[Climacteric disturbances. 2. Therapy of climacteric disturbances]

After defining the terms climacterium and menopause the causes of climacteric disturbances are explained. During the premenopausal stage disturbances of the cycle are prevailing, caused by an insufficiency of the corpus luteum. Of climacteric disturbances should be spoken only after menopause. They are divided into: vegetative disturbances, troubles of metabolism, cardiovascular dysregulation, psychic deviations, sexual troubles and changes of the skin. The therapy of disturbances during the premenopausal stage mainly consists of the substitution of progesterone or in a cycle-like estrogen-progesterone-therapy. In the premenopausal stage estrogens are the therapy of choice. Among orally efficient estrogens the conjugated estrogen and the estradiol-valerianat are preferred. Side-effects and contraindications are discussed in detail. Among gynecologists there exists no disagreement about the necessity of therapy of serious climacteric disturbances, the opinions about prophylactic estrogen-therapy in women differ.