The research, which studied 2,130 post-menopausal women from Australia, New Zealand and Britain, found that using the combined oestrogen and progestogen hormone therapy could improve some quality of life measures.
The results come amid debate about the risks and benefits of hormone therapy for post-menopausal women which has also been linked to a higher risk of stroke, blood clots and breast cancer.
Most women in the study were in their mid-60s, having hit menopause on average 13 years earlier, and most participants did not have symptoms of the change of life.
"Our results show that hot flushes, night sweats, sleeplessness and joint pains were less common in women on HRT in this age group," said Professor Alastair MacLennan, the leader of the Australian arm of the independent study.
"Sexuality was also improved," he added.
The study found that the percentage of women on the combined HRT therapy having hot flushes dropped from 30 percent to 9 percent over a year, while those suffering insomnia dropped from 45 percent to 35 percent.
While 63 percent of women on the treatment said they experienced aching joints and muscles at the start of the trial, this had fallen to 57 percent after 12 months.
MacLennan said that even for women who did not have hot flushes and were well past menopause, there was a "small but measurable improvement in quality of life and a noted improvement in sleep, sexuality and joint pains."
The results, published Friday on the British Medical Journal website, come from one of the world's longest and largest trials of HRT -- the Women's International Study of long Duration Oestrogen after Menopause (WISDOM).
MacLennan, who is head of obstetrics and gynaecology at the University of Adelaide, said the WISDOM study would help reduce the risks of the treatment.
"For most women with significant menopause symptoms the benefits of HRT outweigh the risks," he said in a statement.
The head of the New Zealand branch of WISDOM, Beverley Lawton, said the quality of life benefits of HRT may be greater in women with more severe symptoms near menopause.
"New research suggests that HRT taken from near menopause avoids the cardiovascular risks seen when HRT is initiated many years after menopause," she said.