PURPOSE: To describe women's experiences during decision making about hormonal and nonhormonal therapies during the menopausal transition.

DATA SOURCES: Transcripts from 21 semi-structured audio taped interviews with seven peri- and postmenopausal women who had a recently visited a nurse practitioner (NP) and were making a decision about menopausal management.

CONCLUSIONS: Decision making was a nonlinear process in which women considered available options, weighed benefits and risks and likely outcomes. Reevaluation of the decision was ongoing. Both internal and external conditions influenced their decisions. Media reports of findings from the Women's Health Initiative study may have influenced some women's perceptions of the risk of using hormones for symptom relief.

IMPLICATIONS FOR PRACTICE: Women described caring and empowering consultations with the NPs. They appreciated provision of information, adequate time spent at the visit, and decision support. NPs have a critical role to play in providing women with current research findings about hormone therapy and alternatives for symptom relief, and assisting women with understanding risks and benefits of each possible choice. Both individual and group approaches for decision support should be available to women. The approach of a collaborative partnership in decision making is a model that is congruent with nursing practice. Practitioners.