Alternative remedies to hormone replacement therapy

The most common symptoms of the menopause are hot flushes and sweats, difficulty in sleeping, vaginal dryness, a higher risk of osteoporosis and sometimes anxiety. Below are some suggested treatments for these symptoms.

Hot flushes and sweats

• First, try lifestyle changes. Avoid getting too hot by sleeping in a cool room, wear cotton next to your skin and have lukewarm baths or showers.
  
  
• Cut back on hot drinks, especially those with caffeine and tannin such as tea and coffee. These, along with alcohol and spicy foods can trigger hot flushes.
  
  
• Increase the amount of soya in your diet with tofu and soya milk. Additional intake of pulses and legumes can also be helpful.
  
  
• Supplements such as black cohosh, sage, agnus castus and dong quai may also be helpful. These are available from your local health food shop.
  
  
• Anecdotal evidence suggests that evening primrose oil or vitamin E may have some effect on flushes.
  
  
• If none of the above is effective your doctor could prescribe some non-hormonal medications such as Clonidine or Venlafaxine. Both have been found to be helpful to some women.

Difficulty in sleeping

• The treatment of hot flushes should improve sleep quality.

Vaginal dryness

• Avoid soap in the genital area as it is an irritant. An emolient such as aqueous cream can be used round the labial area and it is very soothing.
  
  
• Vaginal lubricants and moisturisers available over the counter can help lubricate the vagina and ease intercourse. Replens, KY Jelly, Senselle and Sylk (mail order only) are some of the products available.
  
  
• Severe vaginal dryness may need to be treated with prescription oestrogen. These are specific to the inside of the vagina and are not absorbed into the circulation. These include oestrogen creams, a vaginal oestrogen tablet and an oestrogen ring.
  
  
• Oestrogen cream treatment will have no effect on hot flushes

Reduce risks of osteoporosis

• The risk of osteoporosis (bone thinning) increases after the menopause. You should talk to your doctor to see if you are at risk.
  
  
• If you are at risk your doctor can prescribe calcium with vitamin D, plus bone drugs.
  
  
• If you are not at risk it is a good idea to make sure you get adequate calcium and vitamin D. Having a diet high in calcium will help, as will exercise.

General advice

• Don’t smoke
• Eat a healthy diet
• Maintain weight
• Get enough exercise
• Reduce stress

Complementary therapies

You may find some of the therapies listed below quite useful.

• Aromatherapy
• Reflexology
• Homeopathy
• Acupuncture
• Yoga
• Massage
• Nutritional therapy
• Relaxation techniques
• Herbalism