A 24-month prospective trial was carried out in 100 periclimacteric women to study the effects of a combination product containing estradiol valerate and levonorgestrel. After three months of treatment, 93% to 98% of women experienced relief of five of the seven signs and symptoms of the periclimacteric syndrome. Twenty-three percent of the women reported increased libido during the first year of treatment. The maturation index, atrophic at the start of the study, became normal in all patients after one to two months of treatment. No evidence of thromboembolic disorders, endometrial hyperplasia, or endometrial cancer was found during the 24 months of treatment, nor did any serious adverse reactions occur.