As her body adapts to the changes of Menopause, 52-year-old Nancy Bouche has good days and bad. But one thing is for sure - since starting Pilates three years ago, she has more energy, less stress and a striking drop in hot flashes. “I used to have them every day,” she says, “and now I can go for weeks without having any.”

Bouche, an executive assistant at Nickelodeon Animation in Burbank, Calif., is a testament to the power of exercise over menopausal symptoms. That link has been noted by fitness instructors and trainers who have seen the effect on the hot flashes, insomnia, joint aches and weight gain often accompanying this phase of a woman’s life.

But it’s only now starting to get a closer look from researchers and from many women looking for natural ways to ease the symptoms of Menopause. Fueling the scrutiny are recent questions about the safety of hormone replacement therapy and a National Institutes of Health panel calling for Menopause to be “demedicalized.”

One analysis of 12 menopausal women in an eight-week strength training program found that 40 percent of the women felt less anxious and half had less aching, stiffness and irritability. Another, even smaller, study found that yoga helped reduce participants’ overall symptoms by 16 percent.

Other researchers have found, however, that exercise programs produce very little or no improvement of symptoms. One study even discovered that a moderate-intensity exercise program exacerbated hot flashes among a few women.

Yet the prevailing wisdom is that exercise can be a benefit to some women who experience menopausal symptoms - if not by actually reducing the frequency of hot flashes and other discomforts, then by generally improving their health.

“We know that exercise improves quality of life, and if you translate that into any population you see improvements,” says Alysia Mastrangelo, associate professor of physical therapy at the Richard Stockton College of New Jersey and lead author of the strength training and yoga studies. “People who are physically active do better.”

A combination of strength training, cardio workouts and stretching can not only ease many women’s symptoms, experts say; it can decrease the risk of Osteoporosis and Heart disease, two common ailments among postmenopausal women.

One study, published last year in the Journal of the American College of Cardiology, followed 353 women through a four-year diet and exercise program and found it was able to slow the progression of Menopause-related atherosclerosis.

Exercise also can battle the weight gain often caused by a slower metabolism.

“The health benefits of exercise go far beyond management of Menopause symptoms,” says Dr. Carol Mangione, a University of California, Los Angeles professor of medicine and chair of the NIH panel. “In your early 50s is a time when lifestyle interventions can really change the trajectory of chronic disease and functional decline as you age.”

Her panel, an independent group of researchers, health professionals, methodologists and public representatives, was charged with assessing current research and literature on Menopause. It reported that viewing Menopause as more of an ailment than a normal life stage can lead to overuse of treatment programs such as hormone replacement therapy.

That therapy lost some of its appeal after the Women’s Health Initiative study in 2003 found that years-long use of estrogen and progestin causes a slight increase in a woman’s risk for heart attack, stroke and breast cancer, and that postmenopausal women who took hormones had no more relief from symptoms such as depression and low sexual function than those who didn’t.

The reports compelled some women, such as Bouche, to try to wade through Menopause “au naturel” and see if exercise could make a difference. For her, and for many other women, it has.

Sabrena Newton, an exercise scientist for the American Council on Exercise, says she’s seen a marked improvement among her clients and students. “I can’t honestly say that they’ve reported they no longer feel hot flashes, but I have definitely noticed a difference in their quality of life, in their mood and outlook.”

It’s not unusual to find women in various stages of menopause frequenting Pilates, yoga and aquatics classes; the promise of an intense workout without the pounding of high-impact aerobics is often what draws them.

In her classes at 360 Health Club in Los Angeles’ San Fernando Valley , Pilates instructor Robin Schoenfeld educates her students - many of them in various stages of menopause - not only on how to do an exercise but also on why they should do it. Good posture tends to decline during menopause, especially with osteoporosis, so Schoenfeld emphasizes the importance of core strength, upper body toning and resistance exercises. She also shares tips for combating insomnia and doesn’t shy away from talking about hot flashes and other symptoms.

“They’re very thirsty sponges,” she says of her students’ hunger for information.

But it can be difficult to motivate menopausal women to exercise. Mastrangelo says that baby boomers, especially older ones, grew up at a time when exercise “wasn’t a lifestyle and wasn’t encouraged.” The struggle now, she adds, “is getting the population to understand that this is really good for you. It’s as simple as that.”

AP-NY-10-05-05 1241EDT