About one in five women going through menopause have symptoms severe enough to make their lives miserable from time to time. No woman, after all, wants to start sweating profusely in public after a hot flash. And night sweats and difficulty sleeping can leave a woman tired, groggy, irritable, and less than productive for days on end.

But the main drugs used to treat such problems —the hormones estrogen and progestin—have long had a bad rap. They have been linked since 2002 to a broad array of serious risks, including breast cancer, heart attack, and stroke. In our research, we found that new studies of hormone use often get wide media attention, and add to an already confusing topic for women. Our Consumer Reports Best Buy Drugs project has taken a careful look at the evidence on hormone products in a new report that cuts through the confusion and gives women straightforward advice.

The good news is that hormone drugs are now deemed to be a viable option for younger, healthy women who have severe symptoms and desperately need relief. In particular, women under the age of 60 who are at a low risk for heart problems may not increase their risk of heart disease when they take hormones. However—and it's a big however—they still face an increased risk of breast cancer, blood clots, and stroke. So, hormones still need to be prescribed and taken with extreme care, even for women who have severe symptoms.