Objective:To determine changes in the use of hormone replacement therapy (HRT) in South Australia between 1991 and 1993.Design and setting: Survey of women aged 40 years and over, as part of the 1991 and 1993 South Australian Health Omnibus Surveys (household interviews); 868 were interviewed in 1991 and 790 in 1993.Outcome measures: Rates of HRT use.Results:In 1993, 19.0% of women aged 40 years and over were taking HRT and 28.5% had ever taken it (currently or in the past). The highest rates were in the 50–54 years age group (46.2% current use and 57.8% ever use). Between 1991 and 1993 there was a 40% increase in the number of women taking HRT and a significant increase (P<0.01) in the median duration of therapy, from 38 to 54 months. There were also significant increases in rates of use by country women and Australian‐born women (P<0.01). Premarin and Provera remained the most commonly used products in 1993.Conclusion:Australian perimenopausal women are increasingly using HRT. This may reflect recent educational programs on the menopause for both health professionals and the public, and also an increasing number of choices of therapy.