" During the pre-menopause transition there are bio-energetic shifts, and what that means is that the brain’s energy pathways change. When that shift happens in certain women they will be on a different fast forwarding road to Alzheimer’s disease, and our goal as a clinician, my goal in the clinic, is to get them off of that road using evidence-based and safe interventions. Is hormone replacement one of those interventions? I’m fairly sure it is, but it’s not a one-size fits all answer. When to start, what to start, there’s just so many questions here and I think I understand it much more now than five years ago. "