Are there natural alternatives to hormones for birth control and hormone replacement therapy? Naturopath Laurie Steelsmith says the answer is yes, and suggests that it should not be necessary for a woman to use hormones unless required to treat a debilitating medical condition like endometriosis.

She recommends alternatives for contraception — including condoms, the diaphragm, the new "femcap" device, or using your daily baseline temperature as a guideline to recognize times of fertility.

Steelsmith has additional advice for women in midlife who may be in perimenopause or approaching it.

"From the inside out, you want to live a healthy lifestyle," says Steelsmith. "The women I see who arrive at perimenopause and who are not burned out — they sleep at night, eat good food and exercise — they do really well. They'll usually sail through perimenopause and menopause. ...

"For staying youthful, the bottom line is a foundation of good health — good diet, regular exercise, making sure you're taking care of the mind and spirit, and taking the 'garbage' out efficiently and effectively. The foundation of health has to be in place before we do anything else. It's absolutely core."

"Stress ages us fast," says Steelsmith. "So if we want to stay youthful, we want to be able to dance with it. We don't want to live our lives stress-free. That's a big myth. We actually want to go to work every day and have full lives. We just don't want them to completely hollow us out."

These antidotes for menopausal symptoms are recommended in Steelsmith's book "Natural Choices for Women's Health" (Three Rivers Press, 2005).