Purpose: This study explores trends in treatment of menopausal symptoms and use of hormone replacement therapy (HRT) in family medicine settings subsequent to the release of the Women's Health Initiative (WHI) findings. Methods: Anonymous self-administered questionnaires were distributed to family medicine residents and faculty from 8 participating family medicine residency programs in the state of Florida. The survey asked physicians how they typically treated common menopausal symptoms in otherwise healthy menopausal women, and how their practice patterns had changed since the release of the WHI findings. We analyzed survey responses from 62 faculty and 148 residents (66% of eligible respondents). Results: HRT is still prominent for treating irregular menses, vaginal dryness, vasomotor symptoms, and decreased libido. Faculty physicians were significantly more likely than residents to use HRT for menopausal symptoms. Female physicians were more likely than male physicians to say their treatment patterns had changed as a result of the WHI. Conclusions: After weighing the evidence of potential risks of HRT from the WHI study, family medicine physicians altered and broadened their strategies for treating common menopausal symptoms. Although HRT remains a prominent treatment approach, there is now more physician-patient discussion of individual risks and benefits than occurred before the WHI's release of findings.