Alternatives to Hormone Replacement Therapy

Opting Out of Estrogen

But "more research is needed to prove their effectiveness," the guidebook warns. "What's more, most of these products are not 'quality-controlled.'" They may contain very little of their advertised ingredients, and they can have dangerous side effects.

Hudson devises her own medications for patients, using natural hormones and botanicals. They include estrogen, testosterone or progesterone that are derived from plants and biochemically identical to human forms of the hormone, she said.

To learn more about useful alternatives to HRT, she recommends reading her book, "Women's Encyclopedia of Natural Medicine," or one of the many other books on menopause, such as "Dr. Susan Love's Hormone Book: Making Informed Choices About Menopause."

Treating menopausal symptoms without estrogen isn't for everyone, and it isn't easy. "It takes a lot of work — you have to be like a scientist," said Lois Heddens, 52, of Ashfield, Mass. She takes estrogen, but she has friends who have decided to eat a special diet and take supplements instead. "They say they have to do it that way because they got sick or they had problems on estrogen," she explained.

But for some women forgoing estrogen is the stress-free way to go. "If I was taking a pill every day I probably wouldn't be thinking it was helping my bones — I'd be worrying about cancer," says Melissa Herman, 59, of Bethesda, Md. Instead of taking estrogen, she runs, eats a good diet and takes vitamins.