If not hormones--then what?

Background: The Women's Health Initiative study has made women reconsider their use of hormone therapy and made medical practitioners review the risks and benefits to each patient. The significance of lifestyle, nonprescription, and prescription therapies for menopause management are of increasing relevance.

Objective: This article reports on the evidence from randomised controlled clinical trials and population based cohorts on nonhormonal management of menopause symptoms and on the role of diet and exercise in osteoporosis prevention. Personal tips are included.

Discussion: Menopausal consultations should include a discussion of diet and exercise, and education of available over-the-counter therapies. For those women in whom oestrogen is contraindicated, prescriptions of serotonin noradrenergic reuptake inhibitors or clonidine may be indicated.