Countless women find that alternatives to HRT are effective in relieving night sweats and hot flushes as well as the mood swings and depression associated with the menopause. Last year, the Royal College of Obstetricians and Gynaecologists gave warning that many herbal remedies and supplements with purported benefits have not been properly tested and may interact with other medication. You should always discuss with your GP the course you are proposing to take. Here are some to consider:

Isoflavones

As one of the plant compounds called phytoestrogens, isoflavones are known to act in a similar way to the female hormone oestrogen in some parts of the body. Soya is a good source of isoflavones, says Maryon Stewart, spokesperson for the Natural Health Advisory Service and author of Beat Menopause Naturally. In countries such as Japan, where soy is a staple food, less than 25 per cent of women get hot flushes compared with 85 per cent of Western women. The daily consumption of isoflavones in Japan and China is between 20mg to 50mg compared with 1mg in the UK. Researchers suggest that 25 to 50mg has beneficial effects for the menopause. Soya milk, tofu, linseeds, chick peas, lentils and mung beans are good sources.

Vitamins and minerals

“Giving women vitamin C with bioflavonoids has been shown to help reduce hot flushes,” says Dr Marilyn Glenville, author of The New Natural Alternatives to HRT. “It helps to build up collagen, which gives skin its elasticity and it is helpful in the prevention and treatment of vaginal dryness.” Many clinical studies have indicated that vitamin E is helpful for vaginal dryness, common during the menopause, with one indicating that a 400-IU supplement taken daily helped improve the condition in 50 per cent of women. Dr Shirley Bond, a GP and medical adviser to the Natural Menopause Advisory Service, says that zinc (found in seafood) and vitamin B6 (in eggs, fish and poultry) are particularly important in hormone production and maintenance.

Omega oils

Maintaining a proper balance of dietary fats can help to prevent much of the bone loss associated with postmenopausal osteoporosis, according to a study by scientists at the Indiana University School of Medicine last year. Researchers found that diets with a low ratio of omega-6 fatty acids (found in grains and meat) to omega-3 fatty acids (found in nuts and fish oils) minimised the osteoporosis brought on by oestrogen deficiency.

Herbs

According to Dr Shirley Bond, the herbal remedy black cohosh “outperformed HRT in relieving stress and anxiety related to the menopause”. Sage has a direct action on the sweat glands and may help to control the mechanism that underlies hot flushes, she says. Glenville describes agnus castus as “the most potent remedy for hot flushes as it contains the chemical precursors of the sex hormones”. She says that it works as an adaptogen, balancing all hormone production and “it stimulates the function of the pituitary gland which controls the hormones in our body”.

Exercise

Being physically fit offsets cognitive declines attributed to HRT’s long-term use, claims a study at the University of Illinois, published in the Neurology journal last month. “We found that higher fitness levels enhance the effects of shorter durations of hormone treatment and offset the mental declines associated with long-term use,” Professor Arthur Kramer, a psychologist, said. “It may be that HRT and exercise boosts both cognition and brain structure of older women.” It can also ward off menopause-related weight gain. The University of Pittsburg found that twice as many sedentary menopausal women gained 5lb or more.

Homeopathy

Results of small-scale trials in the treatment of menopausal symptoms such as hot flushes, fatigue and mood disturbance, appear to be helped by homeopathy. There are five homeopathic hospitals within the NHS and your GP must provide a referral either to one of them or to a registered homeopath.