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Cardiovascular disease is currently the second leading cause of death among women in France. The menopause period is probably the ideal time to screen for all cardiovascular risk factors. This step is essential before offering menopausal hormone therapy to women suffering from disabling climacteric syndrome. If such treatment is authorized, transdermal estradiol combined with natural progesterone is the safest treatment for women with no history of hysterectomy. The tolerability of this treatment, as well as all cardiovascular risk factors, must be assessed annually in order to optimize the benefit/risk balance.