Can I Take black cohosh with birth control?

SUMMARY:

There is no well-established, specific interaction documented between black cohosh and hormonal birth control in the provided interaction check, but evidence is limited and caution is reasonable.

ADDITIONAL NOTES:

Black cohosh is an herbal supplement sometimes reported to have estrogen-like effects and has rare reports of liver injury; while a clear effect on contraceptive effectiveness is not established, theoretical interaction with hormone-containing contraceptives cannot be fully excluded. Consider avoiding concurrent use if you have liver disease, and watch for new abnormal bleeding, breast tenderness, or signs of liver injury (jaundice, dark urine, abdominal pain). Discuss use with a prescriber or pharmacist before combining.