Women now have an array of options for hormone replacement therapy (HRT). Yet, the medical practitioner faces many challenges in helping women explore these options. Which therapy is right for which woman? What are the risks and benefits of each therapy? Providing hormone replacement therapy entails assessing the individual woman's need for hormone replacement therapy given her cardiovascular health, bone health, vasomotor symptoms, bleeding patterns, and attitudes. A woman who chooses to use HRT has many options, including therapies that vary in preparation, dosing schedule, route of administration, and systemic or local effects. This paper reviews the variety of preparations. Healthcare practitioners now can individualize HRT. The challenge is to evaluate, counsel, and treat women in a way that will promote satisfaction, and thus long-term use of HRT.