1. Menopausal Symptoms A dozen studies or more conducted throughout the 1980s and 1990s confirm that the long-standing use of black cohosh for menopausal symptoms has scientific validity. For example, in a German study involving 629 women, black cohosh improved physical and psychological menopausal symptoms in more than 80% of the participants within four weeks. In a second study, 60 menopausal women were given black cohosh extract, conjugated estrogens, or diazepam (a leading anti-anxiety medication) for three months. Those who received black cohosh reported feeling significantly less depressed and anxious than those who received either estrogens or diazepam. In another study, 80 menopausal women were treated for 12 weeks with black cohosh extract, conjugated estrogens, or placebo. Black cohosh improved anxiety, menopause and vaginal symptoms. In addition, the number of hot flashes dropped from 5 to less than 1 average daily occurences in the black cohosh group compared to those taking estrogen in whom hot flashes dropped from 5 to 3.5 daily occurences. Given these examples, and results of other studies, some experts have concluded that black cohosh may be a safe and effective alternative to estrogen replacement therapy (ERT) for women who cannot or will not take ERT for menopause. Many breast cancer patients use black cohosh to ease hot flashes, a common side effect of medications used to treat breast cancer such as tamoxifen. In addition, although there is some debate about this, black cohosh may contain plant based estrogens, called phytoestrogens. Therefore, there is some concern that if there are phytoestrogens in black cohosh, they may stimulate the growth of breast tumors. This idea has not been substantiated scientifically; in fact, some studies suggest that black cohosh may inhibit the growth of breast cancer cells in test tubes. Additional research is needed before conclusions can be drawn about use of black cohosh in women with a history of or risk for developing breast cancer (such as strong family history). 2. Arthritis & Osteoporosis Preliminary studies also suggest that black cohosh may help reduce inflammation associated osteoarthritis and rheumatoid arthritis. In a review of scientific studies, researchers concluded that a combination of black cohosh, willow bark (Salix spp.), sarsaparilla (Smilax spp.), guaiacum (Guaiacum officinale) resin, and poplar bark (Populus tremuloides) may help relieve symptoms of osteoarthritis. Dosage:Approximately 20 to 40 mg of black cohosh extract, standardized for triterpene glycoside levels (2.5%) should be taken twice per day (total daily dose = 1-2mg triterpene glycosides). A period of 4-8 weeks is required for alleviation of menopausal symptoms. Safety: Black cohosh has an estrogen-like effect, and women who are pregnant or lactating should not use the herb. Large doses of this herb may cause abdominal pain, nausea, headaches, and dizziness. Women taking estrogen should consult a physician before using black cohosh. Large doses of black cohosh cause symptoms of poisoning, particularly nausea and dizziness, and can also provoke miscarriage. Black cohosh should not be used by those who have full-blown measles or those who are having trouble breathing. Chemistry:The Black Cohosh extract is standardized to a 2.5%,8% Triterpene Glycosides.