Design, setting and participants: Cross-sectional questionnaire-based study of Australian women aged 40-65 years living independently in the community. Women able to complete a questionnaire in English were recruited by telephone between October 2013 and March 2014 from a large, representative, national, continually refreshed database derived from the electoral roll.Main outcome measures: Use of CAMs for VMS and other menopausal symptoms (eg, arthralgia, depression and sleep disturbance), assessed using the Menopause-Specific Quality of Life questionnaire.Results: Of 5850 women contacted, 2911 agreed to participate, and 2020 eligible women returned completed questionnaires (response rate, 34.53%). Most of the women were postmenopausal (54.90%), resided in metropolitan areas (62.70%) and were born in Australia (80.43%). The prevalence of use of CAMs for VMS was 13.22%. Phytoestrogens were most commonly used for VMS (6.29%), followed by evening primrose oil (3.91%) and ginseng (1.73%). Compared with premenopausal women, perimenopausal women (odds ratio [OR], 2.09; 95% CI, 1.42–3.06) and early postmenopausal women (OR, 1.83, 95% CI, 1.21–2.76) were more likely to use any CAM for VMS. The prevalence of use of CAMs for other symptoms was 32.23%; being postmenopausal and older were the factors associated with this use.Conclusions: Australian women at midlife are using CAMs that are known to be ineffective for managing VMS. Health care providers need to be more involved in guiding women in the treatment of VMS and other menopausal symptoms. More judicious use of supplements such as fish oil and glucosamine, particularly by older women, is needed until their efficacy and safety profiles are better understood.