[Menopausal hormone therapy: internal-endocrine point of view]

The history of menopausal hormone therapy (MHT) started in 1942 in the US and became very popular in the 1960s worldwide because of the beneficial effects on vasomotor-vegetative and vulvovaginal symptoms. These symptoms may begin already in the premenopausal period, and can last for more than 10 years with reduced quality of life. Many women with vasomotor-vegetative symptoms do not visit a gynaecologist first but primarily a general physician or cardiologist because of instable blood pressure and palpitations, leading to the focus on the heart. To avoid unnecessary examinations and treatment with ß-blockers or antidepressants, an interdisciplinary look is necessary. In most cases, appropriate and low dose hormone replacement will relieve the symptoms and restore quality of life. In addition, it is worthwhile to know about the long-term effect of hormone deficiency as well as replacement on the different organ systems and the possible influences of hormone replacement therapy including contra indications. This is especially necessary after the uncertainties raised after the first deleterious announcements of the currently corrected results of the WHI (women's health initiative) study.