Dermatologists provide care for perimenopausal and menopausal women with hormone-related complaints: hair loss, acne climacterica, acne rosacea, acne inversa (hidradenitis suppurativa), dry skin, wrinkling, hirsutism, pruritus vulvae, and other vulvar dermatoses. The question, “Should I take hormone replacement therapy (HRT)?” is usually unspoken. The answer was complicated in 2002 by the estrogen-progestin arm of the Women’s Health Initiative (WHI) study with the reported increased risk of invasive breast cancer.1