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Hormone Replacement Therapy Q&A

3. What else can I do to prevent menopause symptoms? continued...

KY Jelly, Astroglide, and Replens: These are better over-the-counter lubricants than oil-based petroleum jelly, and can be used safely with condoms. Keep in mind that vaginal dryness happens to all women to some degree as they age. But it affects the sex life of some women more than others. Lubricants help, but so does sex! Indeed, sexual activity, including masturbation and intercourse, maintains a woman's ability to lubricate.

Vitamin E oil: This common vitamin supplement can also be used directly in the vagina to increase lubrication and soothe the vaginal lining. Women can buy vitamin E oil capsules sold in most drug stores and crack open a capsule to get the oil.

4. What can I do to protect against heart disease or osteoporosis?

Now that we know that hormone replacement therapy does not protect against heart disease or stroke, it's time to fall back on some old standby treatments.

Statins: This powerful class of drugs reduces the amount of cholesterol in the blood -- especially LDL, the "bad" cholesterol. Statins have also been found to reduce stroke, may reduce osteoporosis, and could be an adjunct treatment for cancer. A study in the July 6, 2002, issue of The Lancet found that the risk of heart-related deaths in 20,000 men and women (ages 40-80) was reduced by 18% among those who received statins. People who took statins were also 25% less likely to suffer a nonfatal heart attack or stroke or require bypass surgery. Statin use was also linked with 22% reduction of all strokes and 25% reduction in nonfatal strokes in another study published in the journal Circulation: Journal of the American Heart Association.

Blood pressure medications: Common blood pressure drugs such as ACE inhibitors and beta-blockers can effectively lower blood pressure, which is a leading cause of heart disease and stroke. By decreasing the heart's workload, these drugs also seem to protect heart health in general. Ideal blood pressure is under 120/80. Risky levels are 140/90. Even if you're in the "high-normal" range, say 130/85, you should talk with your doctor about lifestyle changes or medications because you're at higher risk of heart attack or stroke, according to Suzanne Oparil, MD, a leading researcher and director of the Vascular Biology and Hypertension Program at the University of Alabama-Birmingham.

Soy protein: Studies of soy protein show varying results in reducing blood pressure and LDL cholesterol in postmenopausal women. Though at least one small study found reductions when patients ate natural soy, other studies did not show improvements from soy extracts. Researchers conclude that different proteins found in natural soy appear to interact with phytoestrogens -- plant estrogens -- to increase their cholesterol-lowering activity. 

Lifestyle changes: Limiting salt in the diet -- and walking at least 30 minutes a day -- can also lower blood pressure in postmenopausal women by a surprising amount, according to a study published in the August 2001 Journal of the American College of Cardiology. In the study, those who ate only a teaspoon of salt a day and walked lowered their blood pressure by 16 points. To lower sodium in your diet, cook with less salt, use herbs and lemon juice to flavor foods, check packed food labels for sodium, and limit salty snack foods.

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