Black Cohosh (Cimicifuga racemosa) . The most researched herb for menopause has to be blach cohosh. In addition to containing phytoestrogens, this herb suppresses luteinizing hormone (LH), a secretion of the pituitary gland which, at high levels, seem to play a role in hot flashes.

Native Americans have long used black cohosh, and the early colonists soon adopted it. Germans have used and studied the herb for more than 40 years, and it is widely available in tablet form under the trade name Remifemin. Controled studies on large numbers of women have shown marked improvement in symptoms such as hot flashes, vaginal atrophy, and depression. In one study, more than 80 percent of patients showed clear improvement within six to eight weeks, with a large number saying that their symptoms had vanished. The research even revealed black cohosh's superiority over HRT when it came to to relieving depression and anxiety associated with menopause. Extensive toxicology data based on clinical research suggest that black cohosh is safe to take over a long period of time without the rish of side-effects.

Dosage. Tori Hudson, a naturaphathic physician and author of Women's Encyclopedia of Natural Medicine (Keats Publishing), 1999), recommends taking black cohosh in the form of a standardized extract tablet at a dosage of 160 mg per day (two 40 mg tablets/capsules twice a day). If you choose a standardized liquid extract, take one-half to one teaspoon a day.

Contraindications. While universally regarded as safe, some experts suggest that those with heart disease should avoid black cohosh. A massive overdose of black cohosh can reportedly cause symptoms such as dizziness, nausea, diarrhea, headache, and decreased heart rate. Also, if you're taking Remifemin Plus, note that St. John's wort in the product can in crease symptoms of excessive serotonin (confusion, nausea, and diarrhea) when used in combination with antidepressants such as Prozac.