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Objective To evaluate current patient perspectives on the postmenopausal period in South Africa. Methods The study was conducted in a specialist private practice in Tygerberg, Gape Town, South Africa during 2004. All women with established postmenopausal status, seen over a period of 18 months, received a survey questionnaire by post. Of the 541 questionnaires that were posted, 421 were returned and 410 were used. Women gave written informed consent. Results The average age of the women was 60 years, with almost half (49%) greater than 10 years postmenopausal, and 78.5% were using hormonal therapy (HT). Of note is that 42% had been on HT for more than 10 years. The doctor was the most important source of information (87%), the most frequent reason for initiation of, and the second most frequent reason for discontinuation of therapy. The most important advantages of HT given were skeletal protection (85%) and treatment of vasomotor symptoms (70%), while development of breast cancer was given as the most prominent disadvantage (79%). Conclusion This group of women was well informed regarding current indications and developments concerning HT. Despite their socioeconomic status, the doctor remained the key factor with regard to information and decision-making. [ABSTRACT FROM AUTHOR]