Menopause Journal: My Struggle with the Menopause Prescription

Some women struggle with hot flashes and hormone replacement therapy. I'm not taking HRT. If things get really bad, I may try Black Cohosh. It's been studied in Germany where there's been some success in treating hot flashes. The studies of Dong Quai, which is supposed to contain phytoestrogens, have been inconclusive. If I get desperate, I'll consider progesterone or estrone creams.

Other than the hormone question, the prescription for menopause is decipherable. For now, my Rx is diet and exercise. That's the hard part, taking the medicine! My menopausal struggle seems to be with self-discipline.

Exercise is conspicuously lacking in my life. I'm not a couch potato. I move. I pull weeds and dig rocks from my garden. I dance a couple times a month. I row the dinghy to the boat. I raise the sails and pull in the sheets. I slap paint on a canvas. But there's nothing very vigorous going on. The truth is. I don't enjoy moving a body part or lifting a weight, sweating or breathing hard for it's own sake. I've got too much else to do.

I'm convinced of the benefits of exercise for everything—heart, bones, weight and mood. But when I try to exercise I feel like a fake, like I'm making a mockery of it. So, I think I need to incorporate it naturally into my daily life.

One disadvantage of rural living is driving —to work, to the grocery store, everywhere because it's too far to walk. When I visit my daughter in the city, I walk 10 times as much as I do at home. We walk, in combination with the metro, to do our business—grocery shopping, movies, restaurants, museums, everywhere. I actually like to walk or bike to daily duties. I was lucky enough to spend a month in Key West last winter and did just that. I felt great and lost a couple of pounds. As soon as I was back to the grindstone, the exercise ground to a halt. The closest gym or health club is 25 miles away. And Maine's long winter of snow, ice and cold makes me want to stay inside, huddle by a fire and eat. Should I relocate?

I'm not excusing myself. I just know myself. Many times I've started exercise regimes and many times I've stopped. My brother-in-law is fond of saying, "Either you do it or you don't do it." So far, I haven't done it.

The dietary prescription is also clear—soy and calcium. Vegetables are essential, plus vitamin supplements. In the Nurses' Health Study, those taking vitamin E had a 40 percent less risk of fatal heart attacks. Folic acid, too, has benefits for the heart as it lowers homocystine levels (high homocystine levels are associated with heart disease). Deficiencies in vitamin B6 and folic acid are associated with osteoporosis. Deficiencies in B12 are linked to depression. And we need the other antioxidants: vitamin C, beta-carotene and selenium.