This study examines trends and correlates of menopausal hormone therapy (MHT) use among postmenopausal women in the US from 1999 to March 2020. Using data from the National Health and Nutrition Examination Survey (NHANES), the researchers found that MHT use declined significantly over the 20-year period, from 26.9% in 1999 to 4.7% in 2020. The decline was most pronounced among women aged 52 to 65 years and was observed across all racial and ethnic groups. Non-Hispanic Black and Hispanic women had lower prevalence of MHT use compared to non-Hispanic White women. Estrogen-only formulations accounted for over 50% of MHT prescriptions, followed by combined estrogen and progestogen. Factors associated with MHT use included higher family income, health insurance coverage, education, and lower BMI. The study highlights the need to consider sociodemographic factors in discussions and policies regarding MHT use.This study examines trends and correlates of menopausal hormone therapy (MHT) use among postmenopausal women in the US from 1999 to March 2020. Using data from the National Health and Nutrition Examination Survey (NHANES), the researchers found that MHT use declined significantly over the 20-year period, from 26.9% in 1999 to 4.7% in 2020. The decline was most pronounced among women aged 52 to 65 years and was observed across all racial and ethnic groups. Non-Hispanic Black and Hispanic women had lower prevalence of MHT use compared to non-Hispanic White women. Estrogen-only formulations accounted for over 50% of MHT prescriptions, followed by combined estrogen and progestogen. Factors associated with MHT use included higher family income, health insurance coverage, education, and lower BMI. The study highlights the need to consider sociodemographic factors in discussions and policies regarding MHT use.