Summary

Hormone replacement therapy (HRT) effectively controls menopausal symptoms affecting quality of life. It also provides long-term protection for the genito-urinary system, the skeleton, the cardiovascular system and central nervous system. Chronic disorders of these systems become increasing common in ilder women. State-of-the art therapy for such older women with an intact uterus is continuos combined estrogen/progestagen, allowing period-free therapy with increasing rates of amenorrhoea when used long-term. In initiating HRT in postmenopausal women, selection of therapy for patients at different ages requires careful consideration to balance risk and benefits. For the prevention of chronic disorders, patient compliance is paramount for obtaining the full benefit of treatment. This can be achieved by the appropriate use of different HRT doses and routes of administration. A new transdermal continuous-combined E2/NETA matrix patch with very good adhesive properties is now available in two dosage strengths with convenient twice weekly application, increasing flexibility of dosage and facilitating compliance. Non-HRT, non-hormonal and non-pharmacological options for use in the management of postmenopausal health are widely used, for example SERMS, bisphosphonates, calcium and vitamin D, and lifestyle changes. Yet nothing is more beneficial than HRT, and the options for this therapy have increased considerably with the introduction of Estalis®.