[The climacteric--physiology or pathology?].

Nearly 30 years of a woman's life is spent after cessation of the reproductive function and about 30% of the female population in Europe is postmenopausal. The medical infirmities resulting from estrogen deprivation among postmenopausal women take a high toll. The greatest number of hip fractures because of osteoporosis occur in this group, resulting in a high death (20%-30%) and morbidity rate. Estrogen deprivation leads to a change of the lipid metabolism with acceleration of arteriosclerosis. While the "estrogen forever" era closed with a striking rise in the incidence of adenocarcinoma of the endometrium, combined estrogen-gestagen treatment drastically decreases the incidence of endometrial and breast carcinoma. Therefore, physicians must be aware of the benefits of estrogen-gestagen treatment and act appropriately.