If like many women you are concerned about the side effects of HRT or hormone replacement therapy there are many natural options to consider. Listed below are alternatives that have solid research backing. In other words, they are solutions you can trust.

Dietary changes:

Whether you are in your 20s or your 50s it’s never too early to start preparing by making sure you have a good balance of nutrients. A healthy diet is the foundation stone of good health and is crucial during menopause for bone health and hormonal balance.

Coffee, sugar, alcohol and soft drinks should be avoided as they are known to increase the risk of osteoporosis. Instead of refined and processed food make sure you are eating plenty of fruit and vegetables, healthy protein and whole grains. You also need lots of nuts, seeds, oily fish like salmon and trout to ensure you’re getting essential fats.

Phytoestrogens are substances found in food that have a similar chemical structure to the oestrogen your body produces, and this may explain their hormone balancing effect. Studies show that they can not only take the place of natural oestrogens and increase oestrogen levels when they are too low but they can also reduce them when they are too high. As well as helping to balance hormones, phytoestrogens are also thought to have a protective effect on the heart. Research indicates that they can lower levels of bad cholesterol.

In addition, they may contain compounds that can inhibit breast and endometrial cancer (often due to excess oestrogen), fibroids, endometriosis and osteoporosis. Food sources of phytoestrogens include virtually all fruit, vegetables and cereals. However, ‘isoflavones’ — found in beans and lentils — are an even better source of phytoestrogens. Other excellent sources include: hummous, tofu, linseeds, lentils, garlic, kidney beans, mung and alfalfa bean sprouts, asparagus, plums and oats.

Food supplements:

If you suffer from dry skin and hair, aching joints, breast pain, vaginal dryness and have difficulty losing weight, you could be lacking in Essential Fatty Acids.

Food sources of essential fatty acids include oily fish, nuts and seeds but you could also supplement with fish oils to make sure you are getting enough Omega 3. The thinking nowadays is that we actually need more Omega 3 oils as we are not getting enough from our diet.

In addition to essential fats a good quality multivitamin and mineral should form the foundation of your supplement programme to make sure you have adequate nutrients for hormone balance and healthy bones, especially if you are over the age of 40 and already experiencing peri-menopausal symptoms. A good multivitamin and mineral I use in the clinic is Menoplus. You can then, if you feel you need an extra helping hand, add in other supplements which have suggested positive results in connection with the menopause; supplements like vitamin E, vitamin B, calcium and magnesium (or a combined calcium & magnesium supplement).

Vitamin E has been studied for many years for its ability to help reduce hot flushes. It is also beneficial for vaginal dryness and is a protective antioxidant that keeps skin healthy and supple. Good food sources of vitamin E include asparagus, avocados, brown rice, egg yolks, lima beans, peas, sweet potatoes, and vegetable oils.

The B vitamins (and vitamin B5 in particular) are renowned for their ability to relieve stress and support the adrenals. B vitamins also help to alleviate symptoms of anxiety, low energy levels and poor concentration that are often associated with the menopause. To boost your B vitamins go for a vitamin B complex (50mg a day of most of the B vitamins) and eat plenty of vitamin B rich food such as fish, eggs, nuts, seeds, soya beans, bananas, and leafy green vegetables.

Osteoporosis is usually a symptom of advancing age, but it can also be a consequence of the menopause. Oestrogen protects the bones by keeping calcium in the bones and thereby maintaining bone density. During and after the menopause when oestrogen levels are reduced, bone density decreases at a more rapid rate and studies have shown that supplementing with a combined calcium citrate and magnesium supplement can help maintain strong bones.

Herbs:

Agnus Castus is a great hormone balancer. It works best taken first thing in the morning, every morning and is especially for the premenopausal symptoms such as mood swings, irritability and depression which may start before the hot flushes and night sweats. Agnus Castus stimulates the pituitary gland which is in charge of producing and setting hormone levels.

Black Cohosh is the herb of choice for the menopause, hot flushes and night sweats and one of the medical journals in 2006 stated that black cohosh is ‘one of the most effective botanicals for vasomotor symptoms’. There have been concerns that black cohosh might have an oestrogenic effect and not be helpful for women with a history of breast cancer but a study showed that adding black cohosh to breast cancer cells actually slowed down the rate at which they multiplied.

There were also some suggestions that black cohosh might have a negative effect on the liver but the National Institutes of Health in America said there is no evidence of this.

Dong Quai is a herb which is often used in traditional Chinese Medicine as a tonic for the female reproductive system. During premenopausal phases, less active versions of female hormones are produced in the body e.g. oestrone instead of oestrogen. Dong Quai is believed to work by increasing the effects of these naturally produced hormones.

New research suggests that Dong Quai also contains phytoestrogens so it can work to boost oestrogen levels at the menopause and achieve a balance. The herb has proven to be most effective for relieving symptoms of the menopause, in particular hot flushes as well as vaginal dryness. (Call 0845 8800915 for details)

Milk thistle is also another useful herb around the menopause as it helps to improve liver function which is important for the detoxification of hormones.

I use a combination of organic herbs in the clinic called Black Cohosh Plus which are in vegetarian capsules.

Finally, herbs such as horsetail, nettle and alfalfa may also be used alongside dietary recommendations, supplements and exercise for the treatment of osteoporosis.

