Objective of the Review: To discuss clinical and experimental research data, focused on some non-reproductive effects of estrogens and the role of menopausal hormone therapy (MHT) in ensuring women’s health during aging and preventing age-associated diseases. Key Points: Combination oral MHT is most effective in preventing cardiovascular diseases, metabolic syndrome, and diabetes mellitus, when initiated during the menopause transition. Individually tailored regimens containing the bioidentical estrogen 17β-estradiol and dydrogesterone, a metabolically neutral gestagen, ensure highly safe MHT. Conclusion: Professional medical communities currently have no doubt about the need for early initiation of MHT, taking into account all indications and contraindications, for arresting menopausal disorders and prevention of metabolic and neurodegenerative conditions. Keywords: menopause, combination hormone therapy, cardiovascular diseases, neurodegenerative conditions, metabolic syndrome.