Of late, the generaly tenor of medical recommendations on hormone replacement are that it is generally a negative as regards increased cancer risk (breast in particular), increased heart disesae, and increased risk of dementia. These latest thoughts are completely opposite to recommendations only 15 years ago.
This remains a confusing topic, but a recent report on dementia and hormone use shows the complexity of the associations.
In this study 5000 woman using hormones and assessing for dementia they found:
If you use hormones immediately when you go into menopause, they reduce your risk for dementia
If you wait to use hormones until several years after menopause, there is an increased risk of dementia.
If you use hormones immediately and for the long term, there is no difference in dementia as compared to women without hormone therapy.

This research suggests a ‘window’ of opportunity for hormone benefits, and explains why there is such contradictory information on hormone use more generally.
Based on my analysis of the research data I believe that:
Estrogen use alone (Premarin or similar) should be started after menopause and will lead to reduced heart disease, reduced breast cancer, reduced osteoporosis, and reduced dementia.
Estrogen + Progesterone combined will lead to reduced heart disease, a slight increase in breast cancer, reduced osteoporosis, and no effect on dementia.

The balance needs to be analyzed in each woman’s situation and is very specific. There is no ‘pat’ answer for everyone.

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