It is highly probable that the menopause, spontaneous or above all artificially induced, is a cardiovascular risk factor. However, it is less important than other conditions (hypertension, smoking, obesity, diabetes, hypercholesterolemia) with which it is often associated and which it may favourise or worsen. In this respect, hormone replacement therapy is probably beneficial, probably by an action on the arterial endothelium itself, and certainly by opposing the factors which favourise the development of atheroma (metabolic and hemostasis disorders). Its aims and techniques, and hence its cardiovascular consequences, are very different from those of hormonal contraception, with which it must neither be compared nor confused. It would be reasonable, on the basis of these advantages, to extend the indications of post-menopausal hormone replacement therapy to an increasing number of women and for a longer period.