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Widely prescribed, estrogen therapy has been associated with increased risk of breast cancer and endometrial cancer in women. Concerned over these issues, millions of women approaching menopause are investigating other available medical options.

One option is phytoestrogens, which are already popular in many parts of the world. The hormone-like substances are extracted from certain kinds of plants. These safe, natural compounds are quickly becoming the treatment of choice against the effects of menopause.

After about with ovarian cancer, and a complete hysterectomy, Karolyn Gazella was prescribed standard estrogen therapy. But Gazella balked, saying, "Because of my family history of cancer, I didn't want to be on estrogen." Instead, Gazella, who publishes a natural medicine journal, began taking black cohosh.

Though resembling a weed, black cohosh has proven to be safe herbal remedy after centuries of use by American Indians. The use of black cohosh however, had all but disappeared in favor of estrogen therapy until researchers, especially in Germany, rediscovered its benefits.

"There have been about a dozen studies that have looked at the ability of this special black cohosh extract to relieve symptoms of menopause," says Dr. Michael Murray.

One of these studies pitted black cohosh against estrogen. The number of daily hot flashes went from five to less than one in the black cohosh group. The estrogen group dropped only from five to three and a half.

These results are not surprising to Dr. Michael Janson, who recommends the herb. "I'm not surprised at all that black cohosh in a standardized form helps with menopausal symptoms," says Janson, the author of Vitamin Revolution.

Dr. Jan McBarron also advocates the standardized use of black cohosh and educates her patients of its benefits. "Taking approximately 20 miligrams twice a day is all you need," she says.

Despite mounting evidence, Janson still finds resistance to the use of black cohosh by many physicians, and says, "Some of them have said to me, 'Send me the research, but you'll never convince me.'

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