At the Monarch difficulty level, I've found that the best approach is to develop a good core 5-6 cities first. Keep them in fairly close proximity to each other so that they are easy to defend. Build up some key early infrastructure (like work boat, workers, barracks, an obelisk, and maybe a forge or temple, or a wonder if you can power through it with stone/marble/industrious trait).
I definitally agree that 5-6 cities is a great way to start off at Monarch Level. I even suggest this as a priority at the risk of sacrificing infrastructure. {NOT Military Presence however} Especially since with your lower production level, the AI will almost always beat you to the punch at expanding if you try to build up a bunch of workers and temples.
By the time you get access to swordsman, you should have very little to build in your cities in terms of infrastructure at this point. This is the perfect time to invest in a force of swordsmen/spearmen/axemen. Get a stack of about 8-10 of these (go heavy on the swordsmen and work towards getting the medic promotion asap since it is incredibly useful for attrition warfare.
This would be better advice for Deity level; and I wouldn't even suggest just swordsmen/axement/spearmen. I'd suggest getting an early UU civiliation like the Mongols or Roman's, and focus on the UU/Swordsmen/Spearmen.
For Monarch level, you'd be alot happier with building up a great defense, and focus on expanding all the way through until the early renessaince era when you get Macemen, Knights and Catapults. A small stack of 4 catapults with City Raider 1 + 2 followed up with a bunch of Macemen, and Knights is a deadly sortie. You'll pound through most cities very quickly even if you lose one or two catapults in the process. Doesn't work well on Deity I've noticed; mostly because the AI usually researches Gunpowder around the time I reach this point. =(
Personally, if I was going to use Medic, I'd purposely make a few very cheap low rating units like Warriors and slap Medic on them. Same purpose; more effect. The only cost to you is your pocketbook; which means little, since you'll save so much on production. Production > Research > Money, prior to Universal Sufferage.
Once you have your stack, send it after the nearest AI and let em have it. You should be able to sack the first city or two fairly easily, which will open up additional territory (I usually keep the cities so that I don't have to waste time building new settlers, unless the enemy city is in a really crappy spot). Conquering subsequent cities will be more difficult, depending on the size of the AI's empire and the difficulty level (the bigger the empire and the higher the difficulty => the more unit that the AI will be producing and throwing at you). The goal is not necessarily to wipe out your neighbor, but just to cripple him and expand your borders at his expense.
Agreed here. At this point you'd actually make more enemies trying to finish off somebody; as you'll be forced to make peace; then redeclare war. If you don't; you'll simply suffer from War Weariness. War's on Monarchy drag on WAY too long. Hell, even on Prince I remember the war's took forever when I wanted to destroy someone. It's better to make a bloc alliance, and cripple the people not in your bloc.
The big advantage that this strategy has over a fast settler/expand strategy is that you won't be strangling yourself with maintenance costs, which start to become very brutal at the higher difficulty levels. Accordingly, you won't lag behind in tech advances. The other big advantage is that you will have a fairly large army early in the game relative to the rest of your opponents. Therefore, the AI will be more hesitant to attack you. Also, you will find that if you manage your initial force properly, you'll be able to get them levelled up fairly quickly early in the game. Later in the game, you'll find these ancient units very useful when you upgrade them to their modern counterparts and they already have 10-15 xp.
Funny enough, Maintenance costs are nothing if you take the Expansive trait for your leaders. Mostly because the extra health means more people to your cities. With larger cities you earn more gold as a result. So Maintenance is not the problem, especially as other civilization's constantly beat you to the completion of some of the more important early wonders. The "real" problem is happiness, which tends to pile up as your cities get too big.
The one downside to this strategy is that you may find that you'll have to pass up a wonder or two that you'd otherwise build. I've been playing as Roosevelt (industrious/organized), so I've generally been able to crank out wonders out of one of my cities anyway thanks to my industrious trait. It all will depends upon how many units the AI throws at you and how many you'll need to in response to defend your borders and take the fight to his cities. Fortunately, it still is fairly easy to outmaneuver the AI in war, you can generally make do with a significantly smaller, more balanced force. Just make sure that your initial force is well balanced with swordsman (for hitting cities), axeman (for killing melee units), and spearmen (for killing cavalry).
A good ratio would be something like 6 swordsmen: 2 axemen: 2 spearmen. Throw some catapults into the mix as soon as you can so that you can bombard city defenses prior to attacking.
Personally Axemen are kind of iffy to me. Especially as the majority of the enemy's defense force is comprised of Longbowmen or Spearmen more often then not. On Monarchy level, I rarely see the AI comprise defense teams consisting of Axemen or Swordsmen. Spearmen would be a problem yes, but Swordsmen more than remove them as a threat, especially if you threw on a couple of city raider promotions. I'd suggest a ratio of 6 swordsmen: 1 axeman: 2 spearmen: 4 Horse Archer: 3 Medic-Promotion Scout/Warrior.