The use of hormone replacement therapy (HRT) has been surrounded by controversy regarding drug safety and to what extent it meets the health needs of menopausal women. HRT became the prevailing treatment in Western medicine for women with menopause-associated complaints, but a huge worldwide reduction in use began in July, 2002, following the release of the Women’s Health Initiative (WHI) reports warning of its risks. The implications of this large reduction on the health needs of menopausal women have not been fully appraised, particularly from the perspective of the women affected. This brings into question whether HRT use actually meets the health needs of menopausal women, and, indeed, what their health needs are. This study investigates the use of HRT by middle-aged women in Taiwan and their menopausal health needs in order to identify these and recommend comprehensive strategies to promote women’s health and well-being. A broad and in-depth exploration of Taiwanese menopausal women’s health needs has been carried out using both quantitative and qualitative methods. As well as examining the allocation and efficiency of health resources associated with menopausal health, it presents and analyses the perspectives of the principal stakeholders of HRT use: women, doctors, health policy decision-makers, women’s health activists and researchers. The study found that menopausal women in Taiwan have significant health needs. In each month of the study period (2000–2004 inclusive), over 60% of the middle-aged women insured with the National Health Insurance (NHI) Scheme utilised NHI-subsidised medical services. Moreover, these women frequently consulted doctors and medical specialists in different fields, indicating that they also had unmet health needs.