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Recently we have seen news stories about two common methods of treating menopausal symptoms: Hormone Replacement Therapy (HRT) and black cohosh, an herbal treatment used widely as a substitute for HRT. Concerns about the safety of HRT have been heightened by a study that found a 15% drop in breast cancer rates in the 18 months after many women stopped taking HRT because of concerns about its safety. Another widely reported study found little improvement when women experiencing hot flashes were treated with black cohosh.

There is a wide range of symptoms associated with menopause; they include hot flashes, night sweats, vaginal dryness, loss of interest in sex, and mood swings. Heart disease and osteoporosis become more prevalent in postmenopausal women.

Scientists are constantly researching various medications, treatments, herbal preparations, nutritional strategies, and physical activity options to find safe and effective ways to make the menopause years comfortable, active and sexy. Here are nine options:

1. Soy can be used as a safe alternative to hormone therapy. Research has shown that soy protein can decrease the intensity and frequency of hot flashes and other symptoms, and can benefit the heart and bones. To be effective, most women need 100-160 grams of soy isoflavones (one type of phytoestrogen) per day, which translates to 2-4 servings of soymilk (1 cup), tofu (1/2 cup), tempeh (1/2 cup), edamame (1/2 cup), or soy nuts (three handfuls) per day. One easy way to eat soy is powdered soy protein that can be mixed with water, milk, or juice.

2. Flaxseed is an excellent source of fiber, Omega 3 fats, and lignins, (the other type of phytoestrogen) which act as cancer and heart disease preventatives. Golden flaxseed is the tastiest variety and can be bought in bulk at natural food stores or in bags in grocery stores. To use flax seed, grind cup and add to yogurt, cereal, and smoothies. Flaxseed oil and capsules can also be helpful, but these forms contain no fiber. Flaxseed should be refrigerated because the Omega 3 fats are highly perishable.

3. ERr 731 is a special extract of Rhubarb that reduced the frequency and severity of hot flashes in perimenopausal women. The women in the group receiving ERr 731 reported an average of 5.5 fewer hot flashes per day and an improved quality of life.

4. Genistein is an isoflavone found in soy and in other plants. Two recent studies have indicated that genistein may be effective in reducing hot flashes safely. In a 2004 study,

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