Alternatives to Hormone Replacement Therapy

Doctors often prescribe supplemental estrogen or a combination of estrogen and synthetic progesterone (commonly called HRT, hormone replacement therapy) to replace women's natural hormones in order to manage the symptoms of menopause, such as hot flashes.

They also prescribe it because studies show that estrogen helps to decrease the risk of developing osteoporosis, or fragile, brittle bones, and may help prevent heart disease. But many women can't or don't want to take the medication.

"The women who come to me are interested in getting off their HRT and finding alternatives," or not starting it in the first place, says Tori Hudson, N.D., a naturopathic physician whose practice in Portland, Ore., specializes in menopause. Her patients worry about the side effects and possible health risks of hormones.

So what's a woman to do who doesn't want to just sweat out menopause or become another broken-hip statistic? Hudson and other health practitioners recommend that women start by exercising regularly, managing stress, eating a healthful diet and giving up smoking.

Only weight-bearing exercises, such as walking, jogging and playing tennis, strengthen bones. Getting outside regularly provides the body with some of the vitamin D it needs to absorb calcium, critical for maintaining bone mass. Women should eat foods that are rich in "phytoestrogens," compounds in certain plants, herbs and seeds that act like estrogen in the body, Hudson said.

Good choices are flaxseed and soybeans, including tofu. In countries where the regular diet includes a lot of phytoestrogen-rich foods, women have fewer menopause symptoms, a number of studies suggest. Women may also want to investigate supplements with compounds that act like estrogen, including ginseng, fenugreek, licorice, gotu kola, dong quai, black cohosh and evening primrose, according to the North American Menopause Society's "Menopause Guidebook."