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For women who reach menopause, questions about hormone replacement therapy often loom as large as worries about symptoms. But, is there a natural alternative?

Doctors are looking for the answer to this question. In the mean time, a simple option may help some symptoms. Exercise. Exercise is a powerful ally for women who have menopausal symptoms, such as stiff joints, irritability and sleep disturbances. It also helps lower the risk of diabetes, heart disease, osteoporosis and weight gain.

According to the North American Menopause Society, three types of exercise can help postmenopausal women stay healthy:

   Aerobic
   Weight-bearing
   Flexibility

For the best results, experts recommend at least 30 minutes of moderate aerobic exercise every day. Be sure to check with your doctor before you start or increase your activity level.

Aerobic exercise promotes the loss of abdominal fat, the place where most women more readily gain weight during menopause. It can also elevate mood and relieve tension. This helps reduce the depression and irritability that can come with menopause. Some women also report fewer hot flashes and more restorative sleep with regular exercise.

Weight-bearing exercise, such as using weights to build muscle, delays or prevents bone loss. It does so by preserving the minerals that keep bones dense and strong. The effect that weight-bearing exercise has on bone mass depends on age, hormonal status and nutrition, as well as the type of exercise.

There is one sure fact about exercise and bone density, though. If you don't use it, you lose it. A marked decrease in physical activity will lead to a significant decline in bone mass. For example, total bed rest can lead to some loss of calcium from bone in a matter of a few days and a detectable drop in bone density after only a few weeks.

Weight-bearing exercises increases bone mass. It also increases muscle mass, which puts more weight on the bones. Over time, this slows bone loss.

If you have been an avid exerciser during the years leading up to menopause, you already have an advantage. You will you have a leg up on bone health because of strength training. Also, ED drugs aerobic activity during childbearing years lowers the risk of breast cancer, which increases with age after menopause.

To get the most out of exercise, plan a balanced program of weight-bearing aerobics, strength training and flexibility. And make it consistent. Try to get some moderate activity on at least most days of the week.