목적: Menopause is a physiological transition marked by estrogen decline, which may impact vestibular function and contribute to BPPV recurrence. While HRT is used to manage menopausal symptoms, its effect on BPPV recurrence remains unclear. This study aims to determine whether menopause is a risk factor for BPPV recurrence and whether HRT reduces this risk through a long-term nationwide population-based analysis. 방법:This retrospective population-based study analyzed data from the Korean National Health Insurance Service (NHIS) database between 2002 and 2017. We included 345,091 female patients diagnosed with BPPV. Patients were categorized based on menopausal status and HRT usage. To evaluate the impact of menopausal status and HRT on BPPV recurrence, we observed and compared the recurrence rates over a 5-year follow-up period. 결과:Postmenopausal women exhibited significantly higher BPPV recurrence rates compared to premenopausal women (HR:1.252, 95% CI: 1.230-1.275, p < 0.0001). Among postmenopausal women, no significant differences in recurrence rates were observed between HRT users and non-users. Similar patterns were observed in cases of premature menopause. 결론:While menopause is associated with increased BPPV recurrence, HRT does not appear to significantly affect recurrence rates. These findings suggest that while HRT may have protective effects against initial BPPV occurrence, its role in preventing recurrence requires further investigation.