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.

激素法曾经是调整绝经期的最佳途径，但现在已经不使用这种方法了，那么妇女们应该如何适应绝经期呢？绝经期可能没什么症状，几个月就过去了，也可能半年，有些人甚至可能在几年里都受到绝经期症状的困扰。有些人只要坚持到底就可以了，而另一些人会使用很多方法、很多非医疗方法设法控制那些症状，比如潮热、发冷、阴道干燥、乳房胀痛、睡眠中断、头痛、情绪波动。下面介绍10种方法可以帮助您平稳度过绝经期：

1、多运动。尽管研究人员还未能从理论上证明这种方法的作用机理，但很多妇女发现，每次运动1小时、每周3次以上能够减轻潮热症状。保持经常运动也可以减轻压力、防止忧郁，这两种症状可能是由潮热引起的。更重要的是，它能够增强肌肉和并可减少骨质疏松和骨折的几率，骨质疏松和骨折是雌激素量降低下的普遍现象。

2、记录潮热日记。这可能能帮你找到引发潮热的原因。卧室里太热？晚餐中有辣椒？白天工作比较紧张？知道原因也许可以帮助防止潮热或者至少可以通过一些办法减少潮热出现的频率，比如坚持吃清淡食物、晚上不用空调等。

3、注意食品选择。除了辛辣食物，咖啡因和酒精也会干扰睡眠，引发潮热。正在绝经期的妇女早上要避免喝咖啡，晚上要避免喝酒。专家们指出，多喝水保持身体内的水分也有助于减轻那些症状。有些妇女很信赖膳食补充剂，比如维生素E（每天400IU）、大豆、黑升麻，但这同样没有研究成果支持。

4、坚持作息规律。每天晚上要睡7到8小时，每天尽量坚持同一时间上床，同一时间起床。如果可能的话，尽量把吃主食和中间零食的时间也变得规律起来。这些方法可以帮助身体系统维持平衡，如果更好一点还可以帮助对抗荷尔蒙变化。

5、深呼吸。练习用腹部慢慢的深呼吸，每分钟6-8次。这种方法在热潮来袭是尤其有效。以这样的速度进行深呼吸练习，每天2次，每次15分钟，对减压也有神奇的效果。做瑜伽和冥想也会对减轻绝经期症状有效。"虽然从临床上还没有证明这些做法对治疗更年期症状有效，但很多妇女都受益于这种方法。"美国宾夕法尼亚大学妇产科研究教授埃伦弗里曼说。

6、考虑使用一些非传统的治疗方法。到现在为止，还没有大量研究能够正视针灸可以帮助减轻更年期症状。但对随机抽取的267妇女进行对比表明，坚持在12周内进行了10次针灸治疗的妇女从总体上来说热潮的频率有所下降。这一结果发表在《更年期》杂志2009年5、6月刊上。而按摩可能还对减轻焦虑、失眠、头痛有效。

7、减轻阴道干涩。这是一种由于缺乏雌激素引起的很不舒服，有时很痛苦的情况。如果K-Y啫喱、维生素E、雷波仑等阴道润滑剂都没有达到效果，医生可能会建议采用局部阴道荷尔蒙治疗法，比如用环、吃药或者用乳膏。雌激素不用经过肝脏就能被血液吸收。如果你还有子宫，医生除了让你吃药片或者一些非片剂药物外，可能还会开孕酮给你，以此来防止子宫内膜癌风险的增加。局部使用雌激素通常对恢复阴道润滑和弹性有效。

8、向医生询问激素疗法。如果潮热、情绪不稳或其他症状在你改变了生活方式后还是继续困扰您，让你感到痛苦，可以征询一下医生激素治疗的方法，比如使用孕酮，或者没有子宫的妇女可以只使用雌激素。但是这种方法存在争议，每个决定都是独立的，都需对风险和效果进行仔细衡量。这是有争议的，该决定是一个人一个需要仔细权衡风险和收益。自从2002年妇女健康提倡协会的研究结果表明服用荷尔蒙对提高妇女患乳癌、血凝块、心脏病的风险后，妇女和医生都避免使用这种方法。现在这种情况似乎有所改观。一些专家说那些风险被夸大了，特别是对那些用量较少的年轻妇女。艾萨 克希夫说，妇女健康提倡协会的研究结果是基于由马萨诸塞州总医院妇产科部门进行的一项研究，参加该研究的妇女年龄平均为63岁。他说："如果你服用这种药物比较早，而且剂量小，可能会对荷尔蒙有些实实在在的好处，它可能会减少那些风险。"有些妇女选择了bioidentical激素，它具有与天然雌激素和孕激素相同的化学结构，相信使用这些产品比使用人工合成激素更安全。但还没有决定性的研究结果证实。

9、正确看待事物。在整个生命过程中，"过渡阶段只是很短的一段时间，"希夫说，"把这个过程看做是一个契机，对你的饮食、营养、运动、总体健康做一次全面清查。更年期并没有那么恐怖。实际上，一些妇女还在期待它，因为以后无需再为怀孕担心了。"

10.防止破坏性的骨质疏松。虽然在学术上这不是更年期症状，但更年期妇女通常都会有明显的骨质流失，为以后的骨质疏松症留下隐患。现在应该开始在日常饮食中额外补充钙质和维生素D了。通常，绝经前每天大约需要1000毫克钙，而更年期后，每天需要1500毫克。果汁、绿叶蔬菜如花椰菜和菠菜等蔬菜、杏仁、豆奶都是钙质的良好来源。

维生素D能帮助人体吸收钙，刺激骨骼形成。政府的建议用量为每日400国际单位，而国家骨质疏松症基金会（NOF）的建议用量为50岁以下的成年人每天400至800国际单位（IU）、50岁以上每天800至1000国际单位。每天晒15分钟太阳维生素D应该就可以吸收够了，至少在夏季是够了。