In the first head to head comparison of a botanical therapy versus a drug for management of menopausal symptoms, a standardized formulation of Black Cohosh was equally effective as tibolone, a drug widely used in Europe and Asia; the herbal formula had fewer adverse effects. Pycnogenol, an antioxidant and anti-inflammatory derived from the bark of French Maritime Pine trees, can reduce menopausal symptoms while improving women’s lipid profiles.