Recent studies in both the US and Britain provide powerful evidence that combined Hormone Replacement Therapy can increase the risk of breast cancer, stroke and heart attack.

In August 2003 results from the Million Women Study in Britain revealed that women on combined HRT were twice as likely to develop breast cancer than those who had never used it. The increased risk started between one and two years of HRT use and grew larger the longer the treatment continued. Whilst health professionals are urging women to discuss using HRT with their doctors if they decide to stop there is a growing need to find healthy alternatives.

There is much information about Bio-identical hormones produced by compounding pharmacists to match a person's own individual hormone profile and there are many success stories about their use. But more importantly, lifestyle modifications can empower women to take responsibility for their own health.

They include:

ü weight bearing exercise on a regular basis such as walking

ü giving up smoking

ü reducing tea and coffee and substituting with herbal teas

ü reducing alcohol consumption

ü using stress reduction techniques like yoga, meditation and tai chi,

ü eating a wholefood, minimally processed diet that is high in vegetables, fruits, wholegrains, fish, nuts, seeds and beans.

ü vitamin, mineral and herbal supplements

Complementary therapies such as homeopathy, naturopathy and Traditional Chinese Medicine can also be very beneficial in alleviating symptoms of the menopause such as hot flushes.

Viewing menopause as a natural part of the female life-cycle and all that it embraces rather than an estrogen-deficiency disease is the first step. Focussing on improving your diet by going back to basics can ease the transition. The antioxidants Vitamin E, C and betacarotene in fruits and vegetables have powerful anticancer and heart protection properties. Eating at least 2 pieces of fruit and 5 serves of vegetables per day (salad at lunch, cooked veg in the evening) is a great start. Other powerful antioxidants are selenium, zinc, glutathione, grapeseed extract, pine bark extract, green tea and rooibos tea.

Reduce highly processed carbohydrates and fatty foods and increase the amount of water you drink whilst cutting back on tea and coffee.

Soysational

Soy beans and foods made from soy beans such as soy milk, tofu and miso contain some of the highest levels of plant hormones. These phytoestrogens, also found in flaxseeds, wholegrains, fennel, celery, parsley, alfalfa and many herbs (black cohosh, dong quai, licorice, wild yam, red clover) can lessen some of the symptoms of menopause like hot flushes and vaginal dryness. They can also acts as anti-estrogens by blocking excess estrogens . Because herbs have a powerful action, it is recommended that you see your health professional to seek advice before incorporating soy-based products into your diet or taking herbs specifically for menopause.

Good oils

Essential fats in flax oil, nuts, seeds and fish are rich sources of omega 3 fatty acids which can reduce platelet stickiness and inflammation, increase circulation and improve immune function as well as revitalising skin, hair and overall wellbeing. Vitamin E, also found in nuts, seeds and their cold pressed oils and eggs, can help reduce hot flushes. It is also a good idea to cut back on hot, spicy foods and alcohol.

Make mine brown

Wholegrains and pulses are high in fibre and complex carbohydrates. Fibre has important cleansing effects in the bowel, absorbing excess estrogens and cholesterol and helping to clear them from the body. Oatmeal is high in soluble fibre keeping the blood sugar constant. It also contains mucopolysaccharides which are important in bone and cartilage structure, wound healing and tissue regeneration. Wholegrains such as rye, millet, barley and rice are also good alternatives for wheat intolerant people. Peas and beans such as chickpeas and lentils are also high in soluble fibre, protein and a good source of iron and zinc.

The calcium connection

Calcium, magnesium, Vitamin D, boron, silicon and other trace minerals are critical to the maintenance of bone. Including three serves of dairy products or other sources of calcium such as sea vegetables found in Japanese foods, tinned fish with bones (sardines and salmon), nuts and seeds, green leafy vegetables and beans in your regular diet can help keep bones strong and reduce the risk of osteoporosis. Drinking tea, coffee and soft drinks with meals, eating highly processed wheat bran and overconsumption of red meat can all rob the body of calcium. If you are taking a calcium supplement, divide the dose through out the day, taking some at night when it is better absorbed. Combinations of calcium lactate, malate or ascorbate are better choices that calcium carbonate as this form of calcium is harder to absorb.

Healthy glands

The adrenal glands manufacture small amounts of estrogen but when you are under continual stress or are eating a diet high in refined carbohydrates such as white bread and sugar the adrenal glands become depleted and are unable to manufacture estrogen. Low or highly refined carbohydrate diets can also deplete the body of B group vitamins which assist in digestion, metabolism and adrenal function, trigger mood swings and depression and contribute to hypoglycaemia (low blood sugar).

An underactive thyroid can cause a whole range of symptoms before, during or after menopause such as fatigue, unexplained weight gain, sensitivity to cold, sluggishness, constipation, dull hair, eyebrow thinning and blood sugar fluctuations. It is advised that women over 50 have a routine blood test for thyroid function. Eating a wholefood, unprocessed diet high in fish, nuts, seeds, wholegrains and beans helps to keep your thyroid healthy.

Most importantly take time to nurture yourself with food. Prepare simple but appealing meals with fresh, preferably organic ingredients and eat with pleasure.