Is Black Cohosh Safe with Hormone Replacement Therapy (Estradiol)?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Discuss use of Black Cohosh with your prescriber before combining with HRT. Monitoring for estrogenic side effects is recommended, and combination use should be medically supervised.
Why this interaction occurs
Black Cohosh has demonstrated serotonergic and partial estrogenic activity that may alter the pharmacodynamic effects of exogenous estradiol. Though often used to manage menopausal symptoms, its interaction with HRT can produce unpredictable hormonal responses.
Evidence
Evidence level: limited.
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 1,131,768 reports mentioning Hormone Replacement Therapy (Estradiol). This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the Hormone Replacement Therapy (Estradiol) + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Black Cohosh interactions → · All Hormone Replacement Therapy (Estradiol) interactions →
Already checked this one — check your whole list
Educational only — not medical advice.
Always confirm with your doctor or pharmacist.