Estrogen replacement therapy (ERT) is known to significantly decrease menopausal health risks, thus, a survey of 200 women attending a tertiary hospital was conducted. Assess their attitudes toward menopause and ERT to determine factors that might increase its use revealed that women taking their ERT were more likely to know that decreased estrogen hormone causes osteoporosis. All groups however believed that natural approaches to menopause are more preferable and ERT should be reserved for women with distressing symptoms. The study suggests that a systematic educational approach could increase awareness and use of ERT especially if the recommended therapy will not cause vaginal bleeding and will cost minimally.