Hormone therapy in menopause (HTM) is used to decrease and/or suppress the discomforts caused by estrogen deficiency, such as hot flashes, vaginal atrophy and for the prevention of osteoporosis, among others. HTM should not be used when there are unexplained transvaginal bleeding, active liver diseases, recentthrombosis or embolism, carcinoma of the breast or endometrium, or adenocarcinoma of the cervix. Use should be carefully evaluated when there are seizures, high blood pressure, hyperlipidemia, migraine, thrombophlebitis, endometriosis, myomatosis and vesicular disease.Before prescribing HTM mammography, blood glucose, triglycerides and total cholesterolshould be evaluated.Periodic evaluation of patients should include all these studies due to the eventual risk in prolonged treatments. The risk of developing breast cancer increases after 5 years of treatment with HTM. The early initiation of HTM(0-5 years after onset) is associated with a decreased risk of stroke; however, late initiation was associated with elevated risks of stroke when estrogen is used as single therapy.Some studies provide evidence for a protective association between postmenopausal HTM use and Alzheimer disease or dementia, although it is only observed a reduced risk among those with long-term self-reported HTM usein other studies. The adverse effects associated with HTM depend on the dose and the type of progestogen used. Among the most common side effects associated with HTM are nausea and vomiting, feeling of fullness, tenderness of the breasts, pain in the legs and edema. Some progestogens may be associated with transvaginal bleeding, changes in mood and irritability.The decision to use HTM during climacteric can be complex given the variability in benefitsand risks of menopausal treatments.