Estrogen replacement can help prevent heart disease. After menopause, the risk of heart disease for women increases dramatically. Women who are premenopausal have a much lower incidence of heart attacks than men. After menopause, if they don’t go on hormone replacement, women begin to catch up pretty quickly. If they do go on hormone replacement, they retain that advantage. It’s no small benefit. It is estimated that 500,000 women a year die from coronary artery disease.