A sample of 45-year-old women from 5 general practices in South London were asked about their intentions to use hormone replacement therapy by postal questionnaire. One hundred and six women (60%) responded. Ninety women who were not taking HRT formed the study sample. Over 80% expressed an opinion when asked about future HRT use. Forty-four percent expressed an intention to use HRT, 42% expressed an intention not to, and 13% expressed a lack of knowledge on which to base a decision. Reasons given by intenders were based on general hopes to 'feel better' among others. Non-intenders gave reasons reflecting disinclination to use drugs and to interfere with a normal process, as well as concerns about side-effects. The characteristics of intenders and non-intenders were compared. There were no significant differences between groups in socio-demographic variables, or in general and gynaecological health factors. However, HRT intenders reported significantly lower self-esteem, higher levels of depressed mood, anxiety, and negative attitudes to the menopause. They also expressed stronger beliefs in their doctors' ability-as opposed to their own- to control their menopause experience. These results suggest that some women might be seeking HRT at menopause to help alleviate pre-existing emotional difficulties and this may have important implications for treatment adherence.