Little is known about how health literacy affects women's decisions about their menopausal health care. This exploratory study provides a crucial first step in gaining an understanding of the relationship between health literacy and potential factors such as knowledge, self-efficacy, and intent to take hormone therapy among postmenopausal women. Data were collected for 106 participants, age range 45-65, who were attending a family clinic. Participants completed a questionnaire that included questions on hormone therapy knowledge, self-efficacy, behavioral intent concerning hormone therapy, and health literacy as well as demographic data. Inferential statistical tests were used to assess the relationships among health literacy, knowledge, self-efficacy, and behavioral intent concerning hormone therapy. Pearson correlations indicated a positive relationship between both health literacy and knowledge about hormone therapy (r = .64; p </= .01) and between health literacy and self-efficacy regarding hormone therapy (r = .69; p </= .01). Only two variables, health literacy and self-efficacy, achieved sufficient strength to enter the stepwise regression. Sixty-six percent of the variance for behavioral intent concerning hormone therapy was accounted for by decision self-efficacy, and 9% was accounted for by health literacy (R(2) = .75; p < .05). Further research to better understand the relationship between health literacy and self-efficacy and the impact of these factors on actual health outcomes and decision making is likely to have important communication implications for both patients and their providers.