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MENOPAUSE
Menopause is defined as the end of a woman’s monthly menstrual periods. The beginning of this time of change is referred to as perimenopause, while the period after menopause is called postmenopause.
Menopause used to be viewed as the beginning of old age. Today a majority of women in developed countries can expert to live more than a third of their lives after menopause.
During menopause, fluctuations in estrogen levels can cause symptoms like hot flashes, insomnia, sweats, vaginal dryness, difficulty concentrating, and weight gain. While some women experience few or no symptoms of menopause, others experience severe symptoms that cause them extreme discomfort.
Menopause can also affect a woman’s life expectancy and quality of life. before menopause a woman’s hormones protect her from developing heart disease, but with the onset of menopause that protection is lost. Bone loss results in part from the lack of estrogen as well as from inefficient absorption of calcium. A woman may lose 10 to 20 percent of her bone mass in the decade following menopause, with a slower but still significant loss thereafter. This bone thinning, or osteoporosis, increases the risk of fractures, which can lead to disability and pain.

HORMONE REPLACEMENT THERAPY
In the past many women have chosen to counteract the effects of estrogen loss with hormone replacement therapy, a combination of estrogen and progestin prescribed by their doctors. It was offered not only to treat the symptoms of menopause, but it was also believed that it provided protection against chronic diseases.
The women’s Health Initiative Study, which included more than 16,000 women, concluded that, although HRT is effective in relieving symptoms of menopause, its long-term use increase a postmenopausal woman’s risk of breast cancer, heart disease, stroke, and blood clots. As a result of these unsettling findings, experts are now recommending that HRT be used in the lowest possible dose, for the shortest period of time, when symptoms of menopause are so severe that they are interfering with quality of life.
To treat milder symptoms, and to avoid development of chronic disease, women are encouraged to adopt a healthy lifestyle and so try other approaches, which can include dietary change, exercise, and herbal remedies.

REGULAR EXERCISE
Regular exercise may help minimize mood swings and hot flashes. At least 30 minutes of exercise four to five times a week is recommended.

HERBAL PRODUCTS
Long before hormone replacement therapy, women often sought relief for their menopausal complaints with herbal remedies. Some of the more popular ones-for which there is some evidence of efficacy - are listed below. The evidence, however, is not compelling and the amounts of these substances found in commercial preparations is not standardized, which makes it difficult to assess results.
Black cohosh (cimicifuga racemosa). A number of studies have shown that black cohosh can alleviate many unpleasant symptoms of menopause, including irritability, poor concentration, insomnia, and depression.
Chasteberry (vites agnus-cactus). This herb has been useful in the management of fluid retention, hot flashes, anxiety, and depression.