Mood swings are a common symptom of mental illness (especially bipolar disorder). Even though it’s just a symptom, mood swings can disrupt various aspects of daily life, from work to relationships. Therefore, it’s understandable many want to identify this symptom alone. With that, some have turned to black cohosh for mood swings.

Black cohosh is an all-natural supplement with several potential health benefits, including relief from menopausal symptoms and mood swings. While research is slim, we’ve identified black cohosh, what it can do for mood swings, and other important information.

What is Black Cohosh?

Black cohosh (Actaea racemosa or Cimicifuga racemosa) is a flowering plant of the buttercup family native to eastern North America. It can be found from the extreme south of Ontario to central Georgia, and west to Missouri and Arkansas. ¹

Black cohosh has been utilized in various cultures, especially Native American medicine. However, recent research has found black cohosh may help with:

• Heart palpitations
• Hot flashes (or hot flushes)
• Irritability
• Nervousness
• Night sweats
• Sleep disturbances
• Tinnitus
• Vaginal dryness

The whole root of the black cohosh plant is extracted, ground up, and utilized for over-the-counter supplements. That said, black cohosh is usually taken through tablets and extracts in tincture or powdered form.

How Does Black Cohosh Affect the Body?

Black cohosh has antiosteoporotic effects which enhance bone formation by promoting calcium and phosphate absorption. Due to these effects, black cohosh is commonly sought after for alleviating menstrual complications, such as cramping and hot flashes in menopausal women.

The chemicals within black cohosh’s root have been found to work on the body’s immune system. This allows them to fight against certain diseases, especially those that cause inflammation. ²

Furthermore, black cohosh is believed to have a similar effect to estrogen. Some research suggests it can increase and decrease estrogen in certain body areas. For this reason, it should NOT be taken as an estrogen supplement. ³

There’s also a belief that black cohosh might be helpful for those with diabetic pain and prostate cancer (as it may slow the growth of cancer cells). ⁴ Still, these claims need more scientific studies to confirm if these effects are substantial enough.

How Does Black Cohosh Affect the Brain?

Black cohosh may interact through neurotransmitters and inflammatory pathways. As a result, this could explain why those experiencing menstrual and menopausal symptoms find relief.

On top of this, some researchers believe black cohosh can act as an antioxidant. Therefore, it may be utilized as an inhibitor of serotonin pathways, explaining how it’s utilized for pain relief. ⁵

Black Cohosh for Mood Swings

While black cohosh is not a cure, it may limit symptoms of bipolar disorder and other mental health conditions, such as anxiety and depression. However, most available studies aren’t directly connected to mental illness. Rather, research seeks out symptoms of other conditions (i.e. menopause) and reveals how black cohosh may help with psychology.

For this reason, black cohosh may only be useful for those who struggle with mental health and physical conditions. Before you take black cohosh, you should consult your healthcare provider.

What Does the Research Say?

By and large, black cohosh has seen positive results in easing mood swings. Most studies involve menopausal women who experience a wide variety of symptoms and have seen overall relief from black cohosh.

For example, a study done by the Department of Obstetrics and Gynecology through the University of Illinois in Chicago looked into the impact of certain herbal supplements (including St. John’s Wort, kava kava, ginkgo, and black cohosh) on menopausal women. They found that St John’s Wort and black cohosh positively affected overall mood, sleep quality, and emotional well-being. ⁶

Black cohosh was more noteworthy as having a significant impact on mood swings and reducing anxiety. On the other hand, St. John’s Wort showed promise in alleviating depressive-related symptoms.

In a separate study, researchers sought to use black cohosh and evening primrose oil to reduce menopausal hot flashes. They found that black cohosh was more effective for hot flashes and improved participant’s quality of life. ⁷

Black Cohosh Dosage Recommendation

Black cohosh doses vary depending on the supplier, but most studies utilize between 20-40 milligrams, taken twice daily.

Still, since black cohosh comes in different forms, it’s best to take the suggested amount on a product’s label. Do not exceed the recommended dose as it could negatively impact health, especially in the long term.

Furthermore, if you’re taking black cohosh for a specific condition (i.e. menopause), it’s best to consult your doctor prior. While it’s uncommon, black cohosh has been found to have negative drug interactions.

What are the Side Effects of Black Cohosh?

The side effects of black cohosh are not as vicious as those found with pharmaceutical therapies. Still, they’re important to be aware of. The most common side effects of black cohosh include: ⁸

• Dizziness
• Nausea
• Rash
• Upset stomach
• Vomiting

Risk Factors with Black Cohosh

There are other risk factors to keep in mind before taking black cohosh:

• Long-term, consistent black cohosh use can result in liver damage. Taking black cohosh alongside other herbs and supplements increases the risk.

• Pregnant or breastfeeding women should avoid black cohosh. It can increase the chances of miscarriage.

• If you have breast cancer, black cohosh may worsen the condition. You should avoid if you’re at a greater risk of developing breast cancer.

• Due to black cohosh’s hormone-like effects, it may increase the risk of blood clots in those with a protein-S deficiency.

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Black Cohosh Reviews

Black cohosh is available over-the-counter as a nutritional supplement from various different suppliers. Although you could go with any of the suppliers you can find online and in-store, here are three specific companies that provide quality and consistent black cohosh products:

Herb Pharm’s Black Cohosh Extract Tincture is an oral supplement that uses measured drops for dosage. It can be placed into your favorite beverage or taken as is. Most agree it’s best to take between meals, squeezing the dropper bulb to 2 oz. of water or juice, two to four times daily. Each dose contains 140mg of the black cohosh root extract.

Their products undergo rigorous testing and approval from internal and external scientists. Swanson Superior Herbs offers a black cohosh capsule in a dose of 540mg.

