Background From the 1990s until 2002, hormone therapy (HT) was a popular treatment for menopausal syndrome in middle-aged women. Since the Women's Health Initiatives (WHI) studies in 2002 warned that the risk of HT might exceed its benefits, there has been a reduction in its use worldwide, including in Taiwan. Many studies reported this decline, but few discussed whether HT may or may not fulfill menopausal women's health needs. This study examines the changes in HT prescriptions and other measures by menopausal women in Taiwan and the implications of these changes in relation to their needs. Methods This study analyzes annual and monthly rates of HT prescription and outpatient care utilization among Taiwanese women in the 45- to 64-year-old age group. It is based on medical claims data of the Taiwan National Health Insurance Programs from 2000 to 2004. Results The data showed that HT was the prevailing treatment for menopausal syndrome before the WHI publications. The rate of HT prescription increased annually, peaking in 2001 at 21.6%, but declined from 2002 to 9.7% in 2004. At the same time, the number of Taiwanese women seeking traditional Chinese medicine for the menopausal syndrome increased. Conclusion HT prescriptions in Taiwan declined significantly after the WHI reports, demonstrating the elasticity of the need for HT. But utilization data in Taiwan showed that attendance at outpatient clinics at menopause remained constant and the use of traditional Chinese medicine increased. Further studies should investigate health needs from menopausal women's perspectives to develop appropriate measures to meet their needs.