Remifemin review: does this black cohosh extract work?

The evidence is mixed. Remifemin's extract matched tibolone, a hormone drug, on symptom scores in a 2007 trial of 244 women, but a 2012 Cochrane review found black cohosh no better than placebo for hot flash frequency. A 2026 review rated the evidence for benefit as moderate.

It's one specific black cohosh extract, called iCR or RemiSure. The Spanish Menopause Society says most well-designed recent trials used this extract. Other black cohosh products use different extracts and doses, and NCCIH says some have contained the wrong herb or unlisted mixtures.

In trials, Remifemin's extract was well tolerated, with fewer adverse events than tibolone. The main concern is rare liver damage reported with black cohosh products. The tablets contain milk, and the label says not to take them if you're pregnant or nursing.

Each tablet has 2.5 mg of RemiSure black cohosh dry extract, equal to 21 mg of black cohosh root, plus lactose, cellulose, potato starch and magnesium stearate. It contains no soy, hormones or artificial colors.

In the 2007 trial, menopause symptom scores had already fallen from 24.7 to 11.2 by week 4 and kept improving to week 12. The label says results are best with ongoing use for up to 6 months.

For most women it appears to be, but rare cases of liver damage have been reported with products labeled as black cohosh. The maker says studies showed no harmful liver effects. Stop and see a doctor if you get abdominal pain, dark urine or jaundice.

There's no head-to-head trial. Remifemin is black cohosh, taken twice a day, with mixed evidence from many trials. Estroven Complete is rhubarb extract ERr 731, taken once a day, with trials mainly from one research group. Black cohosh has more research behind it; Estroven Complete is simpler to take.

Ask your oncology team first: the label says to check with a professional if you've been treated for breast cancer. The maker says the extract has no estrogen-like effects on breast tissue, but NCCIH says black cohosh's safety after breast cancer is uncertain.

No. The label says it's estrogen-free, and the maker says it contains no plant hormones either. It's sold as an option for women who choose not to take hormone therapy, though hormone therapy remains more effective for hot flashes. NAMS doesn't recommend herbal supplements for hot flashes.

It's a nighttime version with 5 mg of RemiSure extract plus valerian, lemon balm and hops, taken one hour before bed. It may cause drowsiness, so avoid alcohol and driving after taking it. It contains soy. Ask first if you take sedatives, tranquilizers or other prescription drugs.