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Black cohosh and weight: does it cause weight gain or help control it?
Black cohosh and weight: does it cause weight gain or help control it?
Last review: May 2026
Many women who start taking black cohosh for menopausal symptoms face a common concern: is the weight gain they notice caused by the supplement? The question is legitimate, and the research provides a clear answer — but it is worth understanding why.
The short answer: black cohosh does not cause weight gain. The issue is that it tends to be started precisely when the female body undergoes compositional changes due to reasons entirely unrelated to supplements.
Table of contents:
- What clinical research says
- Why menopause causes weight gain — and black cohosh does not
- Animal studies: black cohosh and body composition
- The real side effects of black cohosh
- How to choose the right supplement during menopause
- Frequently Asked Questions
What clinical research says about weight gain
The question "does black cohosh cause weight gain?" was directly addressed in a 2021 systematic review published in Climacteric, the journal of the International Menopause Society. Researchers analysed 31 clinical trials — 17 of which were double-blind placebo-controlled — covering a total of 1,839 women treated with Cimicifuga racemosa extract for up to 12 months. Result: no scientific evidence that black cohosh causes weight gain in menopausal women.
Only two of the 31 studies reported body weight as an adverse event. In both cases, there was no significant difference compared to the placebo group — meaning women who took nothing showed similar weight variations. One isolated case of a roughly 2 kg increase had been noted, but the authors did not even specify which group the patient belonged to.
In pharmacovigilance databases, 30 cases of weight gain associated with black cohosh were spontaneously reported over 15 years. In none of these cases was causality considered certain or probable. Only one case was evaluated as "possible" — and it came from a patient self-report, not a physician.
In practical terms: across nearly 2,000 women followed in controlled trials, black cohosh showed no measurable effect on body weight compared to placebo.
Why menopause causes weight gain — and black cohosh does not
The real problem is the timing coincidence. Women start taking black cohosh exactly when they enter perimenopause or menopause — and menopause, independent of any supplement, is associated with a change in body composition.
When oestrogen levels drop, the body redistributes fat: less in the thighs and hips, more in the abdomen. Basal metabolism slows down. Insulin sensitivity may worsen. All this happens because oestrogens directly influence adipocyte activity, leptin receptors, and glucose metabolism.
The practical consequence is that a woman can gain 2–4 kg in the first years of menopause without changing anything in her diet or physical activity. If she also starts taking black cohosh during that period, it is natural to associate it with the weight change. But there is no causal link.
This is the same mechanism by which some women associate other harmless supplements or medications with weight gain during menopause: the timing is misleading.
Read also: How to lose weight during menopause | Cortisol during menopause: managing stress
Animal studies: black cohosh and body composition
The picture shifts further when looking at studies on animal models of surgical menopause (ovariectomised rats — OVX). These models are used precisely because they replicate post-menopausal oestrogenic deficiency.
In a study published in Maturitas in 2008, OVX rats treated with CR BNO 1055 extract gained less weight and accumulated significantly less intra-abdominal fat than untreated controls. Fasting insulin levels were also lower. At the same time, the extract had no effect on the uterus — a sign that the mechanism does not operate through classic oestrogen receptors.
A more recent study (Sun et al., 2016, Rejuvenation Research) followed OVX rats for 3 months with isopropanolic black cohosh extract. At the end of treatment, the black cohosh group showed significant reductions in: body weight, abdominal fat mass, serum triglycerides, hepatic fat accumulation, and adipocyte size. Moreover, insulin resistance and glucose intolerance — two typical problems of menopause — improved in the black cohosh group but not in the oestrogen group.
Note: these are animal studies. They cannot be directly extrapolated to humans. But they indicate that black cohosh does not have a pro-adipogenic action — on the contrary, the data point in the opposite direction, probably through effects on adipocyte lipolysis.
The real side effects of black cohosh
Black cohosh has documented side effects, but weight gain is not among those supported by clinical evidence. What can happen in some cases?
