Newson Health and the menopause industry

My bone specialist recommends HRT for bone density.

Some people asking about blood tests - my best guess is that private clinics are more likely to prescribe testosterone (which IS licensed for low libido but which may GPs do not feel comfortable prescribing) and it is important to make sure a patient has adequate oestrogen levels otherwise the testosterone is just converted to oestrogen anyway. Therefore blood tests important. Or, alternatively, you believe a woman is not absorbing oestrogen well enough transdermally, so want to give her unlicensed doses, maybe you want to check oestrogen. Since GPs are generally not giving unlicensed doses of oestrogen and less likely to prescribe testosterone, BTs are not so helpful. Particularly in a pre-menopausal woman whose levels will be fluctuating anyway.

Sorry I'm on my phone and can't scroll back easily - someone asked what symptoms HRT doesn't help - it is more that symptoms are being ascribed to menopause more and more and often there are other things going on - like a bit of age-related joint pain, or stress from being carer to three generations and still working, or real pathologies that are being missed. HRT may help if they are really menopausal symptoms - but if it doesn't, it may be that the net needs casting wider.

HRT is not licensed for osteoporosis prevention outside of premature menopause, I believe? although it can be used around meno age. There's a good BMS leaflet on it. I don't really know why - probably because trials haven't been done in older women? Main thing is to have plenty of dietary calcium and Vit D and lots of weight bearing exercise, and if you have major risk factors (teenage anorexia or malnutrition, long smoking or heavy drinking history, steroid use, some rheum diseases, strong family history...) bring that to a conversation with your doctor.

You sound like you have been on quite journey @WarriorN and yes beans (and LizOR) are great!

I'm fit and healthy and still suffered really badly.

Please don't make menopause into a competition.

Fwiw HRT gave me my confidence back - so much so that I retrained in a completely different field and even got a degree in it.

Being slim and healthy is great, but that doesn't preclude you from menopausal symptoms. Look at Davina McCall!

Yes, I took Setraline for about a year. At the time, I felt fobbed off as I wondered if I should have been given HRT but my GP won’t prescribe it for non-physical symptoms. I have joined a gym, shifted my diet towards much more plant-based and low carb, and lost a couple of stone. I just feel better in myself.
I stopped the Setraline as I also felt I was just medicating life circumstance issues rather than there being actually anything ‘wrong’. Too much responsibility all around and not enough time for myself; a leadership role at work where I am facilitating colleagues to promotion whilst remaining static myself. General exhaustion with it all.
That’s not to say that HRT is not necessary for other people or should not be prescribed when necessary.
But I genuinely have concerns with a view that all women need medicating through menopause and are somehow deficient as a result of menopause and only HRT can resolve that, and then there are menopause cafes springing up at work and things like that. I feel like I already battled through all the inequalities of having children and being a single parent and now there is a whole industry around menopause which suggests another barrier to get past, even only in people’s perceptions. I don’t want to have my life stage and age a focus of attention at work or elsewhere just because I am female.

I think one of the things that is problematic with the messaging in the last few years, which I was fully on board with, is that it's possible to stave off dementia and bone density issues with exercise alone. And even build bone density.

It's just so very hard to find out how in my experience. It was the cancer exercise books that taught me the bits and bobs I needed. Then other strength advocates

It was also on mn where I read about the Scarborough diet for bone density (various herbs fruit and veg that have been shown to help.)

I had 6 months of sweats and feeling a bit angry. Now it’s over. I haven’t taken anything but ovestin to keep atrophy at bay. I eat nutritious food, fast 18:6 and walk lots. I’m 53 and 3 years since last period. Feel really good.

This is just not true. I have exercised all my adult life, slim, healthy diet. I had no problems with periods during my life and healthy pregnancies. But when meno hit my joints ached terribly, my sleep was appalling and the brain fog, anger and low mood left me feeling like a totally different person. Within 24 hours if HRT the joint pains stopped, low mood and fog lifted within a week.
Please don’t make such sweeping generalisations. HRT also has many protective factors which I value as much as the ability to loose the meno symptoms.

I think Newson is a grifter, she’s always had one foot outside of GP looking for something more glamorous. I hadn’t heard of her until I went to a conference a few months ago where she was speaking. As a medic myself her talk made me angry because I found it deliberately misleading. She completely glossed over the risks of HRT, saying ‘they’re the safest drugs I prescribe’. I mean GPs prescribe things you can buy over the counter so that’s patently untrue, plus there is an established cancer risk which is why they are contraindicated in women who have had certain cancers already.

I felt she was manipulative to her audience of mostly non-medics, because she said how terrible the claim was that women who are wheelchair-bound cannot have HRT. On the face of it this sounds like a truly awful case of disability discrimination, but she failed to mention that this would be because of the increased risk of blood clots (DVT) that someone immobile and on HRT would have. There might be little or poor quality evidence for this, I don't know, but she should have said so if that was the case.

