Hormone therapy use among women in the U.S. remains low, even though it’s an effective treatment for many menopause symptoms, according to a new Mayo Clinic study published in Mayo Clinic Proceedings.

Menopause affects more than one million women each year in the U.S., and up to 75% experience symptoms such as hot flashes and night sweats that can last for years. Yet researchers have found that use of menopausal hormone therapy has steadily declined over time.

The new study found that hormone therapy use dropped from 4.4% in 2007 to 1.7% in 2023. Even among women most likely to benefit—those ages 50 to 59—only about 3.5% were using hormone therapy in 2023.