* Eat the right foods. Eating foods rich in phytoestrogens can allieviate menopausal symptoms. All pulses, tofu and whole soy products (avoid soy protein isolates), nuts, flaxseed and other seeds, grains (rice, oats, wheat, barley, rye), flax-seed oil, fruits (berries, grapes, all citrus fruit, watermelon, apples, cherries, plums), vegetables (celery, carrots, broccoli, sweet peppers, garlic, green beans, potatoes, rhubarb), sprouts (red clover, alfalfa, mung bean) and herbs (sage, fennel, parsley) can help with hot flushes, vaginal dryness and other menopausal symptoms. Aim for the equivalent of 45 g of soy flour a day (J Natl Cancer Inst, 1991; 83: 541-6).
* Cut down on meat and dairy, which slow the passage of stools and increase hot flushes.
* Reduce your intake of high levels of protein, which leaches calcium from your bones.
* Take supplements, including vitamins E (400-1200 IU), C (1 g/day or more) and D (200-400 IU), boron, hesperidin-derived bioflavonoids on an empty stomach (1000-2000 mg/ day) and the amino acid beta-alanine.
* Try homoeopathy, such as Lachesis (30c potency), four times a day for a few days, reducing gradually to once a day just before bedtime, or Silver nitrate (30c). Harald Gaier has had success with low potencies (6c or 30c) of Folliculinum, Caulophyllum or Helonias, once or twice a day for six months.
* Do exercise, particularly yoga, which has been shown to alleviate symptoms, including vaginal ones.
* Take more magnesium, rather than megadosing calcium, which helps to activate the key bone enzyme alkaline phosphatase. Women with osteoporosis are found to lack this enzyme, as well as magnesium, zinc, manganese and vitamin C.
* Use black cohosh for the short term. Of all natural supplements, this traditional herb alone has solid scientific evidence that it works (Ann Intern Med, 2002; 137: 805-13). But don't use it for more than six months and, then, only with the help of a qualified herbalist to monitor its effect on your liver. Don't use it if you have breast cancer in the family as even this herb has shown a tendency to spread breast cancer - at least, in one animal study (Davis VL et al. American Association for Cancer Research annual meeting, July 11-14, 2003, Washington, DC, abstr R910).