Black Cohosh (Actaea racemosa) is a perennial herb native to North America, traditionally used by Native American tribes for women’s health concerns. Its key active compounds include triterpene glycosides (such as actein), phytosterols, and polyphenols. Though it is not a phytoestrogen itself, Black Cohosh exerts its effects through modulation of the hypothalamic-pituitary axis (HPA) and by interacting with neurotransmitter systems in the brain. It is believed to influence serotonin and dopamine receptors, which play a role in thermoregulation, mood, and hormonal signaling. This makes Black Cohosh especially beneficial during menopause, as it may help alleviate vasomotor symptoms like hot flashes and night sweats without directly stimulating estrogen receptors in reproductive tissues, thereby offering a potentially safer alternative to hormone replacement therapy.