It never rains but it pours for the HRT industry.
One of the most lucrative drugs markets came crashing down with the sudden stopping of the Women's Health Initiative trial when, last year, it was discovered that oestrogen plus progestin increased the risk of stroke in post-menopausal women.
This alarming discovery overshadowed another finding from the same trial - finally published only recently - that found the therapy also increases the risk of dementia among women aged over 65.
In fact, the risk is more than doubled in women who take one HRT tablet a day compared with those taking a placebo.
The risk was discovered after tracking over a four-year period the progress of 4,532 women who were older than 65 and had good mental health at the start of the study. Half were given HRT therapy and the rest had a placebo.
Overall, 61 women were diagnosed with dementia, 40 of whom were in the HRT group and 21 in the placebo group.
Researchers estimate that HRT will create an additional 23 cases of dementia a year for every 10,000 women taking the drug.
The risk of dementia, coupled with the increased risk of stroke, means that the risks of HRT outweigh any benefits, the study concludes.
(Source: Journal of the American Medical Association, 2003; 289: 2651-62).