Hi Alicia and lactnetters, Have been catching up with lactnet and reading the hot flashes posts with interest. Black cohosh has shown some efficacy in treating hot flashes and is available in standardized product form. Black cohosh is widely used for menopausal symptoms in Germany, and it's use in the US is increasing. In an interesting review, Francis Brincker (ND) gave a reference describing black cohosh's use as a galactogogue by the Iriquois nation - good to know just in case it's use should see oversupply develop. It's historic use as a labour aid/uterotonic makes me suspect it could be oxytocic, amongst other things. Use not contraindicated for bf by usual sources (Comm. E, Bot Safety Handbook, etc.). Effect on hormones - thought of as estrogenic but research shows dose of 40 mg. standardized extract/day does not alter LH, FSH, etc. but can still effectively reduce hot flashes and other symptoms. Rosemary Gladstar makes these suggestions for hot flashes: more grains, a lot less sugar if possible, increase calcium and Vitamin E - containing foods. David Hoffman discusses the value of oats ( cereal, oat straw preps) as well. Jim Duke considers phytoestrogenic plants such as soy, alfalfa, red clover useful for menopausal symptoms. He makes the point that hot flashes are rare in vegetarian cultures, especially those with legume-based diets ( soybeans again - not my favorite diet item). Vitex: Have read recent study which found chasteberry extract to have D2 dopamine agonist effect, and an anti-prolactin effect in vitro. Animal studies of lactating rats/pups found failure of "milk-spots" to appear ( doesn't sound good but still wish someone would tell me just what a milk spot is in a rat pup!). Authors also found increased mortality amongst test- litters which they related to anti-prolactin effects. These recent studies have stood Vitex researchers' previous findings on their heads - for years they had assumed that Vitex increased prolactin in humans whereas it seems this response is restricted to "certain species" (guinea pigs), as they put it. Old studies of humans from the mid-century reporting a lactogenic effect are more than due for a re-do, to say the least - perhaps modern protocols would help establish what the real story with Vitex is. One observation from the human studies that is still in the product information package of one German company ( the one that did all the research) is that continued use post-partum does seem to cause an early return of menses - if true, this represents an early and preventable loss of important benefits of breastfeeding to the mother. Regards, Sheila Humphrey BSc RN IBCLC [log in to unmask]