Reporting in affected countries underwent five stages: positive support but low actual participation in hydropower development (1971–1991), increasing concerns and active participation by most countries (1992–1994), an emerging negative attitude in downstream countries (1995–2008), spreading opposition by downstream countries (2009–2015), and the coexistence of cooperation and conflict (2016–2020). Media reports from upstream countries (i.e., China and Laos) were positive regarding hydropower development; downstream countries opposed hydropower and prioritized the negative impacts of dam construction. International shifts in attitude were dominated by vulnerabilities to extreme weather and affected by major geopolitical events, including local wars, interference from extraterritorial forces, and established regional alliances. This knowledge will strengthen international water use cooperation in light of global climate change and complex geopolitics.