other · for hot flashes
Black Cohosh
Thought to act on the brain’s thermostat rather than on oestrogen, though that is debated.
Say that in clinical terms
Proposed to act on serotonin and dopamine pathways in the brain's temperature-control center rather than as a classic estrogen; its estrogenic activity in the body appears to be minimal, which undercuts the traditional 'phytoestrogen' explanation.
How strong is the research?
No significant difference between black cohosh and placebo in frequency of hot flushes (mean difference 0.07/day); insufficient evidence to support use for menopausal symptoms.
4 papers read, 4 against.
Tested as: isopropanolic black cohosh extract (Remifemin), 40 mg/day median dose across trials in the Cochrane review; 160 mg/day black cohosh root extract in the NIH-funded HALT trial. Preparation and extraction method vary widely between commercial products.
Who was studied: Studied in women around and after menopause having two or more hot flushes a day.
How much to take
40–160 mg