A survey based on a postal questionnaire sent to all women born in 1936 living in four Copenhagen suburbs (n = 597, response rate = 88%) revealed an overall prevalence of hormone replacement therapy (HRT) use of 22% and a cumulative incidence of 37%. This paper describes the use of HRT in this population and the patterns of exposure to treatment. Our results indicate that the use of HRT, particularly combined oestrogen-progestogen therapy, is increasing and is being initiated during the pre-menopause. Climacteric complaints were the main reason for starting treatment; only a minority of the respondents were motivated by prophylactic considerations. Forty percent discontinued treatment, the majority stating that they had done so because of unpleasant adverse reactions or lack of effect.