Q. Can black cohosh be effective in treating perimenopausal symptoms such as fatigue and mood swings?

A. Black cohosh (Cimicfuga racemosa) has been shown to help reduce hot flashes and vaginal thinning. It is the main ingredient in Remifemin, a widely used menopausal product in Europe, as well as many "menopause" teas and capsules.

If you have heart disease or high blood pressure, don't use this herb without checking with your doctor. Often included in "menopause" products is chasteberry, which may regulate progesterone levels and reduce bloating, fatigue, and headache. These herbs may be helpful around the start of menopause, when your hormones are widely fluctuating and you have symptoms but still have menstrual cycles.