Usually when the word "treatment" is mentioned, drug therapy comes to mind. Although prescription and nonprescription drugs offer many women effective options for treating menopause-related symptoms, making certain so-called "lifestyle" changes should not be ignored or downplayed. Lifestyle changes can have an enormous impact on health. Without a doubt, the most powerful lifestyle habit affecting health is cigarette smoking. In addition to increasing the risk of heart disease and osteoporosis, smoking brings on menopause up to three years earlier --which also increases risk of heart disease and osteoporosis.

Physical inactivity is a lifestyle risk factor for many serious diseases. For example, not exercising is almost as great a risk factor for developing heart disease as smoking. Adequate exercise is the crucial ingredient missing in most women's lives. Activities such as brisk walking, running, aerobics, cross-country skiing, dancing, and tennis not only help the heart, but also the bones, the muscles, balance, and weight management. Some women report fewer hot flashes when they exercise regularly. In addition, exercise promoted better, more restorative sleep and stimulates "feel-good" brain chemistry that turns aside negative thoughts and depressed feelings. It is, without a doubt, the best remedy for a whole host of menopause complaints.

For the greatest benefit, every day get at least 30 minutes of moderate aerobic exercise --such as brisk walking for two miles. Women who are just beginning an exercise program should first check with their health care provider to determine if this level of exercise is appropriate initially.

Diet and health are intimately linked --and women who are approaching menopause have special dietary concerns. With declining estrogen levels, midlife women are at increased risk of developing heart disease and osteoporosis, two serious conditions that are greatly affected by diet. Diet is another "lifestyle" factor that can be considered "menopause treatment."

Heart disease can be lowered by eating little or no cholesterol and fat, plus limiting salt and alcohol intake. Instead, select a proper diet high in fruits, vegetables, and grains. Osteoporosis prevention requires adequate calcium intake --starting as early as in the teen years to build bone strength to its peak so that when bone loss normally begins at about age 30, there is a "bone bank account" from which to draw. Most adults should consume 1,000 mg per day of total calcium, or 1,500 mg per day for postmenopausal women who do not have adequate estrogen levels. If not enough calcium can be obtained from the diet (dairy products, leafy green vegetables), reach the recommended intake by taking a calcium supplement (not containing iron or fiber) in 250 to 500 mg doses. Another nutrient plays a major role in helping the body absorb calcium: vitamin D. Getting at least 15 minutes of sun exposure daily will help the body form its supply; certain foods (fortified milk, liver, tuna) or a supplement may be needed to reach the recommended level of 400 IU daily, especially for women in northern climes. Hot flashes can also be helped by watching the diet. Cut down or avoid the known "flash-inducers" such as spicy foods, hot drinks, caffeine, and alcohol.

Yes, controlling weight is very important. In fact, if a woman is more that 30% overweight, she's at risk for heart disease --even if she has no other risk factor. Furthermore, obesity increases the risk of breast cancer by about 20%.  Many women abandoned hormone replacement therapy because of an increase breast cancer risk of 6/10,000 yet continue to remain obese.  In reaching an ideal weight, pay particular attention to keeping fat off the waistline and tummy, the most dangerous fat locations for heart health.

Yes, prolonged stress can severely impact health. As women enter midlife, they may encounter increased stress --or different stressors --than in their younger years. Changes in the family structure and/or the workplace, illness of death of loved ones, and financial difficulties are only a few of the many possible causes of tension. Many women can benefit from stress-reduction strategies such as exercise or meditation. Some women also report fewer hot flashes when they engage in meditation, yoga, massage, or even just a leisurely bath.

There are also many "natural treatments for both menopause and menopausal symptoms. These include certain ethnic diets, herbs, natural hormones, and combinations of vitamins and minerals. One of the very hot topics in the last year has been the used of natural progesterone.  There are many sources of progesterone cream currently on the market. Another hot topic is the use of DHEA, an adrenal hormone, for energy and to prevent aging.  While many of these therapies have not been subjected to rigorous scientific study, there may be some validity in certain of these approaches. Other methods are pure quackery and when these approaches are looked at closely, it is apparent that the same benefits would be obtained by the principles of general sound health management outlined above. Many of these methods are very costly. Excessive expenditures on these untested and homeopathic remedies may actually do harm since the resources of the family are diverted from more cost efficient approaches to sound health. Just because someone labels something with the contemporary "buzz words" for something good, such as "natural", "anti-aging" or "holistic" does not necessary mean it is better than your common sense or what well meaning people have worked hard on for many years to understand.

Please also see Natural Estrogen, Selective Estrogens, and Fantasy Estrogens.