They have also prided themselves on manufacturing and distributing high-quality extracts and supplements for over fifty years. Nature’s Way has its own Black Cohosh Root Supplement, a 540mg capsule. The product comes with a 100-day supply.

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Other Natural Ways to Treat Mood Swings

If black cohosh isn’t an option due to health risks or side effects, there are other ways to balance mood swings, including:

Engage in Exercise

Exercise isn’t just beneficial for losing weight and gaining muscle mass. It can also reduce stress, raise serotonin levels, and stabilize emotional well-being. ⁹ Regular exercise can help with mood swings, especially when you also incorporate a diet.

Change Your Diet

Diet plays an integral role in our overall health. It impacts how we function, manage weight, and mental health. To manage moods, you’ll want to eat anti-inflammatory meals. It also helps to avoid sugars, additives, caffeine, and alcoholic beverages. ¹⁰

If you’d like to learn more about what foods to incorporate, read our Bipolar Diet Guide.

Utilize Calcium Supplements

Calcium is a necessary nutrient that helps build and strengthen bone. It can also aid in the treatment of mood swings and disorders. A study revealed even a small dose of calcium can curb mood swings and stabilize emotional balance. ¹¹

Get Better Sleep

Sleep is key to so many elements of our health. You don’t just need to get enough sleep. You need restful and restorative sleep for mood regulation. ¹² Stick to a sleep schedule and ensure you receive the right amount. If you feel tired during the day, don’t be afraid to take a 20-minute nap when necessary.

Stress Management Techniques

Stress is often a reason people experience mood shifts. As such, stress relief methods can help manage symptoms of other forms of stress, such as anger, anxiety, and frustration. Stress relief can be as simple as: ¹³

• Decrease the time spent on stressful activities
• Engage in relaxing hobbies
• Spend time on yourself

References

¹ Wobser RW, Takov V. Black Cohosh. 2023 May 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29261886.

² Smith MJ, Germolec DR, Frawley RP, White KL Jr. Immunomodulatory effects of black cohosh (Actaea racemosa) extract in female B6C3F1/N mice. Toxicology. 2013 Jun 7;308:146-57. doi: 10.1016/j.tox.2013.03.017. Epub 2013 Apr 6. PMID: 23571075; PMCID: PMC3684955.

³ Szmyd M, Lloyd V, Hallman K, Aleck K, Mladenovik V, McKee C, Morse M, Bedgood T, Dinda S. The effects of black cohosh on the regulation of estrogen receptor (ERα) and progesterone receptor (PR) in breast cancer cells. Breast Cancer (Dove Med Press). 2018 Jan 18;10:1-11. doi: 10.2147/BCTT.S144865. PMID: 29403307; PMCID: PMC5779278.

⁴ Spangler L, Newton KM, Grothaus LC, Reed SD, Ehrlich K, LaCroix AZ. The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin. Maturitas. 2007 Jun 20;57(2):195-204. doi: 10.1016/j.maturitas.2007.01.002. Epub 2007 Feb 1. PMID: 17275226.

⁵ Ruhlen RL, Sun GY, Sauter ER. Black Cohosh: Insights into its Mechanism(s) of Action. Integr Med Insights. 2008;3:21-32. Epub 2008 Aug 27. PMID: 21614156; PMCID: PMC3046019.

⁶ Geller SE, Studee L. Botanical and dietary supplements for mood and anxiety in menopausal women. Menopause. 2007 May-Jun;14(3 Pt 1):541-9. doi: 10.1097/01.gme.0000236934.43701.c5. PMID: 17194961.

⁷ Mehrpooya M, Rabiee S, Larki-Harchegani A, Fallahian AM, Moradi A, Ataei S, Javad MT. A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes. J Educ Health Promot. 2018 Mar 1;7:36. doi: 10.4103/jehp.jehp_81_17. PMID: 29619387; PMCID: PMC5868221.

⁸ Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause. 2003 Jan-Feb;10(1):58-64. doi: 10.1097/00042192-200310010-00010. PMID: 12544678.

⁹ Schultchen D, Reichenberger J, Mittl T, Weh TRM, Smyth JM, Blechert J, Pollatos O. Bidirectional relationship of stress and affect with physical activity and healthy eating. Br J Health Psychol. 2019 May;24(2):315-333. doi: 10.1111/bjhp.12355. Epub 2019 Jan 22. PMID: 30672069; PMCID: PMC6767465.

¹⁰ Firth J, Gangwisch JE, Borisini A, Wootton RE, Mayer EA. Food and mood: how do diet and nutrition affect mental wellbeing? BMJ. 2020 Jun 29;369:m2382. doi: 10.1136/bmj.m2382. Erratum in: BMJ. 2020 Nov 9;371:m4269. doi: 10.1136/bmj.m4269. PMID: 32601102; PMCID: PMC7322666.

¹¹ Shobeiri F, Araste FE, Ebrahimi R, Jenabi E, Nazari M. Effect of calcium on premenstrual syndrome: A double-blind randomized clinical trial. Obstet Gynecol Sci. 2017 Jan;60(1):100-105. doi: 10.5468/ogs.2017.60.1.100. Epub 2017 Jan 15. PMID: 28217679; PMCID: PMC5313351.

¹² Triantafillou S, Saeb S, Lattie EG, Mohr DC, Kording KP. Relationship Between Sleep Quality and Mood: Ecological Momentary Assessment Study. JMIR Ment Health. 2019 Mar 27;6(3):e12613. doi: 10.2196/12613. PMID: 30916663; PMCID: PMC6456824.

¹³ Esch T, Stefano GB. The neurobiology of stress management. Neuro Endocrinol Lett. 2010;31(1):19-39. PMID: 20150886.