A purposeful sample of 21 well-educated European American women (42-53 years) were interviewed to explore how women make decisions about hormone replacement therapy (HRT) for natural menopause. Menopausal status included women who were premenopausal (n = 1), perimenopausal (n = 11), menopausal (n = 4), and postmenopausal (n = 5). Participants were grouped into 3 categories: taking or in favor of taking HRT (n = 6), undecided (n = 10) and stopped taking or opposed to taking HRT (n = 5). The impact of media attention was an important influence on women's thoughts and decisions-whether in favor, undecided, or opposed--particularly in conjunction with risk factors based on family history and what other family members were doing. Women in favor of taking HRT were interested in short-term symptomatic relief as well as prevention of disease in old age. Women who were undecided cited the scientific confusion in the media as contributing to their reticence about making a decision. The unprecedented number of magazine, book, and newspaper coverage of HRT during the study undoubtably influenced women's thoughts and decisions.