How much black cohosh for night sweats

In liquid or tincture form, some studies showed menopause symptom relief with 40 drops of the herb mixture taken orally one or twice daily for up to 24 weeks. Limited studies have shown that certain doses of black cohosh may be more effective than others at treating individual menopause symptoms. Additional potential dosing recommendations include:. As black cohosh preparations are not regulated by the FDA, there is also a chance that products may contain other botanical or chemical ingredients that could cause harm.

Because of these uncertainties, the North American Menopause Society do not recommend the use of the herb for the treatment of menopause symptoms.

Most health authorities and studies suggest that if black cohosh is used, it should only be taken for a maximum of one year. Though rare, liver injury is the most studied, and potentially the most dangerous, complication associated with black cohosh use.

Those with signs of jaundice or liver failure should immediately see a doctor. If the signs are severe, they should seek emergency care. Many additional health complications of varying severity have been connected with the use of the black cohosh. As the herb acts as a blood thinner, bleeding and blood pressure disturbances may occur with use. A doctor should assess symptoms that involve bleeding or become severe.

Certain people may be at a higher risk of complications if using black cohosh. Those on estrogen or hormone therapies may not be able to take it safely. In many classes of medications, there are ones that increase the risk of complications and interaction when used alongside black cohosh. These classes include:. Some people are allergic to black cohosh and its components.

The herb may also contain small levels of salicylic acid, the active component in aspirin. People with aspirin intolerance or allergies should avoid it. Black cohosh may also interact negatively with other herbs or traditional remedies.

Supplements used to treat conditions, such as those considered risk factors for black cohosh use, might also raise the chance of side effects when used alongside this herb. Depression is more common during menopause, but it is unclear if menopause directly causes it.

Learn more about menopause and depression. Fatigue is a common experience in perimenopause and postmenopause, and can range from mild to severe. Learn more about menopause fatigue. Menopause can cause symptoms such as hot flashes and night sweats, which make sleep more difficult.

Learn more about menopause and insomnia. Menopause is a time of transition. The studies were highly heterogeneous with respect to such factors as design, duration, type and amount of black cohosh used, and main findings. A systematic review and meta-analysis of randomized clinical trials examined four studies of herbal and plant-based therapies that included black cohosh three of which were examined in the Cochrane review described above to treat menopausal symptoms [ 20 ].

The trials randomized a total of women to a daily dose of various formulations of 6. There were no significant associations between supplementation with black cohosh and reduction in the number of vasomotor symptoms, such as hot flashes. Furthermore, there were no beneficial associations between black cohosh use and relief of menopausal symptoms using self-reported rating scales.

The American College of Obstetricians and Gynecologists, in its clinical guidelines for managing menopausal symptoms, concluded that "data do not show that" herbal dietary supplements like black cohosh "are efficacious for the treatment of vasomotor symptoms" [ 21 ]. The North American Menopause Society advises clinicians against recommending herbal therapies such as black cohosh because "they are unlikely to be beneficial" italics in original in alleviating vasomotor symptoms [ 15 ].

Its authors recommended that researchers conduct higher-quality trials with larger samples and provide more details about their experimental protocols. Others have recommended that researchers should completely and comprehensively describe the black cohosh preparation they used so that other researchers could use the same or similar products [ 22 ]. Clinical trials using various black cohosh preparations to treat menopausal symptoms have shown that its use is associated with a low incidence of adverse effects.

The most commonly reported side effects are gastrointestinal upset and rashes, both of which are mild and transient [ 1 , 24 ]. Most studies have examined black cohosh use for short periods, typically 6 months or less, so no published studies have assessed the long-term safety of black cohosh in humans. Across the world, reports have described at least 83 cases of liver damage—including hepatitis, liver failure, elevated liver enzymes, and assorted other liver injuries—associated with black cohosh use [ 1 , 25 ].

However, there is no evidence of a causal relationship. It is possible that at least some reported cases of hepatotoxicity were due to impurities, adulterants, or incorrect Acteae species in the black cohosh products used. However, no one independently analyzed these products to confirm the existence of these problems [ 3 , ]. In , the Australian Department of Health began requiring that products containing black cohosh carry the following label statement: "Warning: Black cohosh may harm the liver in some individuals.

Use under the supervision of a healthcare professional" [ 29 ]. In , the U. Pharmacopeia a nonprofit standard-setting organization for foods and drugs recommended labeling black cohosh products with the following cautionary statement: "Discontinue use and consult a healthcare practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice" [ 30 ]. However, the U. Food and Drug Administration does not require such a warning on black cohosh product labels.

The American Herbal Products Association recommends that pregnant women not take black cohosh except under the supervision of their healthcare provider because studies have not rigorously evaluated its use during pregnancy [ 1 ]. The U. Pharmacopeia advises that individuals with liver disorders should also avoid black cohosh [ 30 ]. It adds that users who develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice, while taking the supplement should discontinue use and contact their doctor.

Black cohosh is not known to have any clinically relevant interactions with medications, although this has not been systematically studied [ 1 ]. This fact sheet by the Office of Dietary Supplements ODS provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc.

Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. Updated: June 3, History of changes to this fact sheet.

Find ODS on:. Strengthening Knowledge and Understanding of Dietary Supplements. Health Information Health Information. American Herbal Products Association's botanical safety handbook. Second ed. Gafner S. Black cohosh laboratory guidance document. Black cohosh: considerations of safety and benefit. Nutr Today ; Bring along a notepad or device to jot down information you receive. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

This content does not have an English version. This content does not have an Arabic version. Diagnosis Your doctor can usually diagnose hot flashes based on a description of your symptoms. Treatment The most effective way to relieve the discomfort of hot flashes is to take estrogen, but taking this hormone carries risks.

More Information Paced breathing: Help with hot flashes? Request an Appointment at Mayo Clinic. More Information Hot flashes: Manage without medication? Share on: Facebook Twitter. Show references AskMayoExpert. Hot flashes adult. Mayo Clinic; Santen RJ, et al. Menopausal hot flashes.

Accessed Feb. American College of Obstetricians and Gynecologists. Practice Bulletin No. Reaffirmed Lobo RA, et al. Menopause and care of the mature woman. In: Comprehensive Gynecology. Elsevier; North American Menopause Society. Nonhormonal management of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Hickey M, et al. Non-hormonal treatments for menopausal symptoms.