OBJECTIVETo describe self-reported prevalence of the use of alternative therapies for menopause symptoms and subject characteristics associated with their use.METHODSA telephone survey of 886 women aged 45–65 years (87.2% response rate) was conducted at Group Health Cooperative in Washington state. Women were asked about eight alternative therapies and their use for menopause symptoms.RESULTSThe proportion of women who used each therapy was 76.1% for any therapy, 43.1% for stress management, 37.0% for over-the-counter alternative remedies, 31.6% for chiropractic, 29.5% for massage therapy, 22.9% for dietary soy, 10.4% for acupuncture, 9.4% for naturopath or homeopath, and 4.6% for herbalists. The proportion of women who used it to manage menopause symptoms was 22.1% for any therapy, 9.1% for stress management, 13.1% for over-the-counter alternative remedies, 0.9% for chiropractic, 2.6% for massage therapy, 7.4% for dietary soy, 0.6% for acupuncture, 2.0% for naturopath or homeopath, and 1.2% for herbalists. Among women who used these therapies, 89–100% found them to be somewhat or very helpful. A history of breast cancer was associated with a six-fold increase in use of dietary soy for menopause symptoms (odds ratio 6.23, 95% confidence limits 2.54, 15.28). Current users of hormone replacement therapy were half as likely to use alternative remedies or providers (odds ratio 0.48, 95% confidence limits 0.29, 0.77) as were never users. Sleep disturbances were associated with a four-fold increase in the use of body work, a three-fold increase in the use of stress management, and more than doubled the use of dietary soy products to manage menopause symptoms.CONCLUSIONThe use of alternative therapies for menopause symptoms is common, and women who use them generally find them to be beneficial. Physicians should routinely ascertain perimenopausal women's use of alternative therapies.