MENOPAUSIA: PANORAMA ACTUAL DE MANEJO

there has been a marked decline in hormonal therapy (ht) for menopausal symptoms, since 2002, due the understanding of the benefits and risks as described in the women's health initiative (whi). nevertheless, revisions of the whi and current evidences determine that the ht: (a) is the most effective treatment for menopause vasomotor symptoms and their potential consequences (diminished sleep quality, irritability, and reduced quality of life), and to treat urogenital atrophy. (b) prevents the osteoporosis and, in women with healthy endothelial arteries, it reduces the risk of hypertension, diabetes ii and coronary heart disease; but, the benefit-risk ratio is favorable for women who initiate ht close to ovarian failure or menopause. (c) there is the tendency to minimize dose, give no oral estrogens and pure progestagens, in order to diminish its potential risks. (d) tibolona and paroxetine are good alternatives to treat menopausal vasomotor symptoms. (e) finally, the changes in the lifestyle are excellent ht adittional aids to prevent postmenopausal chronic diseases; but these diseases deserve specific treatments.