This is a genuine, live disagreement in the evidence. Both sides below are independently sourced and graded — read the grades, not just the labels.
Favorable for most healthy, recently menopausal women
For healthy women who start hormone therapy within 10 years of menopause or before age 60, modern individualized regimens have a favorable risk-benefit profile — 20-year WHI follow-up data show no clear increase in breast cancer or cardiovascular mortality in this group, and HT remains the most effective treatment for vasomotor and genitourinary symptoms.
There is reasonably consistent research, but important limitations or unanswered questions remain.
Real caution still warranted for some populations and regimens
The original WHI trial — largely reflecting older women starting hormone therapy more than 10 years after menopause, on a specific oral estrogen-plus-MPA regimen — found increased breast cancer, heart disease, stroke, and blood clot risk. That finding still argues for caution around late initiation, longer duration, and certain hormone formulations, even as it doesn't generalize cleanly to younger, recently-menopausal women on different regimens.
There is reasonably consistent research, but important limitations or unanswered questions remain.