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    Menopause: Is There Life Beyond Hormone Replacement Therapy?

    Post-HRT, what are women doing to manage menopause symptoms? And are compounded bioidenticals safe?

    Birth control pills for perimenopause continued...

    Birth control pills or patches “put your ovaries to sleep,” she says. They take over delivering hormones. When estrogen levels are steadied this way, hot flashes and other menopause symptoms often improve, according to Minkin. (Some women, though, should avoid all birth control pills, including very-low-dose kinds: smokers over age 35, women with uncontrolled high blood pressure, and women who have had breast cancer, heart disease, or deep blood clots.)

    Very-low-dose birth control pills are sometimes a better option than hormone therapy because they shut down the ovaries, Minkin explains. In contrast, perimenopausal women on hormone therapy might still have irregular cycles and bleeding.

    Nonhormonal treatments for menopause

    Millions of women remain leery of any type of drugs and choose not to use either HRT or birth control pills. After doing her menopause homework, Richardson opted for a solution with only lifestyle changes. “I created a plan to maintain my health and deal with menopausal symptoms naturally.” Starting an exercise program helped control hot flashes and weight gain, Richardson says. She began working out at the gym after years of hectic 60-hour workweeks that left little time for exercise. “It alleviated a lot of my symptoms.”

    Avoiding extreme changes in temperature, layering clothing, and saying no to both caffeine and spicy foods are other ways to help with hot flashes. So is reducing stress through meditation or deep breathing, say experts.

    What about alternative treatments for hot flashes, such as black cohosh or soy products? They may be worth a try, but aren’t strong bets for everyone, says Margery Gass, MD, director of the University Hospital Menopause and Osteoporosis Center at the University of Cincinnati.

    “When you look at a critical review of all the studies, none of them have turned out to be highly effective,” she says of alternative menopause products. “But that does not mean that, on an individual level, one particular person might not benefit. If people want to try those products, they just need to keep an open mind and consider a one-month trial to see if there’s any benefit.” But women should inform their doctors about what they’re taking, she adds.

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