Oprah Winfrey (at age 55), Angelina Jolie (at age 39), and Jane Seymour (at age 47) all declared hormone replacement (HR) was essential for them to feel good and think clearly. And data support the benefits if HR is taken for five to 10 years around the time of pre-menopause/menopause with a daily low-dose aspirin.

But there are always questions about potential drawbacks.

A study in JAMA looked at the use of estrogen by women with prior hysterectomy, and estrogen and medroxyprogesterone acetate (one form of progesterone) use by post-menopausal women who had not undergone hysterectomy. They found that women taking only estrogen saw a significant reduction in breast cancer risk. 

Women taking both hormones, however, had a greater risk of breast cancer compared to those on placebo.

In my opinion, that was with a very, very poor choice of progesterone; instead try a micronized progestin such as Prometrium.

The bottom line: Women with increased risk for breast cancer, who have BRCA1 or 2 genes, who started their periods before age 12 or reached menopause after age 55, or who've had cancerous or noncancerous breast disease, should talk with their doctor about their increased breast cancer risk and the risks of adding HR on top of that.

Those with no preexisting breast cancer risks who want to take both hormones should discuss the risk-benefit ratio with the doctor too.

And remember, HR's major risk is clotting. So, talk to your doc about a daily low-dose aspirin (with a half glass of warm water before and after).