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Black Cohosh Dosage for Hot Flashes

author image Charlotte Waterworth
Based in London, Charlotte Waterworth has been writing about health since 2000. Her work has appeared in trade magazines, including "Independent Community Pharmacist," "Pharmafocus," "Current Drug Discovery" and "Hospital Healthcare Europe." She is a member of the European Medical Writers Association. She holds an honors Bachelor of Science in biochemistry and a doctoral degree in gene therapy, both from Cardiff University.
Black Cohosh Dosage for Hot Flashes
Middle-aged woman drinking tea Photo Credit Wavebreakmedia Ltd/Wavebreak Media/Getty Images

Hot flashes are characterized by a feeling of intense heat in the face of body, a rapid heartbeat and perspiration. They commonly affect women going through the menopause. Although uncomfortable, hot flashes do not require treatment unless they are interfering with your life. If you find hot flashes distressing, your doctor may prescribe treatments including hormone therapy and antidepressants. Black cohosh is sometimes used as an alternative remedy for hot flashes, although evidence to prove that it is effective is mixed. Talk to your doctor before taking this herb.

Properties and Potential Benefits

Also known as Cimicifuga racemosa, black cohosh is used as an alternative remedy for a number of ailments including premenstrual syndrome, painful menstruation and menopausal symptoms, like hot flashes. It may work in a similar manner to the hormone estrogen, and according to the University of Maryland Medical Center, might provide the benefits of hormone therapy without the negative effects. However, the Memorial Sloan-Kettering Cancer Center states that evidence to show it has oestrogen like effects is mixed.


Black cohosh is available as a tea and as a liquid tincture although it is usually supplied in capsules or tablets. The University of Maryland Medical Center notes that 20 mg taken twice daily is sometimes used to alleviate hot flashes. However, this is only a general guideline. Check with your doctor, pharmacist or a qualified herbalist if this dose is suitable for you.


Evidence to show that black cohosh is an effective treatment for hot flashes is mixed. The results of a small clinical study published in 2004 in "Cancer Investigation" found that black cohosh reduced weekly hot flash frequency by 56 percent. In contrast, an analysis of data from clinical studies, published in 2009 in "Drugs and Aging" concludes that the benefits of black cohosh in the management of hot flashes remains to be proven.

Safety Considerations

Black cohosh use has been linked with several cases of liver disease, although evidence is lacking to prove this herb was responsible. Nevertheless, people with kidney disease should not use this herb. In addition, the Memorial Sloan-Kettering Cancer Center advises using this herb only under medical supervision. Common side effects include gastrointestinal upset, nausea, dizziness and rashes. It might also interact with other drugs you may be taking including tamoxifen and chemotherapeutic drugs.

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