Many approaches have been promoted as aids in managing the symptoms of menopause. Below are some complementary and alternative treatments that have been or are being studied:

• Phytoestrogens: These estrogens occur naturally in certain foods. There are two main types of phytoestrogens — isoflavones and lignans. Isoflavones are found in soybeans, chickpeas and other legumes. Lignans occur in flaxseed, whole grains and some fruits and vegetables. Researchers first became interested in phytoestrogens when they noted that women in Japan and China, who eat diets high in isoflavones, report fewer menopausal signs and symptoms and have a lower incidence of heart disease and osteoporosis than do women in the West. Whether the estrogens in these foods can relieve hot flashes and other menopausal signs and symptoms remains to be seen. Most studies have found them ineffective.

  Isoflavones have some weak estrogen-like effects, so there's some concern about cancer risk. If you've had breast cancer, talk to your doctor before supplementing your diet with isoflavone pills. Experts generally consider whole foods containing soy or isoflavones to be healthy and safe, when consumed in moderation.

  The bottom line? Phytoestrogens are estrogens, and there's no evidence that effective doses wouldn't cause problems similar to those that prescription estrogens are known to raise.

• Vitamin E: This vitamin occasionally provides relief from mild hot flashes for some women. However, scientific studies haven't proved its overall benefit in relieving hot flashes, and taking more than 400 international units of vitamin E supplements daily may not be safe.

• Black Cohosh: Black cohosh has been used widely in Europe for treating hot flashes and has been popular among women with menopausal symptoms. While its safety record has been good, there's no longer much reason to believe that it is effective for menopausal symptom relief.

  You may have heard of - or even tried - other dietary supplements, such as dong quai, licorice, chasteberry, evening primrose oil and wild yam (natural progesterone cream). Although some might swear by these remedies, scientific evidence of their safety and effectiveness is lacking.

Be sure to consult your doctor before taking any herbal treatments or dietary supplements for signs and symptoms of menopause. Herbal products can interfere or interact with other medications you may be taking.