Black cohosh is a perennial wildflower native to the northeastern part of the Americas. More than two centuries ago, Native Americans discovered that the roots of black cohosh help to alleviate menstrual cramps and menopausal symptoms including red hot flashes, anxiety, mood swings and sleep disturbances. Today, black cohosh is still used for these purposes. In fact, the herb has been widely used in Europe for more than 40 years, and in Germany it is approved for premenstrual discomfort, dysmenorrhea and menopausal syndrome. Black cohosh, also known as racemic cohosh, its main active ingredient is terpene glycoside. Black cohosh produces estrogen-like effects that regulate endocrine balance, which helps relieve menopausal symptoms such as insomnia, hot flashes, back pain, and emotional out of control. At least eight special trial reports have shown that using “black cohosh” to improve the accompanying symptoms of menopausal women is safe and effective. Therefore, many doctors in the clinic recommend high-concentration extracts of black cohosh to menopausal women.