By Sandra Gordon

Hot flashes. Memory loss. Sleeplessness. Let's face it - Menopause, which is defined as missing your period consecutively for a year at around the age of 51 (though it can happen anywhere from 30 to 59) when the ovaries stop producing estrogen doesn't exactly have a pleasant reputation, but look to the bright side. "You don't have to worry about contraception anymore, and if you were troubled by heavy periods, endometriosis, fibroids, or PMS, menopause cures that," says Mary Jane Minkin, M.D., clinical professor of obstetrics and gynecology at Yale University School of Medicine and the co-author of A Woman's Guide to Menopause and Perimenopause (Yale University Press, 2005). "It can be a wonderful time in life."
Still, estrogen is a powerful hormone. During menopause, a cluster of symptoms that can disrupt your life may occur due to the loss of estrogen, and last from one to four years or longer, until "the change" is complete. "Studies show that ten years past menopause, 85 percent of women are 100 percent better, but 15 percent continue to have moderate to severe symptoms," says Dr. Minkin, who is 53.Whether your symptoms are fleeting or lingering, here's what you can do during menopause to maintain your quality of life:

Hormone Help
Waking up between 1 a.m. and 3 a.m. — and taking a while to go back to sleep — is a common menopausal symptom, as are hot flashes (feeling heated or flushed, which can be mild or extreme) lasting from 2 to 30 minutes, especially at night. Nocturnal awakening and hot flashes often accompany each other; they're thought to be caused by surges of adrenaline and other hormones activated by the brain to try to drive the ovaries to make more estrogen, says Dr. Minkin.
Nonetheless, to have the energy to get through your day, you need to get your ZZZ's. To say goodnight to nighttime hot flashes and awakenings, consider supplemental estrogen or a combination of estrogen and progestin (a synthetic form of the female hormone progesterone), taken by pill or skin patch. Despite the Women's Health Initiative, a major study that showed that hormone therapy could increase a woman's risk of breast cancer and heart disease, supplemental hormones are still used for menopausal symptoms like nocturnal awakenings and hot flashes. Studies involving pre- and postmenopausal women find that estrogen replacement helps women go to sleep faster, decreases wakefulness after falling asleep, and increases total sleep time. "When estrogen gets into the blood, the brain gets tricked into thinking the ovaries are making
estrogen," explains Dr. Minkin.

Bottom-line: You're less likely to experience the hormonal surges that can disrupt your shut-eye.
The current thinking is that hormone therapy is safe if taken for a short time in low doses. Dr. Minkin believes
hormone therapy is worth trying for a month or two, to see if your menopausal symptoms abate. But hormone therapy isn't right for everyone. It's not recommended, for example, if you have a history of cancer, stroke or heart attack. If you're
prescribed hormone therapy, be sure you're evaluated every three to six months to make sure you still need it. To discontinue hormone therapy, work with your doctor to taper off the medication.

Consider the Alternatives
If you can't take hormone therapy or don't want to try it, non-hormonal remedies are available and may ease many symptoms.
If natural or homeopathic efforts such as meditation or calming caffeine-free tea to help you get your sleep don't work, you may want to talk with your doctor about short-term prescription sleep medications.
For hot flashes that occur day or night, some women find relief by loading their diet with flaxseed and soy, including tofu, tempeh, miso and edamame. Both flaxseed and soy are natural sources of plant estrogens that may work like
supplemental estrogen. If you have a family history of breast cancer, ask your doctor about recent soy studies. Layer your
clothing, keep the temperature low and avoid common triggers, such as hot coffee, wine and hot soup.

Back to Basics
Finally, exercising regularly, not smoking, eating a balanced diet and finding fun ways to relax to reduce stress can enhance your quality of life during menopause. While you're at it, if you have children, keep a journal. You may want to share it with your daughter or granddaughter someday.

Sandra Gordon is a freelance writer living in Weston, Connecticut.