[Current position about the use of estrogen therapy in women during the climacteric period]

The hormonal therapy should begin only in order to control the symptoms of the climacteric in women; its use is not recommended to prevent other types of affections associated to the posmenopause, because, despite some other recognizable benefits have been described, many of them have not been demonstrated. Before beginning the treatment of hormonal therapy, it is recommended to analyze the risk factors for heart attack or other cardiovascular diseases, and also estimate risk for osteoporosis and breast cancer. Diverse presentations and ways of administration of the hormonal therapy have been used, with which outcome have been obtained that vary in connection with predominant symptoms. Recently, the introduction of the concept based on the combined use of an estrogen associated to selective estrogen receptor modulator (SERM), the tissue selective estrogen complex (TSEC), allows a better clinical profile for the patient. With this combination it is obtained endometrial protection and positive action about the changes that the menopause produces. The decision to continue the hormonal therapy should be individualized, based on the severity of the symptoms and recurrence, considering the risk-benefit foreseen with the woman in the clinic.