“The messaging about HRT is so positive and all-consuming right now,” Ms. Maylone said. It seems like “you can experience this phase of your life totally differently, and there is relief,” she added.

“I feel totally cut off from that,” she said.

Rebecca Hastings, 46, cannot take hormone replacement therapy because it raises the risk of blood clots, which she is already more likely to develop because of a genetic mutation that she carries.

At a recent family party, she started commiserating with another woman about perimenopause symptoms, which for Ms. Hastings have included night sweats and hot flashes. They were half-complaining, half-laughing when the woman became serious: She had wasted two years suffering before starting hormone therapy, she told Ms. Hastings. It had fixed everything.

“I immediately lost connection and felt isolated,” Ms. Hastings said.

As a woman on the receiving end of these posts and marketing and friends, it really does seem like the overall and only answer to perimenopause and menopause is HRT. And not only that, but managing symptoms through just diet and adding a fan to the bedroom is difficult and doesn't provide the type of relief that HRT can.

Doctors don't have much guidance for other ways of managing the symptoms either. So much of this knowledge is still being passed from woman to woman.

Jamie Davis Smith, a 51-year-old writer and adjunct professor in Washington, D.C., said her doctor advised against hormone replacement therapy because she is at increased risk of stroke, but has not suggested any alternative ways to treat her symptoms, including brain fog that often causes her to lose a word midsentence while she is writing or teaching.

Ms. Maylone said that when she tried to raise the subject with her providers, she hit a wall. “Through no fault of their own, they’re like, ‘We’re trying to have you not have cancer,’” she said. “It just feels like you hit a dead end.”

There is a “humongous provider knowledge gap” when it comes to menopause care, said Dr. Rajita Patil, director of the Comprehensive Menopause Program at UCLA. While demand has exploded, many clinicians are still not up to speed on the full range of treatments, including nonhormonal options, she said.