I also felt she presented an ideological view of the post-menopause state as ‘hormone-deficient’, requiring lifelong ‘replacement’ of hormones. Now I am totally open to that point of view and would be very interested in research exploring that. But currently it is not evidenced... therefore I think that view should be couched in those terms. Encouraging women to stay on HRT lifelong (as she said she would do) is quite radical. So in that way this treatment feels almost experiental. It's not like she's conducting a randomised controlled trial on all the women that she treats at her clinic. I don't have anything against the radical aspect but I do against the ideological aspect.

While women's health is so politicised, in any direction, we lose out. I want the same well-researched, evidence-based treatment for any condition that I would have if I were a man with cardiovascular disease.

She is not well respected by breast surgeons and oncologists.
She has given some very dubious advice re cancer risks and HRT post cancer treatment. She also quotes a lot of “research” carried out on her own patients which are a far from random group.
I know a number of women who have seen her but have lost confidence.

Some women just use oestrogen though without progesterone. Those of us who have had a hysterectomy don’t need progesterone.

Lifestyle changes can help but protein or beans is not going to help your atrophy. Also if you’re in such a pit of doom that everything seems hopeless and you’re too anxious to do anything, hrt can give you the “oomph” you need to implement lifestyle changes.

Did they get micrograms and milligrams mixed up on Panorama?

She deserves to be struck off! Offering more than two or three times the licensed dose of estrogen is just asking for trouble, it’s well known that this can cause hyperplasia (increased cell production in the womb) this can develop into cancer, absolutely horrendous. I have no medical qualifications, but it’s so easy to find the information on the web, she’s putting women’s health at risk. I see a menopause specialist and she has explained the risks to me of estrogen in too high a dose, and would never deviate from the British Menopause Society guidelines, Jesus it’s unbelievable 🤦‍♀️

Yes - with the cancer exercise stuff they all yell "eat loads of protein!" As you're trying to remain strong.

If you go for plant protein (google vegan body building) you're also ticking off the good stuff we need to eat for meno - beans, nuts seeds etc.

I'm not vegan but eating way more of that type of thing than I ever was to boost protein.

Went through a rather windy phase though 💨

So the wonderful Liz o riordan pointed me towards the research around and books linked to how exercise reduces risk of reoccurrence post cancer, as well as helping manage side effects of chemo and radiotherapy mostly by trying to manage fatigue (and interestingly improving the impact of those treatments too.) if you were doing very little exercise pre diagnosis and start doing the recommended amounts, reoccurrence rates can be reduced by something like 30 % (might even be higher.) that's as much as some of the drugs you're given.

There's actually a trial looking at getting exercise classes for women post bc on the nhs.

Diet really does seem to help my meno symptoms.

A recent Zoe podcast said they'd found that many women on hrt still had symptom but diet could alleviate up to 30% for both those on hrt and those not on hrt.

I've also been reading bits of "grow your own hrt" - the old style diets of eating buckets of cabbage and swede appears to have been to western women what soya is to the women of Japan.

I would second anti depressants. Sertraline has helped me enormously. Anxiety was one of my first symptoms when I was peri (though I've always had anxiety to one degree or another) and I haven't come off them since starting low dose hrt. I don't think hrt alone would cut it for me.

Thank you. It is good to get this opinion from a medical professional. I agree completely that lifestyle plays a huge part in symptoms of menopause along with so many other health issues, but this isn’t what people want to hear. They want a magic bullet and there’s a whole industry just waiting to capitalise on this.
I wonder what incentives these celebrity HRT promoters are given.

Quite shocking. Louise Newson isn’t all she’s cracked up to be.

I once questioned the whole anti-depressants versus HRT thing on a forum and ended up being completely piled-on by her acolytes

Anti depressants are another excellent tool to try. It's the only medication for women with hormonal cancers and it does really work.

All options should be presented to women and risks and benefits explored.

I know of a woman who's found beta blockers a game changer

I exercise for cancer and eat for menopause
Could you explain what this means, please?

I have been told by my NHS GP and NHS Rheumatology that hrt is the first line treatment for oesteopenia. I was put on it at age 41 due to low bone density. Most women's bone density drops rapidly in menopause due to the lack of oestrogen so if yours is low hrt is advised in NICE guidance.
https://theros.org.uk/information-and-support/osteoporosis/treatment/hormone-replacement-therapy/

I need to add that none of the above was easy and I 100% used my cancer diagnosis to take time off to learn how to manage my symptoms.

That is a luxury few women are able to have in my opinion. And yes I saw it as a luxury!

I think meno care starts when we are in our 20s and 30s with education about maintaining and building strength for bones.

Totally support women's right to have access to hrt but bigger picture needed of how to use it as a tool and not the only focus.

This is interesting, I looked at her website recently as wondering if I might have some peri menopause going on

Will watch it later tonight