Objective. To examine the use of hormone therapy (HT) or alternative treatments for climacteric symptoms among women aged 52-56 years in 2000. Design. Questionnaire study. Setting. Cross-sectional Finnish female cohort in the year 2000. Sample. Random sample of women aged 52-56 years. Methods. Univariate and multivariate analysis. Main outcome measures. HT explained by 12 physical and 9 background and social variables. Results. The use of HT was significantly (p<0.001) associated with the severity of climacteric symptoms, a history of not having breast cancer, oophorectomy, low body mass index, high professional education and high alcohol intake. A total of 66% of the women used some form of treatment for their climacteric symptoms. Of them, 71% used systemic HT, 25% alternative treatments (hypnotics, antidepressants, tranquillizers\, trace elements, vitamins, lifestyle modifications) and 4% local estrogens only. Altogether 33% of the women with severe climacteric symptoms did not use HT at all, whereas 27% without any symptoms used HT. Conclusions. In early 2000, almost half of the Finnish female population at menopause used HT to alleviate their climacteric symptoms. The impact of the controversial reports on HT use after the time of data collection needs further study.