A healthy eating plan includes a variety of foods:

* Fruits and vegetables — Be sure to include dark green and orange vegetables and a variety of fruits in various forms.

* Grains — Make sure at least half of your grain choices are whole grains, such as whole wheat, oatmeal, and brown rice.

* Milk, cheese, and yogurt — Choose low-fat or fat-free dairy products.

* Lean meats, beans, eggs, and nuts — Vary your protein choices and use low-fat cooking methods.

* Fats — Choose foods with heart-healthy fats (polyunsaturated and monounsaturated fats) and limit heart-harmful fats (saturated and trans fats, and cholesterol).

Your fitness routine should include aerobic and strength-training activities, and may also include stretching and balance activities. This physical activity should be in addition to your routine activities of daily living, such as cleaning or walking short distances, such as from the parking lot to your office. Health benefits are gained by doing the following each week:

* Aerobic activity that includes:
o 2 hours and 30 minutes of moderate-intensity aerobic activity, or
o 1 hour and 15 minutes of vigorous-intensity aerobic activity, or
o A combination of moderate and vigorous activity

and

* Muscle-strengthening activities on 2 or more days of the week

If you have not been physically active, start slowly and then work your way up as you become more fit. Regular physical activity and healthy eating habits — together — can help you feel your best today and everyday.

Source: http://www.womenshealth.gov/menopause/eating/

Soy. This contains phytoestrogens (estrogen-like substances from a plant). Some research has shown that soy food products can help with mild hot flashes. Other research suggests that women who have been diagnosed with estrogen-dependent breast cancer should be cautious with their soy intake. Eating large amounts of soy products could be harmful for women with this type of breast cancer.
Other sources of phytoestrogens. The active ingredients in most dietary supplements for menopause are phytoestrogens — chemicals found in plants that may act like the estrogen produced naturally in the body. These include herbs, such as black cohosh, wild yam, dong quai, and valerian root.
Bioidentical hormone therapy. Bioidentical hormones are custom-mixed formulas containing various hormones that are chemically identical to those naturally made by your body. These over-the-counter products are marketed as being tailored to a woman’s individual hormone needs. There are two main types of Bioidentical hormones:

1. Those that are FDA-approved and commercially available with a prescription
2. Those that are mixed on an individual basis for women in compounding pharmacies, which are NOT FDA-approved

It is important to know that alternative therapies can affect medical care by introducing personal belief systems that are not typically a part of the doctor-patient relationship.

Source: http://www.womenshealth.gov/menopause/treatment/

• Reducing hot flashes
• Treating vaginal dryness
• Slowing bone loss
• Easing mood swings and mild depressive symptoms—MHT alone is not effective in treating depression
• Improving sleep

For some women, MHT may increase their chance of getting:

• Blood clots
• Heart attacks
• Strokes
• Breast cancer
• Gall bladder disease

Who should NOT use MHT for menopause:
Women who . . .

• Think they are pregnant
• Have problems with vaginal bleeding
• Have had certain kinds of cancers (such as breast and uterine cancer)
• Have had a stroke or heart attack
• Have had blood clots
• Have liver disease

MHT can also cause these side effects:

• Bleeding
• Bloating
• Breast tenderness or enlargement
• Headaches
• Mood changes
• Nausea

Source: http://www.womenshealth.gov/menopause/

During perimenopause, some doctors suggest birth control pills to help with very heavy, frequent, or unpredictable menstrual periods. These pills might also help with symptoms like hot flashes, as well as prevent pregnancy. As you get closer to menopause, you might be bothered more by symptoms like hot flashes, night sweats, or vaginal dryness. Your doctor might then suggest starting MHT. A woman whose uterus has been removed can use estrogen alone to control her symptoms. But a woman who still has a uterus must take progesterone or a progestin (a man-made progesterone) along with the estrogen. These hormones will probably help with menopause symptoms and prevent the bone loss that can happen at menopause. However, there is a chance your symptoms will come back when you stop MHT.

Once a woman reaches menopause, MHT currently is recommended only as a short-term treatment of moderate to severe symptoms such as hot flashes or night sweats. Women who have problems with vaginal dryness can try lower dose estrogen products, such as vaginal creams, rings, and tablets. Long-term use of MHT is no longer advised, and doctors very rarely prescribe MHT to prevent certain chronic diseases, like osteoporosis. Postmenopausal women should not take MHT as they grow older to prevent problems like heart disease. A woman should talk about the benefits and risks of using MHT with her doctor to decide if MHT is right for her.

Source: U.S. Department of Health and Human Services.

