Black Cohosh and Peony Root have been part of women’s herbal traditions long before anyone thought to put them in a capsule

More women are approaching menopause differently today. Instead of simply pushing through uncomfortable symptoms, we are asking better questions, looking for deeper understanding, and exploring evidence-based ways to support our bodies through the transition.

That curiosity often leads somewhere interesting: the botanical world.

Plants and herbal remedies have been supporting women through hormonal shifts for centuries, long before modern wellness trends put them in capsules and supplements. Two that consistently stand out in both traditional medicine and modern research are black cohosh and peony root.

These plants aren’t the latest fad. They have long histories, ongoing and growing clinical interest, and a reputation among practitioners for helping women navigate the physical and emotional changes that come with perimenopause and menopause.

If you’re keen to deepen your understanding of the hormonal changes happening during perimenopause and menopause, our guide to hormones and the role they play in perimenopause and menopause explores this topic.

Black Cohosh: One of the Most Studied Herbs for Menopause Symptoms

Black cohosh (Actaea racemosa) grows in the forests of eastern North America and has a long history of use among Indigenous communities including the Algonquin, Cherokee and Iroquois peoples. 

Traditionally it was used for a range of women’s health concerns, from menstrual discomfort to musculoskeletal pain. By the 19th century, black cohosh had also become part of mainstream herbal medicine in Europe and North America.

What makes it particularly interesting for modern women experiencing perimenopause and menopause symptoms is its long history of use during the menopause transition. Researchers are still exploring exactly how black cohosh works, and today it’s commonly used for hot flushes and night sweats associated with menopause.

Today, black cohosh is considered one of the most researched herbal remedies for menopause symptoms.

Menopause Symptoms Black Cohosh May Help With

Two of the most well-known menopause symptoms are hot flushes and night sweats (often referred to medically as vasomotor symptoms). Several clinical trials have investigated black cohosh for these symptoms, including a widely cited 2013 randomised clinical trial that reported meaningful reductions in both the frequency and intensity of hot flushes.

That doesn’t mean it works identically for everyone. Herbal support always interacts with individual physiology, but for many women, black cohosh has become a valuable part of how they support:

• Hot flushes associated with menopause
• Night sweats associated with menopause
• Healthy female hormonal balance during menopause

This matters more than people often realise. When hormones fluctuate unpredictably, the ripple effects can be felt right through daily life, so it’s worth talking to your health professional about any symptoms that are bothering you.

Peony Root: The Calmer Companion Herb

If black cohosh tends to get most of the attention, peony root (Paeonia lactiflora) plays a quieter but equally important role.

Peony has been used in Traditional Chinese Medicine (TCM) for more than 1,500 years. Peony root is traditionally used in Chinese medicine to help relieve hot flushes associated with menopause and to support healthy reproductive hormones.

In Japanese Kampo medicine, peony root appears in classic formulations still used today, including Shakuyaku-kanzo-to. Peony also appears in a number of other traditional Kampo formulas for women.

Researchers are also beginning to study compounds in peony root, particularly paeoniflorin, though much of this work is still at an early stage.

The Missing Conversation: Stress and Menopause

One factor that doesn’t always receive enough attention in menopause discussions is stress.

When cortisol (the body’s primary stress hormone) remains elevated for long periods, it can interfere with hormonal signalling. During menopause, when hormones are already shifting, this additional pressure can intensify symptoms such as:

• Hot flushes
• Sleep disturbances
• Mood fluctuations
• Fatigue
• Reduced immune resilience

In other words, stress and menopause symptoms can reinforce each other. But thankfully there are natural ways we can work to break that unpleasant cycle!

Astragalus and licorice are traditionally used in Western herbal medicine and Chinese medicine to help the body adapt to stress.

And during midlife - a stage that often includes career shifts, family changes, ageing parents, and evolving identities - helping your body adapt to stress can be just as important as relief from physical symptoms.

Why Herbs Are Often Combined

Traditional herbal medicine rarely relies on a single magical plant. Instead, it tends to combine herbs that work on different aspects of the same issue.

Black cohosh and peony root are a good example of this approach.

On one hand, black cohosh is typically associated with hot flushes and night sweats associated with menopause. Peony root, meanwhile, brings its own long history in Chinese medicine.

This kind of multi-herb thinking isn't new; it's actually the basis of most traditional herbal medicine systems.

Where These Herbs Come Together: The Foundation Blend

Black cohosh and peony root are two herbs that form part of our Foundation blend, designed as a supportive starting point for women navigating perimenopause and menopause.

Alongside black cohosh and peony root, the formula also includes:

Astragalus root: Traditionally used in Chinese medicine to help the body adapt to stress and support stamina, and in Western herbal medicine to support immune system health.

Licorice root: Traditionally used in Western herbal medicine as a body tonic and to help the body adapt to stress.

Together, these ingredients may help:

• Support healthy female hormonal balance during menopause
• Relieve hot flushes and night sweats associated with menopause
• Help the body adapt to stress¹
• Support immune system health¹

It’s not intended as a quick fix. Menopause is a complex biological shift and every woman experiences it differently. But a thoughtfully constructed herbal foundation can offer meaningful and ongoing support.

¹ Astragalus and licorice are traditionally used in Western herbal medicine and Chinese medicine.

ALWAYS READ THE LABEL AND FOLLOW THE DIRECTIONS FOR USE. 

Supporting the Menopause Transition with Respect for the Body

Menopause is a natural life stage, rather than a condition that needs ‘fixing’. However, anyone experiencing the symptoms that can accompany it - the sleep disruption, the sudden heat waves, the emotional unpredictability – knows that support and understanding are vital at this time.

Black cohosh and peony root have been part of that support for centuries, across cultures and medical traditions. Today, modern research is continuing to explore what many herbal practitioners have long understood: that plants can play a meaningful role in helping women move through menopause with greater comfort and balance.

At The Menopause Co., we honour that history by bringing these ingredients together in supportive formulations that respect both traditional knowledge and modern science.