Coleen Barnes' days were marked by unbearable hot flashes and fatigue, and her nights were filled with tossing and turning. Although she exercised regularly and thought she ate well, Barnes, 55, wanted more information on how to manage her menopause symptoms without taking artificial hormones.

After consulting with licensed nutritionist Darlene Kvist, director of Nutritional Weight and Wellness in St. Paul, she revamped her eating habits and started using magnesium and commercially available progesterone cream.

"I saw results within a couple weeks," said the former Bloomington resident, who now lives in Wisconsin. "I could tell I just felt better overall. I had more energy and was sleeping better." Her hot flashes subsided, she lost 35 pounds and her blood pressure went from high to healthy.

Barnes is one of many women using nutrition to reduce symptoms of menopause and perimenopause, the years leading up to a woman's last period when hormone levels begin to change and symptoms can begin.

"This population of boomers is very interested in nutrition, exercise and supplements -- they bring these things up on their own," said Sandy Greenquist, director of the Menopause Center of Minnesota, nurse midwife and certified menopause clinician. "Yesterday a woman asked me, 'Are there foods I should be eating that would be helpful to me?' It's a very popular topic at the center."

Some women with mild symptoms have been able to manage them through better nutrition, Greenquist said. But if symptoms become too intense or if women have other long-term health concerns, hormone replacement therapy may be appropriate, she added.

Even women who choose hormone replacement therapy will probably find they need less of it if they are also eating right, exercising and using supplements. "I can't give you hormones and make you feel good unless you're also taking care of yourself," Greenquist said.

There's no solid evidence that nutrition is helpful for menopause, said June LaValleur, a board-certified obstetrician-gynecologist and associate professor in the Department of Obstetrics, Gynecology and Women's Health at the University of Minnesota. However, LaValleur agrees that while women with intense symptoms may need hormone therapy, eating right and exercising may also reduce symptoms and is important for all women. For example, she said many women are deficient in vitamin D, which may contribute to aches and pains, sleeplessness and low mood.

Sandra Koch, 47, changed her diet this summer in the same way Barnes did. Both women removed processed carbohydrates such as muffins, cereal and refined bread from their diets and now emphasize complex carbohydrates, including vegetables, whole grains and fruit. They make sure to get enough healthy fats by eating salmon, avocados, olives, nuts and olive oil, and they eat protein with their meals throughout the day.

The tips that follow are good for everyone, but this balanced diet is especially therapeutic for women with menopause symptoms, according to Kvist and Sharon Lehrman, a registered dietician with a private practice in St. Louis Park.

Symptom: Weight gain, especially around the middle

Step 1. When women stop ovulating, hormonal changes make it easier to gain weight and harder to keep it off. So it's especially important to cut out processed carbohydrates and replace them with complex carbohydrates. Processed carbohydrates and sugar cue your body to pump insulin, and too much insulin can lead to weight gain, especially around the middle.

Step 2. Buy 100 percent grass-fed, organic meat with no added hormones. Hormones from conventional meat may affect humans and contribute to weight gain.

Symptom: Mood swings and feeling crabby or down

Step 1. Reduce refined carbohydrates and sugar, which cause your blood sugar to spike and drop suddenly, leaving you moody, tired and hungry.

Step 2. Eat complex carbohydrates with lots of fiber, such as vegetables and beans, which will stabilize your blood sugar and keep it from spiking and dropping.

Step 3. Throughout the day, include protein and healthy fat with your complex carbohydrates to keep your blood sugar and mood steady.

Symptom: Insomnia (with exhaustion, forgetfulness, irritability)

Step 1. Before bed, take 400 to 600 milligrams of magnesium glycinate, a form that's easy for your body to absorb. Many people are deficient in magnesium, which helps you relax. Getting eight or nine hours of sleep might reduce forgetfulness, irritability and fatigue. Getting less than seven hours of sleep can increase your risk for obesity. Health food stores and co-op grocers carry magnesium glycinate.

Step 2. Women's levels of progesterone naturally diminish during perimenopause and menopause, and the hormone helps with sleep. Progesterone cream is available at health food, co-op or grocery stores. You may want to check with your health care provider before using.

Symptom: Vaginal dryness

Step 1. Eat healthy fats, which will hydrate the tissue.

Step 2. Diuretics, such as blood pressure medications, and antihistamines reduce liquid in the body, compounding this problem. Drink plenty of water to offset the drying effects.

Symptom: Hot flashes

Step 1. Reduce processed carbohydrates, sugar, alcohol and caffeine.

Step 2. Ask your doctor about using ΒΌ teaspoon of progesterone cream before bed to balance hormones.

Step 3. Add 1 to 2 tablespoons of ground flax seed to oatmeal or smoothies. Flax has lignans, which is a weak form of plant estrogen that may help balance women's hormones.

Symptom: Achy, painful joints and bones

Step 1. Avoid all trans fats and oils such as corn oil and soybean oil. Instead, use olive oil, avocados and avocado oil, and fatty fish such as salmon. These healthy fats can reduce the inflammation that can contribute to aches and pains. Fat and protein are needed to build and maintain healthy bones. Also, healthy fats protect against heart disease, the leading cause of death for women after menopause.

Step 2. Before bed, take 500 to 600 milligrams of calcium citrate, a form of calcium that's easily absorbed. Taking it before bed makes it more effective at building bones as you sleep. Take another 500 to 600 milligrams in the morning. This will also protect against osteoporosis.

Sarah Moran is a Minneapolis freelance health writer in Minneapolis.