Many symptoms of menopause -- such as night sweats, mood swings, and hot flashes -- lessen over time. In fact, they may go away in a matter of months without any medical intervention. However, other menopause symptoms, such as vaginal dryness, often do require some treatment. This article from the Johns Hopkins Health After 50 newsletter provides alternative treatments for women who are reluctant to go on hormone replacement.

Menopause is associated with a number of symptoms; however, these menopause symptoms vary considerably in frequency and intensity from one woman to another. For many women, menopause symptoms are mild and/or infrequent, and therefore tolerable. For other women, menopause symptoms are so severe that some form of intervention is necessary.

While most symptoms of menopause are relatively innocuous, the decline in hormone production can cause bone loss and alterations in cholesterol levels -- changes that can markedly increase the risks of two serious disorders, osteoporosis and coronary heart disease (CHD).

For women who are reluctant to go on hormone replacement therapy (HRT) to relieve menopause symptoms because of the associated risks, alternatives are available. These options are proven to work:

• Off-label medications for menopause symptom relief. Selective serotonin reuptake inhibitor (SSRI) antidepressants given in small doses may be effective against hot flashes in some women. Gabapentin, a drug approved for the treatment of epilepsy, and blood pressure medications such as clonidine (Catapres) or methyldopa (Aldomet), also given in small doses, may help with hot flashes, too.

• Self-management for menopause symptom relief. Dressing in layers, avoiding hot beverages and spicy foods, and limiting alcohol may help reduce hot flashes. Healthy eating and exercise may also work.

• Vaginal lubricants for menopause symptom relief. Over-the-counter water-based lubricants are available. Prescription estrogen creams may also provide some short-term relief.

Other options are advertised to help relieve menopause symptoms, but research suggests otherwise:

• Phytoestrogens for menopause symptom relief. These supplements can be purchased over the counter. They are derived from plant estrogen, which is usually synthesized from soy beans or yams . Some women have claimed that plant estrogens relieve hot flashes, but recent research contradicts these reports.

  Approach these "natural" alternatives to estrogen with caution, because, like all supplements, phytoestrogens are not approved by the U. S. Food and Drug Administration, so their safety and efficacy have not been substantiated in rigorous clinical trials.

• Black cohosh for menopause symptom relief. A study that was published in the Annals of Internal Medicine of 351 women found that this herbal medicine relieved hot flashes no better than placebo.