[Menopause and cardiovascular risk : a window of opportunity for women's health]

Menopause is a major hormonal transition associated with a significant increase in cardiovascular risk. The decline in estrogen levels negatively affects the lipid profile. Early and individualized management of risk factors is essential. Hormone replacement therapy (HRT) is not recommended for primary or secondary cardiovascular prevention. Late initiation, especially in oral form, substantially increases the cardiovascular risk, particularly the occurrence of ischemic stroke. A window of opportunity exists for initiating HRT in women under 60 years old or within 10 years of menopause onset, who experience severe vasomotor symptoms, preferably using transdermal estrogen combined with micronized progesterone. HRT should be initiated at the lowest effective dose and reassessed annually.