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Abstract：
Menopause Hormonal Treatment (MHT) was initially developed to correct the climacteric symptoms induced by postmenopausal estrogen deficiency. In non-hysterectomized women, MHT combines estrogens and a progestogen, the latter opposing the negative impact of estrogen on endometrial proliferation. In France, and contrary to the USA and Northern European countries, MHT mainly combines 17β-estradiol, which is the physiological estrogen produced by the ovary, and progesterone or its derivative, dihydrogesterone. France has been a pioneer in the development of cutaneous administration routes (gel or transdermal patch) for estradiol, allowing better metabolic tolerance and a reduction of the risk of venous thromboembolism compared to the oral route. The choice of the doses as well as the treatment regimen is underpinned by tolerance as well as acceptance and compliance. The risk of breast cancer, which is one of the main risks of MHT, is higher with estro-progestogen combinations than with estrogens alone ; the preferential use of progesterone or dihydrogesterone being likely to limit the excess risk of breast cancer associated with MHT at least for duration of treatment of less than 5 to 7 years. The question of the optimal duration of MHT remains an issue and must take into account the initial indication of treatment as well as the benefit-risk balance, which is specific to each woman. Continuation of MHT is conditioned by the benefit-risk balance, which must be evaluated regularly, but also by the evolution of symptoms when MHT is stopped as well as menopause-related health risks or induced by MHT. After stopping MHT, it is necessary to maintain a medical follow-up to be adapted to the clinical situation of each woman and in particular, her cardiovascular and gynecological risk factors.
摘要：
绝经激素治疗（MHT）最初是为了纠正绝经后雌激素缺乏引起的更年期症状而开发的。在非子宫切除的女性中，MHT结合了雌激素和孕激素，后者反对雌激素对子宫内膜增殖的负面影响。在法国,与美国和北欧国家相反，MHT主要结合17β-雌二醇，这是卵巢产生的生理雌激素，和孕酮或其衍生物，二氢孕酮.法国一直是开发雌二醇皮肤给药途径（凝胶或透皮贴剂）的先驱，与口服途径相比，允许更好的代谢耐受性和静脉血栓栓塞的风险降低。剂量以及治疗方案的选择以耐受性以及接受和依从性为基础。患乳腺癌的风险,这是MHT的主要风险之一，雌激素-孕激素组合比单独使用雌激素更高；至少在少于5至7年的治疗持续时间内，优先使用孕酮或二氢孕酮可能会限制与MHT相关的乳腺癌的额外风险。MHT的最佳持续时间仍然是一个问题，必须考虑到治疗的初始指征以及利益-风险平衡，这是每个女人特有的。MHT的持续受利益-风险平衡的制约，必须定期评估，还有MHT停止时症状的演变以及与更年期相关的健康风险或由MHT引起的。停止MHT后,有必要保持医学随访，以适应每个妇女的临床情况，特别是，她的心血管和妇科危险因素。
