There is an epidemic of menopausal syndrome today. Hot flashes, night sweats, vaginal dryness, mood swings, and osteoporosis are now common and often difficult to treat. Hormone replacement therapy (HRT) has been shown to be dangerous because of an increase in the incidence of breast cancer, heart attacks, strokes, and thromboses. Mainstream treatment with pharmaceutically altered hormones, antidepressants, and anticonvulsants has not been shown to be safe. In integrative medicine there are many interesting approaches that are discussed. Still, lifestyle is the most powerful medicine we have.