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    Natural Alternatives to Hormone Therapy

    Herbal Choices

    Also gaining scientific momentum is black cohosh, an herb used in the Native American community that has shown promise in treating hot flashes and insomnia, and possibly vaginal dryness, says Sadja Greenwood, MD, MPH, a San Francisco gynecologist and author of Menopause, Naturally.

    European and American clinical studies have shown that black cohosh is effective for hot flashes and other menopausal symptoms. One review study published in 1998 in the Journal of Women's Health concluded that black cohosh was a "safe and effective alternative to estrogen replacement therapy." The National Institutes of Health (NIH) has just awarded more than $7 million to the University of Illinois to study black cohosh, along with other herbs for women's health, including red clover and dong quai and ginseng, also promoted in herbal circles as menopausal remedies.

    "Before taking black cohosh or any herbal supplement, talk to your doctor," says Gail Mahady, PhD, a researcher at the new University of Illinois center established by the NIH grant. "There's plenty of evidence to show it works, but we don't know what the mechanism is. Until we know for sure, women who have problems with estrogen really must be cautious. There's always the possibility of an adverse reaction."

    Useless Yams

    Greenwood is far less impressed with wild yam creams, which have also been marketed to relieve menopausal symptoms. The products' promoters claim the creams contain a precursor to progesterone -- commonly taken alongside estrogen -- that counteracts estrogen's negative effect on the uterine lining. While naturally derived progesterone, available over the counter, can help with some symptoms like hot flashes, Greenwood says, the yam cream formulations aren't effective.

    Lifestyle for a Lifetime

    The most effective alternative to hormone therapy, however, doesn't come in a bottle. Physicians say that preventing heart disease, osteoporosis and cancer often boils down to lifestyle, one that includes regular exercise and a healthy diet. A diet high in calcium along with weight-bearing exercise bolsters bones. Avoiding high-fat foods and participating in regular aerobic exercise keeps the heart healthy.

    These habits can prevent the diseases; studies have proven it over and over again. Consider it, Greenwood advises. "Those things are so much more effective than [most] any pill you can put in your mouth."

    Nelson Watts, MD, director of the Osteoporosis and Bone Health Program at The Emory Clinic in Atlanta, and principal investigator at the Atlanta site of the Women's Health Initiative, offers a word of caution. "Often, diet and exercise are not enough by themselves." he tells WebMD. "A woman needs to first talk with her doctor about what symptoms she wants to relieve, and look at the treatment options."

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