Many women are trying to avoid traditional drug therapy when treating menopausal symptoms like hot flashes, depression, sleeplessness, and dry vagina.  Hormone replacement therapy with either synthetic or bio-identical hormones can significantly reduce these symptoms however are not without side effects.  IF you have female diseases that are reliant upon estrogen like Fibroid tumors, Endometriosis and Adenomyosis these replacement therapies can and will fuel your disease process. There are a few herbs on the market that can be effective at mitigating the above symptoms…..pine bark (pycnogenol), black cohosh, and St. Johns wart have shown some effectiveness. Herbs are not without side effects so check with your doctor prior to taking them…..but they may be an effective alternative to traditional hormone treatments.