How do you counsel women post-natural menopause who are interested in HRT for reducing dementia risk?

The literature on estrogen replacement and dementia risk is mixed. The Women's Health Study originally found that estrogen replacement was a risk factor for dementia, but later analyses have not confirmed this, and some (as the questionnaire mentions) have suggested a protective effect. Not all studies have confirmed this, and the combination with a progesterone compound may increase risk. Short-term use of estrogen alone in the years after menopause may be worth recommending, but not for prolonged use, and not with progesterone in combination. The decision concerning whether or not to prescribe postmenopausal estrogen therapy should also take into account the increased risk of breast and gynecological cancers, and the reduced risk of osteo...