Estrogens have a multifactorial protective effect on various components of the cardiovascular system, and postmenopause in women is associated with an increased incidence of cardiovascular disease. Admission of menopausal hormone therapy helps to reduce the risk of cardiovascular events, but the perceived benefit far outweighs the risks in cases where women begin treatment no later than at the age of 60 or 10 years after menopause. Studies have shown that the combination of estradiol and drospirenone is effective and safe in terms of preventing cardiovascular diseases. The antiandrogenic effect of drospirenone has additional metabolic effects that may be preferable in certain groups of postmenopausal patients.