In a nutshell:

The menopause is a natural event in women’s lives and not an illness. There are many natural and effective alternatives to the drug approach of HRT, the most reliable of which have been detailed above, and these can really help to ease the emotional and physical discomfort associated with this time of life.

Eating well, exercising and using natural remedies around the menopause enables you to get on with your life and keep living it to the full.

If you’re taking a good multivitamin and mineral but still find it hard to feel energetic throughout the day it could be time to consider herbs. There is no herbal equivalent to a multivitamin but herbs can help treat symptoms such as anxiety, poor concentration, headaches, insomnia and lack of energy.

For concentration: Ginkgo biloba is the memory herb and studies have shown it can help prevent dementia.

For ageing: Milk thistle is a fantastic herb to help your body get rid of the effects of ageing free radicals.

For anxiety: Valerian and skullcap can help relax your nervous system when you feel anxious and tense. You can take them daily until you start to feel calmer.

For hot flushes: The best herbal supplement for hot flushes is black cohosh. Buy the whole herb in capsules or tincture and get organic where possible. I use a mix of herbs in the clinic containing black cohosh, agnus castus, dong quai, sage and milk thistle; they are contained in Black Cohosh Plus

For headaches: If you get recurring headaches you need to find out why. Are you getting enough sleep? Are you under stress? While you are working out why try taking feverfew everyday.

For mood: Taking St John’s Wort three times a day is a great way to lift your mood. Studies have shown that it is effective as an antidepressant, as long as you are NOT on any other medication, especially the pill or HRT. If stress or tiredness are contributing to your low mood try taking rhodiola daily for four weeks.

For weight loss: The best way to lose weight is to eat healthily and exercise more but some herbs, such as as green tea extract could help rev up your metabolism to help you burn more calories.

There are plenty of ways to boost your libido this March without resorting to prescription drugs like Viagra. In addition to healthy eating and regular exercise the following herbs are all thought to be beneficial:

(Note: If you’re on medication, pregnant or hoping to be seek specialist advice before taking these herbs.)

• Agnus Castus (vitex/chasteberry tree) has been shown to stimulate and normalise the function of the pituitary gland which in turn helps to balance sex hormones in women, in particular the ratio of progesterone to oestrogen.
• Damiana, derived from the dried aromatic leaves of a small shrub, has a long folk history dating back to the ancient Mayans as a sexual stimulant. It gently increases sensitivity of nerve endings to produce tingling and throbbing sensations in the genitals. It can be beneficial for those whose loss of sex drive is linked to decreased sensitivity and difficulty in achieving arousal.
• Dong Quai, or Chinese Angelica, is probably the best known Chinese herbal tonic for women. Valued highly in the East it is used to treat the entire reproductive system and encourage normal functioning of sex organs.
• Gingko Biloba is thought to improve blood circulation to the reproductive organs and have a stimulating effect on the genitals. Research on men suffering from erectile dysfunction showed a beneficial effect after six to eight weeks treatment, and after six months half of the patients had regained full potency. Ginkgo is also thought to be helpful for those whose low sex drive is linked to stress and fatigue.
• Siberian Ginseng can help you adapt to physical or emotional stress and fatigue. Ginseng is helpful for those whose low sex drive is linked to stress, over-work, fatigue, or hormone imbalances. It is also helpful for women whose low libido is related to menopausal symptoms.
• Horny Goat Weed: animal studies have demonstrated the aphrodisiac qualities of horny goat weed suggesting that it may influence levels of feel-good chemicals in the body. The leaves of horny goat weed also contain a variety of flavonoids (one prominent flavonoid is Icariin) that positively influence our reproductive health in many ways. For example, Icariin in particular is known to help with erectile function.
• Maca encourages hormonal balance which is great for sex drive as when hormone levels are balanced libido and well being are naturally boosted. So, if a man or woman is experiencing a lower sex drive due to declining levels of a certain hormone Maca increases production of that hormone.
• Passion Flower (Passiflora): studies show that passion flower improves circulation and nutrition to the nerves, including those in the sex organs. It’s a wonderfully stimulating but also relaxing remedy so you can have great sex and awake feeling refreshed and alert in the morning – time and time again.
• Saw Palmetto is a nourishing tonic for the reproductive system and well known remedy for low libido in both men and women for increasing sexual energy and fertility.
• St John’s Wort can significantly boost sex drive in those who are depressed or physically exhausted or for those whose loss of sex drive is linked to anxiety, stress, irritability or low mood. In one recent study, 60 per cent of post-menopausal women who took St John’s Wort for three months said they found themselves feeling more sexy and felt making love was more enjoyable.
• Wild Oat (avena sativa) is often used for stress and fatigue and is an ancient Chinese remedy for sexual decline. It is thought that oats can lower blood pressure and balance hormones and therefore boost desire in men and women.
• Wild Yam is an anti-inflammatory agent with hormone balancing properties, which can improve menstrual function and fertility in women. Yams (sweet potatoes) are a superfood for women because they are a good source of vitamin B6. Several studies have shown that vitamin B6 is essential for hormone balance and fertility in women. Vitamin B6 is also a great health boost for men too as it’s associated with reduced risk of poor health and increased vitality.