For many women, the side effects of HRT have made it a less desirable option to manage the symptoms of menopause. However, the discomfort of these symptoms mean some treatment is necessary.

Hot flashes, night sweats, panic attacks, headaches, and mood swings can make life difficult for a menopausal woman, as well as affecting her relationships with her family. When we feel ill, our whole outlook on life can be affected, making it more challenging to engage the levels of spiritual transformation that are associated with menopause.

Fortunately, there are a number of options available to women who'd prefer to experience menopause naturally. It's important to note though, that medication may still be needed for some. Dr Christiane Northrup has written of some menopausal patients of hers that were adamant they were not taking HRT. But after exhausting the herbal and nutritional options, the symptoms were still so bad that in the end they opted to take hormone replacement therapy.

One well known herbal treatment for menopause is black cohosh. Also known by the botanical name of Cimicifuga racemosa, this powerful herb is a phytoestrogen. Phytoestrogens were originally thought to work by binding to the estrogen receptors in the body. Phytoestrogens are similar to natural estrogen in chemical structure, though they have a milder effect on the body. Thus, when they locked into the estrogen receptors, they were thought to have an effect that mildly mimicked estrogen, thus counterbalancing the reduced levels of estrogen in a woman's body.

However, this is now not believed to be the main way phytoestrogens like black cohosh work. Whilst they do in fact bind to at least one subtype of estrogen receptor, they may actually work to block that receptor, rather than activate it. It is now believed that black cohosh regulates the hormonal system in the body.

Despite a lack of clear understanding in how black cohosh works, scientists have found that it works very well. One study comparing black cohosh with HRT and valium found that it was just as effective in helping both the physical and psychological symptoms of menopause. A Japanese study also found that black cohosh increased bone mineral density, which makes it very useful in preventing age related osteoporosis.

Black cohosh has been found to help 76 to 93% of women find an improvement with the symptoms of irritability, hot flushes, heart palpitations, depression, headaches, and sleep problems. These women took a standardized extract, twice a day.