Most important ovarian hormones are estrogens, progestins, and androgens. Menopausal ovarian failure leads to hormonal deprivation with variable repercussions among women, such as symptoms with negative effects on quality of life, and changes in future risks of some important and prevalent pathologies. Hormone replacement therapy is the etiologic treatment to avoid all that, but it introduces modifications to these risks, in addition to some side effects. However, many types of composition, formulations, doses, pathways, and schemes are available for hormone therapy, with relevant differences in terms of pharmacokinetics, efficacy, or side effects, that may be even targets for selection, such as the bleeding pattern or lipid profile effects. Therefore, issues like information, indication, therapy selection, acceptance, and compliance are difficult or laborious in many cases and require knowledge and experience from the healthcare professional. In this chapter, we will review and discuss all these topics, the therapeutic plan approach, and follow-up management.