Dr Caoimhe Hartley

The other thing I get asked about all the time is brain.

Like, where do we stand on should I start HRT to reduce my risk of dementia?

And the truth is, we don't know.

And the data set isn't there.

We don't have sufficient evidence to really confidently guide women

Again, there's some suspicion that there might be a window of opportunity for dementia protection.

So maybe for younger women who are still making some estrogen, so perimenopausal women, we might gradually or kind of in a minor way slow down their risk of ultimately developing something like Alzheimer's dementia.

With women who are older, there's some evidence to say if you start HRT in your 60s, not if you stay on it, but if you start HRT in your 60s, that we might increase the dementia risk.

The problem is those studies... Do we know how, even biologically, that could be possible?

A lot of those studies used oral estrogen.

So maybe it was the fact that they were, like the tablet form of oestrogen is much more impactful on your blood vessels.

So potentially through that mechanism, we see changes.

So it's really hard to extrapolate from that data.

I know.

I know what in God's name I'm supposed to be telling women.

Isn't that really depressing?

Oh, Jesus.

That's the driving force.

That's the motivation.

So we still use numbers from the Women's Health Initiative.