Vitex

⚠️ Non recommandé pendant la grossesse ou l'allaitement

2 interactions médicamenteuses connues — Certaines peuvent être graves

Contre-indications

Effets secondaires possibles

Qu'est-ce qu'une interaction plante-médicament ?

Interactions Médicamenteuses Connues (2)

Résumé

Contexte

Usages traditionnels

Composés actifs

Mécanisme d'action

Preuves cliniques

Sécurité et effets indésirables

Grossesse et allaitement

Interactions médicamenteuses

Posologie et administration

Synthèse des preuves

Sources PubMed

Sources gouvernementales

Black Cohosh

Sources et citations

Plantes associées

Dong Quai

Red Clover

Vitex

⚠️ Non recommandé pendant la grossesse ou l'allaitement

2 interactions médicamenteuses connues — Certaines peuvent être graves

Contre-indications

Effets secondaires possibles

Qu'est-ce qu'une interaction plante-médicament ?

Interactions Médicamenteuses Connues (2)

Résumé

Contexte

Usages traditionnels

Composés actifs

Mécanisme d'action

Preuves cliniques

Sécurité et effets indésirables

Grossesse et allaitement

Interactions médicamenteuses

Posologie et administration

Synthèse des preuves

Sources PubMed

Sources gouvernementales