OBJECTIVE: To critically review qualitative research on women's decision making about the use of hormonal and nonhormonal remedies for the menopausal transition.

DATA SOURCES: Computerized searches in CINAHL, MEDLINE, Medscape, and PsychINFO databases, using the keywords decision making, hormone therapy, herbal remedies, attitude toward hormone therapy, and qualitative research; and ancestral bibliographies.

STUDY SELECTION: Articles from indexed journals from 1982 to 2001 in the English language relevant to the keywords were evaluated. Sixteen studies met inclusion criteria and were included in the analysis.

DATA EXTRACTION: Study findings were organized into several categories and compared and contrasted across publications and categories.

DATA SYNTHESIS: Half of the researchers described decision making as a weighing of benefits and risks. Women's considerations, beliefs, and values, as well as interaction with the environment, were primary influences on the process.

CONCLUSIONS: Major gaps in care for midlife women were identified. Women need information about the process of menopause and the range of available options for menopause management. Nurses can play a major role in providing information, counseling, and developing decision aids. Women's values and beliefs, cultures, life contexts, and desire for involvement in the decision should guide interventions.