In the years since hormone therapy was dethroned as the best way to adjust to menopause-the transition ranges from a few symptom-free months to six or more life-disrupting years-how have women adapted? While some are simply toughing it out, others are trying numerous approaches, many nonmedical, to manage their hot flashes, chills, vaginal dryness, breast tenderness, sleep disruptions, headaches, and mood swings. Here are 10 strategies that can help you make the transition smoothly:

    1. Get moving.Many women find that working out for an hour three or more times a week provides relief from hot flashes, though researchers haven't been able to document this in studies. Aerobic exercises such as walking, swimming, dancing, and bicycling are good options. Staying active also reduces stress and staves off the blues, which can both result from hot flashes. What's more, it builds muscle and may reduce bone loss and fractures, which become more common as estrogen production falls.

    2 . Keep a hot flash journal.This may help you pinpoint what's triggering those hot flashes. Is it an overheated bedroom? Spicy supper? Stressful day? Knowing the cause may help you ward off hot flashes or at least reduce their frequency by, say, sticking with blander foods or turning down the thermostat at night.

    3. Watch what you eat.In addition to spicy foods, caffeine and alcohol can disrupt sleep and trigger a hot flash. Women who are affected can limit caffeine to mornings and avoid alcohol in the evening. Experts note that it also helps to stay hydrated by drinking plenty of water. Some women swear by certain dietary supplements: vitamin E （400 IU a day）, soy, and black cohosh, but, again, research is lacking on these.

    4. Stick to a regular schedule.Make it a priority to get seven to eight hours of shut-eye a night, and try to go to bed and wake up at roughly the same time each day. If possible, eat your meals and snacks on a regular schedule. All of these help keep your body's systems on an even keel, better able to withstand hormonal changes.

    5. Breathe deeply.Practice slow breathing from the abdomen-taking six to eight deep breaths a minute. This technique can be particularly helpful at the onset of a flash. Carving out 15 minutes twice a day for this type of slowdown can work magic in busting stress, too. You may also benefit from adding yoga or meditation to your regimen. "While these practices have not been proven to be effective for treating menopausal symptoms in clinical trials, many women do find relief," says Ellen Freeman, a research professor in the department of obstetrics and gynecology at the University of Pennsylvania.

    6. Consider unconventional treatments.Until now, no large study has shown that acupuncture helps relieve menopause symptoms. But a randomized controlled trial of 267 women, published in the May/June 2009 issue of the journal Menopause, shows an overall reduction in hot flash frequency in women who received 10 treatments over 12 weeks. Massage may also help in relieving anxiety, insomnia, and headaches.

    7. Alleviate vaginal dryness.This is an uncomfortable, and sometimes painful, condition frequently due to a lack of estrogen. If estrogen-free vaginal lubricants such as K-Y Jelly, vitamin E, or Replens don't provide relief, your doctor might recommend a local vaginal hormone treatment via a ring, tablet, or cream. The estrogen is absorbed into your bloodstream without passing through your liver. （If you still have a uterus, your doctor may prescribe progesterone tablets to counteract an increased risk of endometrial cancer associated with taking estrogen pills alone and possibly with nonpill forms of estrogen.） Topical estrogen is usually effective at restoring vaginal lubrication and elasticity.

    8. Ask your doctor about hormone therapy.If hot flashes, mood swings, and other symptoms continue to make your life miserable after you make lifestyle changes, consult your doctor about hormone treatment-estrogen with progesterone, or estrogen alone for women who no longer have a uterus. This is controversial, and the decision is an individual one that requires carefully weighing the risks and benefits. After the 2002 Women's Health Initiative findings suggested that women taking hormones were at a higher risk for breast cancer, blood clots, and heart disease, women and doctors turned away from the treatment. Today, the pendulum seems to be swinging back. Some experts now say the risks have been overblown, especially for younger women on low doses. The WHI findings were based on a study of women with an average age of 63, says Isaac Schiff, head of the obstetrics and gynecology service at Massachusetts General Hospital. "If you start relatively early with small doses, there are some real benefits to hormones, which can bring relief with diminished risks," Schiff says. Some women are opting for bioidentical hormones, which have the same chemical structure as natural estrogen and progesterone, in the belief that these products provide safer relief of menopausal symptoms than do synthetic hormones. But the jury is still out on that.

