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For many women who reach menopause, questions about hormonal replacement therapy often loom as large as worries about hot flashes. But wait. Is there a natural alternative?

Doctors say yes. There is a simple therapy that is right for just about any postmenopausal woman. It's exercise. Exercise is a powerful remedy for a whole host of menopause complaints, such as hot flashes, joint pain, irritability and sleep disturbances. Also, exercise might help reduce the risk of heart disease, osteoporosis and weight gain.

According to the North American Menopause Society, three types of exercise can help postmenopausal women stay healthier: aerobic, weight-bearing and flexibility. For the greatest effect, the society recommends getting at least 30 minutes of moderate aerobic exercise every day.

Aerobic exercise promotes the loss of abdominal fat, the place where most women more readily gain weight during menopause, according to the American Council on Exercise. In addition, the council says the mood-elevating, tension-relieving effects of aerobic exercise help reduce the depression and irritability that can come with menopause. Some women also report fewer hot flashes when they exercise regularly and better, more restorative sleep.

Weight-bearing exercise, such as working out with weights to build muscle, delays or prevents bone loss by stimulating 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. However, there is one sure fact about exercise and bone density, if you don't use it, you lose it. A marked decrease in physical activity will result in a significant decline in bone mass. For example, total bed rest can lead to a 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 not only affect bone but also can increase muscle mass, which puts more weight on bone and, in turn, slows bone loss over time.

If you have been an avid exerciser during the years leading to menopause, you already have an advantage, according to the American Council on Fitness. You will you have a leg up on bone health because of strength training. Also, aerobic activity during childbearing years reduces 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, striving for some moderate activity daily or at least most days of the week.

A study published in The Journal of the American Medical Association showed that exercise - as little as one long walk a week - can prolong life. The study of 40,000 postmenopausal women, followed throughout a period of seven years, found that women who gardened, bowled or took that one long walk a week were 33 percent less likely to die during the study.