Two hundred perimenopausal women who suffered from several symptoms and signs of menopause participated in this 3-year prospective study. Because they were still menstruating more or less regularly, these women were afraid of becoming pregnant and asked for contraception as well as hormone replacement therapy (HRT). Therefore the HRT chosen was a low dose triphasic oral contraceptive. The patient population was divided into two groups; one group (100 women) took the triphasic contraceptive as HRT and the other group served as controls (100 women). During the three years of this study this form of HRT was demonstrated to prevent conception and bone-mass loss, combat vaginal dryness and sexual disturbances, eliminate hot flushes and profuse sweating, correct breast atrophy, and prevent or improve psycho-functional disturbances, such as depressive mood, loss of concentration, insomnia, nervousness, palpitations and fatigue. It was concluded, based on the results of this study, that the triphasic oral contraceptive is the treatment of choice in the prevention and treatment of menopausal symptoms during the perimenopause--when contraception is still required.