    9. Put things in perspective.In the overall scheme of things, "the transition is a very short time in your life," Schiff says. "Look at this as an opportunity to do an inventory of your diet, nutrition, exercise, and overall health. There's no terrible danger about menopause. In fact, some women actually look forward to it-happy not to have a period or worry about pregnancy."

    10. Prevent crippling bone loss.While technically this isn't a menopause symptom, menopausal women typically lose a significant amount of bone mass, setting the stage for osteoporosis later in life. Now is the time to start adding extra dollops of calcium and vitamin D to your daily diet. In general, before menopause, you need about 1,000 mg of calcium per day. After menopause, you need 1,500 mg per day. Good sources are fruit juices, green leafy vegetables-such as broccoli and spinach greens-almonds, and soy milk.

    Vitamin D helps the body absorb calcium and stimulates bone formation. The government's recommended daily amount is 400 international units, though the National Osteoporosis Foundation （NOF） recommends 400 to 800 international units （IU） of vitamin D daily for adults under 50 and 800 to 1,000 IU of vitamin D daily for adults 50 and over. If you get 15 minutes of sunlight a day, that might be enough, at least in the summer months.

    激素法曾經(jīng)是調(diào)整絕經(jīng)期的最佳途徑，但現(xiàn)在已經(jīng)不使用這種方法了，那么婦女們應(yīng)該如何適應(yīng)絕經(jīng)期呢？絕經(jīng)期可能沒什么癥狀，幾個月就過去了，也可能半年，有些人甚至可能在幾年里都受到絕經(jīng)期癥狀的困擾。有些人只要堅持到底就可以了，而另一些人會使用很多方法、很多非醫(yī)療方法設(shè)法控制那些癥狀，比如潮熱、發(fā)冷、陰道干燥、乳房脹痛、睡眠中斷、頭痛、情緒波動。下面介紹10種方法可以幫助您平穩(wěn)度過絕經(jīng)期：

    1、多運(yùn)動。盡管研究人員還未能從理論上證明這種方法的作用機(jī)理，但很多婦女發(fā)現(xiàn)，每次運(yùn)動1小時、每周3次以上能夠減輕潮熱癥狀。保持經(jīng)常運(yùn)動也可以減輕壓力、防止憂郁，這兩種癥狀可能是由潮熱引起的。更重要的是，它能夠增強(qiáng)肌肉和并可減少骨質(zhì)疏松和骨折的幾率，骨質(zhì)疏松和骨折是雌激素量降低下的普遍現(xiàn)象。

    2、記錄潮熱日記。這可能能幫你找到引發(fā)潮熱的原因。臥室里太熱？晚餐中有辣椒？白天工作比較緊張？知道原因也許可以幫助防止潮熱或者至少可以通過一些辦法減少潮熱出現(xiàn)的頻率，比如堅持吃清淡食物、晚上不用空調(diào)等。

    3、注意食品選擇。除了辛辣食物，咖啡因和酒精也會干擾睡眠，引發(fā)潮熱。正在絕經(jīng)期的婦女早上要避免喝咖啡，晚上要避免喝酒。專家們指出，多喝水保持身體內(nèi)的水分也有助于減輕那些癥狀。有些婦女很信賴膳食補(bǔ)充劑，比如維生素E（每天400IU）、大豆、黑升麻，但這同樣沒有研究成果支持。

    4、堅持作息規(guī)律。每天晚上要睡7到8小時，每天盡量堅持同一時間上床，同一時間起床。如果可能的話，盡量把吃主食和中間零食的時間也變得規(guī)律起來。這些方法可以幫助身體系統(tǒng)維持平衡，如果更好一點還可以幫助對抗荷爾蒙變化。

    5、深呼吸。練習(xí)用腹部慢慢的深呼吸，每分鐘6-8次。這種方法在熱潮來襲是尤其有效。以這樣的速度進(jìn)行深呼吸練習(xí)，每天2次，每次15分鐘，對減壓也有神奇的效果。做瑜伽和冥想也會對減輕絕經(jīng)期癥狀有效。"雖然從臨床上還沒有證明這些做法對治療更年期癥狀有效，但很多婦女都受益于這種方法。"美國賓夕法尼亞大學(xué)婦產(chǎn)科研究教授埃倫弗里曼說。

