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Objectives: To assess the prevalence of climacteric symptoms and the use of hormone replacement therapy in a former eastern European country. All 55-, 57-, 59- and 61-year-old women in Kladno in the Czech Republic were asked to participate in the study., Method: In 1993, 1505 women in Kladno of the Czech Republic were sent a postal questionnaire concerning age at menopause and their climacteric symptoms., Results: Answers were received from 799 women (53%); 98% were postmenopausal. The median age at spontaneous menopause was 50 years, 49.5 years among women smoking at least 5 cigarettes/day and 51.0 years among non-smokers (P < 0.05). About every fifth woman smoked. Totally 22% of the women had undergone hysterectomy and/or oophorectomy and 3% had been treated for a gynaecological malignancy. The majority of the women (58%) reported ongoing vasomotor symptoms; half of them had moderate to severe vasomotor symptoms. In all, 79% of the women reported ever having vasomotor symptoms. Only 3% of the women had ever tried hormone replacement therapy (HRT) and one woman had current treatment. Dysuria was reported by 22% and 4% had recurrent urinary tract infections; 70% of the women had a partner and 50% were sexually active. Reasons for not being sexually active were mostly lack of a partner, loss of sexual desire or partner's disease or impotence., Conclusion: Climacteric symptoms including vasomotor and urogenital symptoms had the same prevalence in the Czech Republic as previously reported in other Western Countries. Only a few women had tried HRT. Smokers had a slightly earlier menopause.