Making the Most of HRT and Nonhormonal Therapy

You should not rely entirely on hormones or other medications to enhance the quality of life after menopause. It is within your power to take very practical measures that can prevent or alleviate many of the symptoms that occur.

For example, there is a natural approach to take against osteoporo­sis. Remember that osteoporosis is preventable if you can control two main processes. First, you can develop as much bone as possible during your first forty years, before menopause. Second, you can reduce the rate of bone loss that may occur after menopause.

Success in doing these things often requires some changes in life­style that call for dedication and persistence. But, studies have shown conclusively that an inappropriate diet, lack of weight-bearing exer­cise, and heavy cigarette smoking contribute to loss of bone. If you are willing to make a few changes in your lifestyle, you could protect your skeleton.

There is still the problem of hot flashes and the question of whether, they can be alleviated without drugs. Hot flashes are one of the most disabling symptoms of menopause. They can interfere with the quality of a woman’s life and even with her ability to function. There is no doubt that HRT remains the most effective method known for dealing with this symptom.

For women who cannot tolerate taking estrogens, or who are not medically permitted to take HRT, the fact that nonhormonal medica­tions are not generally effective can be a desperate medical dilemma. Biofeedback training may provide some relief in such cases. With this process women learn to control and manipulate various body mech­anisms, such as heart rate, blood vessel diameter, and muscle tension, which are usually controlled without your awareness by your autono­mous nervous system. Research in biofeedback training is still in its early stages, but we hope that in the future it may offer a nonpharmacologic means of reducing the discomfort of hot flashes.

Work continues as well with progressive relaxation training, a fairly recent method for learning how to relieve stress and tension through practiced relaxation, which may bring some relief. While new tech­niques are under study, you can try other minor changes in your lifestyle to reduce the severity or the number of your hot flashes. Changing the kind of clothes you wear may help. Give up heavy sweaters and try layering clothing instead. Alter your activities when­ever possible to reduce stress. Attempting to gain some conscious control of your hot flashes through relaxation therapy may be produc­tive. A good relaxation therapist can teach you how.

Avoiding Cardiovascular Disease

As we will discuss later, the use of estrogen in HRT does appear to be associated with a distinct reduction in the risk of cardiovascular disease. Other factors can also be employed to reduce the incidence of this disease.

Other ways of combating heart disease without estrogen include stopping smoking. Smoking is the most harmful of all habits and probably the most significant cause of coronary heart disease. Another method is gaining control of the stresses in your life and working toward reducing your negative responses to them if you cannot elimi­nate the stresses themselves.

Enhanced Well-Being

Exercise also produces this special feeling of well-being. Often termed “runner’s euphoria” or “swimmer’s high,” athletes some­times cite this sense of well-being as one of the benefits of pursuing their sport. Many people start an exercise program, lose interest, and drop out. Quitting is most likely to occur during the first three months of an exercise program, which is a shame, because most studies show that the mood-enhancing effects of exercise develop strongly after three months of regular exercise. After several months, you usually achieve physical fitness as well. If you hang in there, you can expect to feel better, enjoy all of your activities more, combat exhaustion from work, and perhaps relieve menopausal discomforts.