I tried black cohosh years ago, when I was in peri. It didn't do a thing. I just deal with the flashes. Usually keep a big bottle of water by me and drink a bunch when I feel one starting. I mostly have one big one when I wake up.
My worst symptom has been the "dryness" issue, which put a severe crimp in my love life. I got an E-string about 5 years ago and it has made a nice improvement, but the issue is still there. The nurse practitioner I went to at my last doctor said that this is also an issue of "use it or lose it," so i guess I need to "use it" more. But, getting the E-string, definitely eliminated some of the pain I had cycling, which were not really saddle issues.
My gyn. is a tri-athlete, but when I first went to her, she had not started this and she was kind of clueless when I tried to describe the issue I was having. Now, she always asks.