What menopause treatment is best for me?

By: Dr. Vanda

On July 9, 2002, the federal government halted a research study being conducted by the Women's Health Initiative on the effects of Hormone Replacement Therapy (HRT), stating that the risks of long-term use of HRT outweighed its benefits. The study found that women using estrogen plus progestin had an increased risk of coronary heart disease, stroke, breast cancer and pulmonary embolism.

Despite the above findings, there are still some benefits to long-term HRT use that should be noted. These benefits include:


  • A decrease in hip fractures
  • A decrease in colon cancer
  • A decrease in or an elimination of hot flashes
  • A decrease in nocturnal wakefulness
  • An increase in vaginal lubrication

In her best-selling book The Pause, psychologist and sex therapist Dr. Lonnie Barbach states that a Yale University study found 90 percent of women who had experienced less sexual interest prior to the study "reported an increase in desire and sexual activity after being treated with estrogen for three to six months." Barbach does not report the sample size of this study.

Natural Hormone Replacement Therapy (NHRT)

NHRT, or bio-identical hormones, work like hormones found in the body naturally. Natural hormones are derived from the yam plant or soybean plant. Unlike synthetic hormones, bio-identical hormones are manufactured to have the same molecular structure as the hormones produced in the body.


When the ovaries stop producing estrogen, they also stop producing testosterone. Testosterone has been called the hormone of desire. Therefore, if a woman's testosterone level falls below her personal baseline, she will likely experience a decrease in sexual desire. Doctors can test the level and prescribe the appropriate amount of testosterone.. If the testosterone is going to work, it will start taking effect immediately. Taking more than is needed will not increase your sexual drive further, and too much testosterone produces acne, oily skin and hair. It can cause hair loss on the scalp and hair growth on other parts of the body. While taking testosterone it's important to be monitored by physician.


  • Vitex (chasteberry) tends to balance female hormones. It evens out mood disruptions, gets rid of hot flashes and restores vaginal lubrication. It can also be used for PMS. You can take it as a tincture. A tincture is an alcohol extract of an herb and is sold in a bottle. The directions on the bottle will state how many drops you should take in a small amount of hot water. Vitex also comes as a tea. The problem with Vitex is it takes two to three months to begin working and you must take it at least twice a day. It also comes in pill form, but this takes six months to become effective.
  • Siberian ginseng reduces hot flashes. Like Vitex, it may take a few months to start working.
  • Skullcap can be helpful for irritability or anxiety.
  • Passionflower, motherwort and valerian are natural sedatives.
  • Some sources recommend dong quai to reduce hot flashes; however, others cite research that shows it is no more effective than a placebo.


  • Avoid or cut down on caffeine (including chocolate), alcohol and spicy foods. They can increase hot flashes and cause fatigue.
  • Increase your intake of soy products, such as tofu, miso, tempeh and soybeans, which are rich in isoflavones. They reduce hot flashes.
  • Eat small meals. Large meals dilate blood vessels and cause the body to grow warmer.


Cognitive Control Over Mood Swings

There are certain cognitive things you can do for yourself while you are going through this phase. First, you can start by being gentle with yourself. You are going through something real. It is not "all in your head," so take good care of yourself.

Often, just knowing that your mood is being affected by the decrease in your estrogen levels can put you back in control. Before blowing your cool, take a deep breath, reminding yourself to put your head in charge of your feelings. Remember that this phase won't go on forever. Once your hormones have found their new level, you're going to feel fine again.


It's important, especially during this time, to maintain a good support network with family and friends. Research indicates that women who have a support group they can rely on experience fewer symptoms.


Exercise decreases stress. Lessening stress helps to lessen all symptoms. Exercise is good for mood swings; it increases brain endorphins, blood flow and oxygen in the cells, which makes you feel better. In one study done in Stockholm, Sweden, women who engaged in regular exercise had significantly fewer menopausal symptoms, including less negative moods, when compared with women who did not exercise. Also, doing some form of aerobic exercise three times a week for 30 minutes can prevent insomnia as well as reduce hot flashes.

Maintaining an active sex life also reduces hot flashes. A Stanford research study showed that women who have intercourse regularly (one or more times a week) have fewer or less intense hot flashes.