More than 1 million women in the U.S. experience menopause each year. But despite menopause being a common life transition, there is still a lot that’s not understood about this life stage — along with confusion over how to safely help women going through it.

A recent Yahoo News/YouGov poll finds that many women going through menopause struggle with several symptoms, but aren’t using available treatments that can help them to feel better. Doctors who treat women in menopause say that, unfortunately, they see this in the patient population too.

So what are the biggest symptoms women in menopause are experiencing, and what can help? Here’s a breakdown.

First, some basics about menopause

Before we dive into the survey’s findings, it’s important to clarify what menopause is. Menopause signals the end of the menstrual cycle and is diagnosed after not having a period for 12 months, according to the Mayo Clinic. The years before that are called the menopausal transition or perimenopause.

Menopause usually starts between the ages of 45 and 55 and typically lasts about seven years, says the National Institute on Aging. The poll found that 53% of women 45 to 64 years old reported being in menopause. During menopause, estrogen levels in the body drop. That can cause women to experience symptoms such as hot flashes, trouble sleeping, vaginal dryness, mood changes and weight gain.

What are the most common menopause symptoms?

The Yahoo News/YouGov survey, which was conducted from April 11 to April 15, polled 1,794 American adults about a range of lifestyle and health care issues, including menopause. Of the women who said they were in menopause, many reported having uncomfortable symptoms. Those included:

• hot flashes (48%)

• trouble sleeping (46%)

• weight gain (44%)

• night sweats (39%)

• brain fog (35%)

• lowered libido (32%)

• mood changes (32%)

• pain during sex (16%)

Only 20% of the those who were in menopause said they didn’t have any of these symptoms. But despite 80% of people in menopause saying that they had at least one menopausal symptom, the overwhelming majority — 79% — said they’ve never taken hormone replacement therapy (HRT).

HRT, which is also just called hormone therapy, is a medical treatment that can help to relieve the symptoms of menopause and perimenopause, according to the American College of Obstetricians and Gynecologists (ACOG). Hormone therapy is usually broken down into two categories — estrogen-only therapies and estrogen and progestin therapies. Both are designed to help replace hormones that drop significantly during perimenopause and menopause.

Doctors stress that hormone therapy can help

Menopause experts overwhelmingly recommend using hormone therapy to help with symptoms. Hormone therapy “is the most effective intervention for these issues, and the vast majority of women do not have contraindications that would preclude its use,” Dr. Mary Jane Minkin, clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine and founder of Madame Ovary, tells Yahoo Life.

Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, agrees. “Hormone therapy is the safest and most effective way to not only deal with short-term symptoms such as sleep issues, hot flashes and sexual issues, but it’s also beneficial long term,” she tells Yahoo Life.

So why aren’t more women taking it? Back in 2003, researchers published preliminary results of the Women’s Health Initiative clinical trial, linking hormone therapy to serious health conditions such as stroke, heart disease and breast cancer. The study was stopped early as a result. After that, many women and doctors avoided hormone therapy.

But follow-up analyses of the study found that original conclusion was inaccurate — it included women who were 65 and up who already had a higher risk of heart attack, stroke, blood clots and more, and also didn’t consider the age of the women when they started hormone therapy, which skewed the data. Research and menopause experts have since concluded that hormone therapy is a safe and effective treatment for menopause symptoms. Even the original authors of the Women’s Health Initiative study said in a follow-up analysis published earlier this month that hormone therapy is safe for women in menopause.

However, many women and doctors — particularly primary care physicians — aren’t aware that the data has changed and continue to avoid hormone therapy, Dr. G. Thomas Ruiz, lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., tells Yahoo Life. “But hormone replacement therapy is safe — that is the big thing,” he says.

Minkin says that there are “certainly other remedies that can help,” especially with hot flashes, including sleeping in a cool room, wearing layered clothing and avoiding known hot flash triggers such as red wine and spicy foods — both of which may cause blood vessels to dilate. Exercising regularly and limiting alcohol can also be helpful at combating symptoms of menopause, women’s health expert Dr. Jessica Shepherd, an ob-gyn in Texas and author of the upcoming book on menopause, Generation M, tells Yahoo Life.

Minkin says that some herbal products like Remifemin (German black cohosh), Remifemin Good Night (Remifemin “with some sleep herbs”) and Relizen (Swedish pollen extract) may also be helpful. There’s also a new FDA-approved oral prescription medication called Veozah that’s specifically designed for hot flashes, she says.

Overall, Shepherd says it’s important to meet with a menopause specialist, such as an ob-gyn who is knowledgable about the topic, to talk about where you’re at. “This is a transition in hormones and metabolism that requires a full look at lifestyle, hormone replacement and also supplementation,” she says. “It is important to understand that this can be addressed with many options.”

This article contains affiliate links; if you click such a link and make a purchase, we may earn a commission.