Alternatives for Estrogen Replacement Therapy

Symptoms of menopause usually appear soon after menstrual periods have stopped completely. One common symptom is hot flashes--intense feelings of heat followed by chills. Other symptoms include vaginal dryness (which may cause pain during sexual intercourse), difficulty sleeping, anxiety, and irritability. These symptoms, particularly hot flashes, usually improve in 1-2 years and they are severe in only about 10% of all women.

Estrogen replacement therapy can treat most of these symptoms. However, many women choose not to take estrogen or can't because of other medical conditions. There are some alternatives to estrogen that may help relieve these symptoms, but none of these is as effective as estrogen, and not all approaches are effective for all women. Suggestions for alternative approaches include the following:

~Avoid things that often trigger hot flashes, such as tight clothing, spicy foods, alcohol, and warm environments.

~Try relaxation techniques such as biofeedback and meditation.

~Add phytoestrogens (plant estrogens) such as soy products to your diet. Studies have shown that 50 grams of soy protein a day reduces hot flashes by about 50%.

~Try a "botanical" product called black cohosh. Twenty milligrams twice a day may reduce hot flashes.

~Talk to your doctor about other medications, including progesterone replacement therapy and certain blood pressure medications.

The decision to begin estrogen replacement therapy, or any of its alternatives, is different for each person. It is important to talk with your doctor about the risks and benefits of each of these medications before making a decision.



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