By CAMILLE SWEENEY


After six years on a prescription estrogen patch that alleviated her hot flashes, but did nothing to address her midlife 11-kilogram weight gain, Martha B. started searching for a natural alternative to treat her menopausal symptoms.

��When I couldn��t button my size 12 jeans, I just told myself ��Enough��s enough,���� said the 57-year-old teacher who lives in Atlanta and requested that her full name not be used.

She turned to an over-the-counter supplement called Estroven, with ingredients that include black cohosh and phytoestrogens - botanical compounds found in soy and other plants that have been shown to have estrogenlike effects in humans.

Without changing her eating habits, Martha said she lost 9 kilograms. But after four months off the patch, the hot flashes came back. Now, she said, she is wondering, ��What do I do next?��

According to experts, about 70 percent of women experience hot flashes, weight gain, loss of libido and other symptoms as they transition from their fertile to postfertile years and their hormone levels fluctuate sharply.

In 2002, when the initial findings of a National Institutes of Health study - known as the Women��s Health Initiative project - suggested that women on conventional hormone therapy were at greater risk for heart disease, cancer, stroke and blood clotting, the market for alternative treatments soared. There are now more than 500 products that purport to relieve symptoms.

But some, like Rebecca Hulem, a nurse practitioner and menopause coach in Agoura Hills, California, said there is confusion about the products. ��Many of my patients come in with a bag of stuff they��ve been trying a few weeks here, a few months there, and tell me, ��Sometimes this works, sometimes it doesn��t,���� she said.

��Women have to be sophisticated consumers about their own health and whatever they��re taking, and ask themselves, ��Is it safe? Is it effective?���� said Dr. Winnifred Cutler, author of ��Hormones and Your Health: The Smart Woman��s Guide to Hormonal and Alternative Therapies for Menopause.�� ��Just because it��s natural, doesn��t mean it��s good for you.��

But some experts contend it is not the products that are harmful, but how they are used. ��I think over all these products are generally safe, but must be taken in the right circumstances and in conjunction with a mindfully healthy approach to life if they are going to be effective at all,�� said Dr. Theresa Ramsey, director of the Center for Natural Healing in Paradise Valley, Arizona.

Still, some studies have questioned the efficacy of progesterone creams. Other experts have suggested that even small amounts of progesterone can accumulate in fat cells and disrupt the production and synthesis of other hormones. Some studies suggest that the use of soy supplements may lead to an increased risk of breast cancer and other hormone-related cancers.

��There is a lot of confusion,�� said Dee Adams, who runs minniepauz.com, a Web site devoted to menopause. ��A lot of women went cold turkey after the Women��s Health Initiative results came out. They stopped trusting their doctors. They stopped trusting the pharmaceutical companies. Many see these natural treatments as a way of taking back control of their bodies. The problem is, we have no idea of what��s in them.��


There are more than 500 products for menopause, but confusion arises over which ones are safe and effective.