Black Cohosh has been used successfully to control menopausal symptoms in a high percentage of women. It may need to be taken for several weeks before benefits are noticed. It is often found sold as an extracted form called RemeFemin, available from health food stores. The standard dose of 40mg (extract) per day is sufficient to treat menopausal symptoms such as hot flashes and seems not to be dose-dependent.
Some supplements pack more than 500mg (non extract) of black cohosh into each pill. This will leave you guessing somewhat as to what the correct dose should be. Unextracted sources of black cohosh should be considerably cheaper than the extracted sources. RemiFemin contains 20 milligrams of black cohosh extract per pill and is to be taken twice daily. The dose of extract recommended by German studies is 40 to 80mg per day.
The use of Remifemin is not associated with an estrogenic effect systemically in either perimenopausal or menopausal women, which removes the concern about increasing breast cancer risk.