Because the significant health risks related to postmenopausal osteoporosis can be reduced by estrogen replacement therapy (ERT), this study assessed women's attitudes toward ERT to assess factors that might increase its use. Results showed that women taking ERT were more likely to know that decreased estrogen levels lead to osteoporosis, to perceive that menopause is a medical condition, to believe that natural approaches to menopause are less preferable, to be seeing a gynecologist for care, and to believe that women should take ERT for hot flashes. The study suggests that a systematic educational approach could influence women's willingness to take ERT, especially if the recommended therapy does not cause withdrawal bleeding.