- Mild gastrointestinal disturbances: nausea, stomach heaviness, especially in the first weeks
- Headache: reported in a minority of cases in trials
- Mastalgia: temporary breast tenderness
- Dizziness: rare and generally mild
The most debated topic in recent years has been hepatotoxicity. Isolated cases of liver damage associated with black cohosh have been reported, but a direct causal link has never been conclusively established. As a precaution, it is recommended not to exceed the indicated doses (equivalent to 40–80 mg of dry herb per day) and to discontinue use in case of symptoms such as jaundice, dark urine, or upper abdominal pain.
For those with pre-existing liver conditions, it is always advisable to consult a doctor before starting.
Read also: What is black cohosh and what are its benefits for women?
How to choose the right supplement during menopause
Black cohosh is most effective for vasomotor symptoms — hot flushes, night sweats — and for sleep disturbances and mood changes associated with menopause. On bones it has a positive effect on bone formation, but it is not a substitute for specific treatment for osteoporosis.
For weight management during menopause, black cohosh is not the primary ingredient to consider. More relevant are isoflavones (which modulate oestrogenic metabolism), moringa (which supports glucose metabolism and reduces inflammatory markers), and a lifestyle including resistance exercise, which is the only intervention with solid evidence for countering the reduction of muscle mass during menopause.
A supplement specifically formulated for menopause — combining multiple synergistic ingredients — can be more useful than a single extract.
Menopause Supplement for Hot Flushes and Weight by RedMoringa — isoflavones, moringa and metabolic support in a single formula designed for women going through menopause.
Menopause Hot Flushes Relief by RedMoringa — concentrated formula with isoflavones and moringa for women with more intense vasomotor symptoms.
Frequently Asked Questions about black cohosh and weight
Does black cohosh cause weight gain?
No, black cohosh does not cause weight gain. A 2021 systematic review (Climacteric) analysed 31 clinical studies on 1,839 women treated for up to 12 months: there is no evidence that Cimicifuga racemosa extract causes significant weight changes compared to placebo. The weight gain some women notice while taking it is attributable to menopause itself, not the supplement.
Why do women gain weight during menopause?
Weight gain during menopause is caused by the reduction in oestrogens, which alters the distribution of body fat (more abdominal, less peripheral), slows basal metabolism, and can worsen insulin sensitivity. These changes occur independently of supplement use. Black cohosh is often started precisely during this period, which creates a false causal association with weight.
What are the side effects of black cohosh?
The most common side effects of black cohosh are mild gastrointestinal disturbances (nausea, stomach heaviness), headache, breast tenderness, and occasionally dizziness. These are generally transient and resolve in the first weeks. The hepatotoxicity topic has been discussed in the literature without a causal link being established: it is recommended not to exceed the suggested doses (40–80 mg dry herb/day) and to stop if liver symptoms appear. Body weight does not feature among side effects supported by controlled clinical evidence.
Can black cohosh actually help with weight loss during menopause?
Animal studies indicate that black cohosh extract can reduce abdominal fat accumulation and improve insulin sensitivity in surgical menopause models. These effects have not been confirmed in controlled human trials, so it is premature to consider it a weight-loss supplement. That said, it does not appear to increase weight — and may have favourable metabolic effects that remain to be quantified in humans.
How long can black cohosh be taken?
Most clinical studies have evaluated treatment periods of up to 12 months without relevant safety issues. Some guidelines recommend 6-month cycles with reassessment. For longer use it is advisable to agree this with your doctor, especially in the presence of liver conditions or concurrent use of other hormonal medications.
Black cohosh or isoflavones: which to choose for menopause?
They have different targets. Black cohosh acts mainly on vasomotor symptoms (hot flushes, sweating) and mood via non-oestrogenic mechanisms. Soy and red clover isoflavones bind to oestrogen receptors with broader effects on metabolism and bones. For those wanting to address weight and metabolism as well, the combination isoflavones + moringa makes more sense than black cohosh alone. Many women benefit from combining them, but it is better to do so under medical supervision.
Black cohosh remains one of the menopause supplements with the largest number of clinical studies behind it. It does not cause weight gain — but it is not a weight remedy either. For those wanting to address menopause while also working on metabolism and body composition, choosing the right supplement requires a broader approach including isoflavones, glycaemic support, and an active lifestyle.
Read also: Soy isoflavones in menopause: hot flushes yes, bones no | Black cohosh: why it is valuable against menopausal symptoms
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