Hi - Vagifem IS natural - it's estrogen. Are you scared because you've read about estrogen increasing the risk of cancer recurrence in some women? If so, then you need to balance your (perhaps, not necessarily) increased risk of cancer, with the side effects of menopause you're currently experiencing. So far as I know, there's nothing "natural" that'll help with hot flashes; Effexor, an antidepressant, has been shown to work somewhat, but it's a fairly powerful drug. And there's nothing natural (beyond estrogen) that helps with vaginal atrophy - so far as I know.

Many oncologists feel comfortable prescribing Vagifem and similar products, as they're topical estrogen, and so little is actually absorbed into your system that they feel it doesn't increase your risk of breast cancer. My own doctor prescribed it to me, and I had a fairly aggressive, estrogen-receptive stage 2 cancer. So, bottom line: weigh those tough side effects against your fear of Vagifem, and make your decision. Cancer is full of tough decisions... and this is one of them. Best of luck to you - PJH