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Andrea, they've been all over the place on black cohosh - the latest is, no, don't take it. And don't take any of the "natural" hot flash remedies involving soy, either. Soy in its "natural" state (e.g., tofu, soy milk, etc.) is fine; but once they break it into its chemical components and isolate them, one of the main components in natural hot flash remedies—genistein—can actually encourage tumor growth. Frankly, I haven't found anything that works for hot flashes, and I've tried lots of so-called remedies, from vitamin E and black cohosh to drugs. I do notice that caffeine and alcohol seem to promote hot flashes, as does warmer weather; but I've never found anything to tone them down. Open the freezer door and keep fanning! Good luck- PJH