Interesting that if started after age 65, HRT increases the risk of dementia. I would not have thought...

As a person who had breast cancer fed by estrogen and progesterone, I am mystified by the 1 in 1,000 statistic for women on HRT who get breast cancer. One in 8 women get breast cancer and 80% of those are driven by hormones. I guess the key is not to use it too long:

" Hormone therapy (combined estrogen and progestogen) might slightly increase your risk of breast cancer if used for more than 4 to 5 years. Using estrogen alone (for women without a uterus) does not increase breast cancer risk at 7 years but may increase risk if used for a longer time."

@babs10 thank you for the link.

This menonote is dated 2017. I wonder what clinical trial results it is based on. To me, it appears to be a blend of some of the conclusions of WHI studies with some contemporary views/practices.

The topic of HRT is very confusing to say the least. To start, an understanding of WHI study design and its results/conclusion is a must. CEE and MPA are no longer the predominant meds. The newer formulation (E2 +/- micronized progesterone) and different route of administration beg for good, large scale RCTs so more women could benefit from hormone therapy, for whatever their needs might be. When drawing our own statements, opinions or conclusions, we have to consider the following:

-the age at which hrt is started
-how long hrt is used
-formulation of estrogen (mainly E2 vs CEE)
-formulation of progestin (mainly micronized progesterone vs synthetic medroxyprogesterone)
-estrogen alone or in combo with progestin
-route of administration
-dose variation
- the cohort of a RCT

For the newer formulation, there are KEEPS and ELITE studies which made some preliminary conclusions regarding cardiovascular risks. Good studies are few and far between regarding different risks associated with new formulation, and in different cohorts of women. So @windyshore, I wouldn't let the dementia risk mentioned in this particular menonote bother me. Let's find most recent reputable RCTs and let the results speak in detail. As for breast cancer risk, it is also complicated... in general, docs don't recommend hrt therapy to someone who has history, or family history of breast cancer.

@babs10 A certified practitioner/naturopath through the N.A. Menopause Society I recently consulted suggested this podcast by Dr. Streicher's Inside Information-Hormone therapy after age 60 with Dr. James Simon (April 10,2024): . https://audioboom.com/posts/8488754-hormone-therapy-after-age-60-with-dr-james-simon