* Hot flashes. Keep track of when hot flashes happen. You might be able to identify a pattern or triggers, which you can avoid. Dress in layers and keep a fan in your home or workplace. If lifestyle changes don’t seem to help, ask your doctor about menopausal hormone therapy or nonhormonal prescription drugs. Research has found that nonhormonal prescription drugs, such as antidepressants, help hot flashes in some women.
* Vaginal dryness. Try an over-the-counter water-based vaginal lubricant. Prescription estrogen replacement creams and tablets also can help restore moisture and tissue health. If you have spotting or bleeding while using estrogen creams, you should see your doctor.
* Problems sleeping. One of the best ways to get a good night’s sleep is to get at least 30 minutes of physical activity on most days of the week. But avoid physical activity close to bedtime. Also avoid alcohol, caffeine, large meals, and working right before bedtime. You might want to drink something warm, such as herb tea or warm milk, before bedtime. Keeping your bedroom cool and dark also can help. Avoid napping during the day and try to go to bed and get up at the same times every day.
* Memory problems. Some women complain about problems with memory and concentration. But there is no proof that menopause causes memory problems. Try to get enough sleep and engage in physical and social activity. If forgetfulness or other mental problems worry you or are affecting your everyday functioning, talk to your doctor.
* Mood swings. Try to get enough sleep and be physically active. Set limits for yourself, and look for positive ways to ease daily stress. Think about going to a support group for women who are going through the same thing as you, or getting counseling to talk through your problems and fears. Talk to your doctor if mood swings are causing you distress. Medicines might help. For instance, menopausal hormone therapy might help if mood swings are related to disrupted sleep caused by night sweats. Also, your doctor can look out for signs of depression, which is a serious illness that needs treatment.

Source: Office on Women’s Health in the U.S. Department of Health and Human Services.

• 2 hours and 30 minutes of moderate-intensity aerobic physical activity

  or

• 1 hour and 15 minutes of vigorous-intensity aerobic physical activity

  or

• A combination of moderate and vigorous aerobic activity

  and

• Muscle-strengthening activities on 2 or more days of the week

If you are not active, ask your doctor what’s okay for you. Activity is important for everyone.

Source: Office on Women’s Health in the U.S. Department of Health and Human Services.

Source: Office on Women’s Health in the U.S. Department of Health and Human Services.

• Soy. Soy contains phytoestrogens (estrogen-like substances from a plant). But, there is no proof that soy  —  or other sources of phytoestrogens  —  really do make hot flashes better. And the risks of taking soy  —  mainly soy pills and powders  —  are not known. The best sources of soy are foods such as tofu, tempeh, soymilk, and soy nuts.
• Other sources of phytoestrogens. These include herbs such as black cohosh, wild yam, dong quai, and valerian root. Again, there is no proof that these herbs (or pills or creams containing these herbs) help with hot flashes.

Products that come from plants may sound like they are safe, but there is no proof that they really are. There also is no proof that they are helpful at easing symptoms of menopause. Make sure to discuss these types of products with your doctor before taking them. You also should tell your doctor about other medicines you are taking, since some plant products can be harmful when combined with other drugs.

Source: Office on Women’s Health in the U.S. Department of Health and Human Services.

• Estrogen alone didn’t affect the risk of a heart attack. Estrogen did increase the risk of stroke. Estrogen also increased the risk of blood clots in the legs.
• Estrogen plus progestin may have slightly increased the risk of a heart attack. Progestin is a manmade form of the female hormone progesterone. Estrogen plus progestin raised the risk of stroke and blood clots in the legs and lungs.

Researchers continue to study this issue. The age at which MHT is started may be the key to whether this therapy reduces your chanc­es of getting heart disease. Most of the women in the NIH study did not start MHT until after the age of 60. Yet menopause happens for most women after the age of 45. Some experts think that many of the women in the NIH study may have already de­veloped narrowing and hardening of the arteries because of many years in which their estrogen levels were low. This would explain why estrogen did not protect against heart disease in the study.

More research on younger women may support the use of some kind of MHT to prevent heart disease. And more research will be need­ed to ensure that the benefits of such a therapy outweigh its risks. For now, the safest option for meno­pausal hormone therapy is to stick with the lowest dose for the shortest time to treat menopausal symptoms or treat bone loss, but not to prevent heart disease.

Studies on the effects of MHT on memory and other brain functions also have had mixed results. For now, MHT should not be used to prevent memory loss, dementia or Alzheimer’s disease.

Source: Office on Women’s Health in the U.S. Department of Health and Human Services.

• Think they are pregnant
• Have problems with vaginal bleeding
• Have had certain kinds of cancers (such as breast and uterine cancer)
• Have had a stroke or heart attack
• Have had blood clots
• Have liver disease
• Have heart disease

MHT can also cause these side effects:

• Vaginal bleeding
• Bloating
• Breast tenderness or swelling
• Headaches
• Mood changes
• Nausea

Be sure to see your doctor if you have any of these side effects while using MHT.

Source: Office on Women’s Health in the U.S. Department of Health and Human Services.