    6、考慮使用一些非傳統(tǒng)的治療方法。到現(xiàn)在為止，還沒有大量研究能夠正視針灸可以幫助減輕更年期癥狀。但對隨機(jī)抽取的267婦女進(jìn)行對比表明，堅持在12周內(nèi)進(jìn)行了10次針灸治療的婦女從總體上來說熱潮的頻率有所下降。這一結(jié)果發(fā)表在《更年期》雜志2009年5、6月刊上。而按摩可能還對減輕焦慮、失眠、頭痛有效。

    7、減輕陰道干澀。這是一種由于缺乏雌激素引起的很不舒服，有時很痛苦的情況。如果K-Y啫喱、維生素E、雷波侖等陰道潤滑劑都沒有達(dá)到效果，醫(yī)生可能會建議采用局部陰道荷爾蒙治療法，比如用環(huán)、吃藥或者用乳膏。雌激素不用經(jīng)過肝臟就能被血液吸收。如果你還有子宮，醫(yī)生除了讓你吃藥片或者一些非片劑藥物外，可能還會開孕酮給你，以此來防止子宮內(nèi)膜癌風(fēng)險的增加。局部使用雌激素通常對恢復(fù)陰道潤滑和彈性有效。

    8、向醫(yī)生詢問激素療法。如果潮熱、情緒不穩(wěn)或其他癥狀在你改變了生活方式后還是繼續(xù)困擾您，讓你感到痛苦，可以征詢一下醫(yī)生激素治療的方法，比如使用孕酮，或者沒有子宮的婦女可以只使用雌激素。但是這種方法存在爭議，每個決定都是獨立的，都需對風(fēng)險和效果進(jìn)行仔細(xì)衡量。這是有爭議的，該決定是一個人一個需要仔細(xì)權(quán)衡風(fēng)險和收益。自從2002年婦女健康提倡協(xié)會的研究結(jié)果表明服用荷爾蒙對提高婦女患乳癌、血凝塊、心臟病的風(fēng)險后，婦女和醫(yī)生都避免使用這種方法�，F(xiàn)在這種情況似乎有所改觀。一些專家說那些風(fēng)險被夸大了，特別是對那些用量較少的年輕婦女。艾薩 克希夫說，婦女健康提倡協(xié)會的研究結(jié)果是基于由馬薩諸塞州總醫(yī)院婦產(chǎn)科部門進(jìn)行的一項研究，參加該研究的婦女年齡平均為63歲。他說："如果你服用這種藥物比較早，而且劑量小，可能會對荷爾蒙有些實實在在的好處，它可能會減少那些風(fēng)險。"有些婦女選擇了bioidentical激素，它具有與天然雌激素和孕激素相同的化學(xué)結(jié)構(gòu)，相信使用這些產(chǎn)品比使用人工合成激素更安全。但還沒有決定性的研究結(jié)果證實。

    9、正確看待事物。在整個生命過程中，"過渡階段只是很短的一段時間，"希夫說，"把這個過程看做是一個契機(jī)，對你的飲食、營養(yǎng)、運(yùn)動、總體健康做一次全面清查。更年期并沒有那么恐怖。實際上，一些婦女還在期待它，因為以后無需再為懷孕擔(dān)心了。"

    10.防止破壞性的骨質(zhì)疏松。雖然在學(xué)術(shù)上這不是更年期癥狀，但更年期婦女通常都會有明顯的骨質(zhì)流失，為以后的骨質(zhì)疏松癥留下隱患。現(xiàn)在應(yīng)該開始在日常飲食中額外補(bǔ)充鈣質(zhì)和維生素D了。通常，絕經(jīng)前每天大約需要1000毫克鈣，而更年期后，每天需要1500毫克。果汁、綠葉蔬菜如花椰菜和菠菜等蔬菜、杏仁、豆奶都是鈣質(zhì)的良好來源。

    維生素D能幫助人體吸收鈣，刺激骨骼形成。政府的建議用量為每日400國際單位，而國家骨質(zhì)疏松癥基金會（NOF）的建議用量為50歲以下的成年人每天400至800國際單位（IU）、50歲以上每天800至1000國際單位。每天曬15分鐘太陽維生素D應(yīng)該就可以吸收夠了，至少在夏季是夠了。