Q. Dear Terry, “Over the past six months, I noticed changes with my menstrual cycle, plus I developed occasional hot flashes, irritability, and other things. I’m at the age where menopause is right around the corner. What are some good herbs to start taking now to support my body during this perimenopausal time?” – Julia P., Erie, PA

A. Dear Julia, Black cohosh has been used as a medicinal plant for centuries. Over the past 50 years, black cohosh has been the focus of clinical research on perimenopause and menopause relief. Black cohosh has been scientifically proven to relieve hot flashes, night sweats, mood swings, and other troubling menopause symptoms.

The effectiveness of black cohosh comes down to many things, and foremost among them are concentration, standardization, and dosage levels. I’ve heard from many women that they tried black cohosh and either it didn’t work, or it stopped working after a short period of time. I believe this is because they were not using the correct amount or a standardization of black cohosh.

Many black cohosh products on the market today are using hundreds of milligrams, but it appears that black cohosh may actually provide less benefits as you increase the dosage. That’s because the herb works on a bell curve. Once you pass the peak of that curve, it’s just not effective anymore.

In fact, clinical studies have found that the best dose of black cohosh is much less than you may expect – 13 mg daily. Be sure to use it consistently each day for best results.

For additional support, you could also consider adding in the adaptogenic herb Rhodiola rosea. Rhodiola is known to help with improving focus, mood, energy levels, and the ability to cope with stress. Look for a rhodiola that is clinically studied and standardized for rosavins and salidroside.

In a recently published study, a combination of black cohosh and rhodiola relieved menopause symptoms better than black cohosh by itself in just twelve weeks. The combination group was found to reduce menopause symptoms by 71%, including hot flashes, fatigue, stress, and restless sleep. I would take 413 mg of a combination of black cohosh and rhodiola per day.

There is also good research supporting the use of B vitamins for helping with menopause, particularly folate. I prefer B vitamins in their bioactive forms: vitamin B6 as pyridoxal-5-phosphate (P-5-P), vitamin B12 as methylcobalamin, and folate as methylfolate. These forms of B vitamins don’t require conversion in the liver and are in the form the body already uses. I would take 25 mg of P-5-P, 1,000 mcg of methylcobalamin, and 1,360 mcg of methylfolate per day.

Healthy Regards!

Terry . . . Naturally