Yes, sometimes diet (and lifestyle changes) alone, aren't enough.
As an example, I've suffered with mild to moderate eczema/psoriasis all my life and over the years I have tried most things 'natural' - St John's Wort, Evening Primrose Oil, Fish Oils, Vitaimin E, Ginseng, Oil of this, Oil of that, various Chinese herby things that sound similar to Black Cohosh etc - I could have opened up my own Holland & Barretts with the amount of natural stuff I bought and tried over the years, (not to mention spending a small fortune), but guess what....
At the end of the day, when I get a rash and I want it sorted, without any fuss - I go to the Doctor and get a Prescription Cream and it clears it up within hours (if not minutes).
Yes, the 'natural ways' can help towards keeping things at bay a little, but when symptoms are severe and prolonged, then medical intervention is GOOD.
I, (personally) think the same thing applies to the Menopause - Yes, there are some 'natural' things that MAY help towards alleviating things............ but at the end of the day, the only way you are going to get enough female hormones back into your body once again, is by going to the Doctor and getting a prescription for HRT of some sort.
The other stuff may keep you healthy up to a point, but they are no substitute for the real thing.