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Women around the world face hot flashes, night sweats and depression due to menpause every hour. And thousands more reach menopause every day, according to the International Menopause Society.

Coping isn't just about hormone therapy anymore. Consider acupuncture and staying away from the marinara sauce.

If you’re approaching the steamy throes of menopause, Dr. Barbara Soltes, director of the Center for Women’s Research at Rush University Medical Center, offers some survival tips. 

Q. As women approach menopause, is there anything they can do to prepare?
A. They should be trying to optimize their health in terms of improving their diet, their weight and trying to exercise on a regular basis. Exercise has truly been shown to decrease the symptoms of menopause, so that the more that women exercise they seem to pass through the menopausal phase quite easily. They can’t shorten it but it makes it much easier because the symptoms are much less.

Q. You mention diet. What changes do you recommend?
A. There are foods that seem to aggravate the basal motor symptoms -- the hot flashes, the night sweats. These are alcohol, caffeine, citrus and the spices associated with marinara sauce and some of the Asian and Mexican foods.  What would not be a good idea, if you are already having hot flashes, would be to have a glass of wine followed by a cup of coffee and then a piece of chocolate cake. If women are already starting to experience those symptoms, those are very simple things they can do to just make a difference.

Q. What are some of the emotional issues that are involved with menopause?
A. What we know is that, as the estrogen levels lower, a lot of the neurochemicals change, so the way that women tend to deal with stress is different. It’s a much more exaggerated response. Unfortunately, another hormone that changes is serotonin, and serotonin is related to depression and feeling down. That’s why a lot of women that are starting to approach menopause say they feel down in the dumps and they don’t know why because nothing’s changed. It’s a hormonal event that’s happening. I have found that giving them low dose estrogen will help.

Q. Who is a good candidate for hormone replacement therapy?
A. We used to think hormones were great for everyone, but now we know it’s restricted to women who are symptomatic. That’s the woman who is having hot flashes, night sweats, poor sleep, mood swings, just a poor quality to her life. When symptoms start interfering with your life, you’re a perfect candidate.

Hormone replacement is perfectly safe. And, if used in low doses and for a short period of time, it’s fine. We know that for most women, the symptoms of menopause don’t last longer than three to five years.

Q. Are there any risks associated with taking hormones?
A. I think the major risks are associated with having abnormal bleeding. That’s when a women needs to be evaluated. If they’ve been having abnormal breast biopsies and have had problems with their breasts all along, they might not be a good candidate for hormones. Because although we know estrogen does not cause breast cancer, if there are abnormal cells, it could move it along.

Q. What alternative therapies do you recommend?
A. There are so many new things. We have lots of non-hormone alternatives that are used for other disorders, like high blood pressure medication that in small doses is very effective for hot flashes and night sweats. There is also a seizure medication that is very effective for symptoms.

And acupuncture is equally effective [compared] to hormone replacement in terms of treating menopausal symptoms. Lots of patients go that route and do very well.

Q. How does menopause affect a women’s health in positive ways?
A. Perhaps the most obvious is that there is no longer the fear of pregnancy. Now they can enjoy their sex lives without that fear. Women can start focusing more on not only their bodies, but their health, whereas during the childbearing years they worry about their kids.

Q. As the number of women 50 and above rises around the world, do you think menopause may be viewed differently in society?
A. Absolutely, because we’re learning more and more about prevention of problems of women as they age. [In the past] there was not such a focus on prevention [of] osteoporosis and heart disease. It’s only because we’re having an aging population of women that we’re focusing our research more on women.

Q. Are there any misconceptions about menopause?
A. I think the big fear is about breast cancer. Women are still very focused on estrogen and estrogen causing breast cancer. It’s really heart disease [that's the greater risk]. They really need to change their focus. Women manifest heart disease problems in different ways, as a result they don’t focus on that. They need to focus on their hearts, not their breasts, because their hearts are what’s going to kill them. We are picking up abnormal breast cells very early now and we removethem and you're cured. Once you have a heart attack, either you die or you'll have cardiac problems forthe rest of her life.