Newson Health and the menopause industry

Not read the thread but just wanted to add that, after being left in an awful emotional position after surgical meno 4 years ago, I Iooked at the Newson website for info and with a view to an appointment. I can't remember the context but something to do with "people" or "men and women" who experience meno was referenced and it made my blood run cold. Just bollocks to you, Newson et al!! I stopped reading and have zero interest in a meno specialist who fkn panders to gender ideology- so pathetic. Sorry for the derail- good to get off chest!

It's not just Newson, it's going to be all over the wording of the new NICE guidelines. Look at some of the consultation documents on the NICE website (Arabella posted a link below).

And GenderGP is listed as a "Diagnosis and Management Stakeholder" (in a long list)

Not read the thread but just wanted to add that, after being left in an awful emotional position after surgical meno 4 years ago, I Iooked at the Newson website for info and with a view to an appointment. I can't remember the context but something to do with "people" or "men and women" who experience meno was referenced and it made my blood run cold. Just bollocks to you, Newson et al!! I stopped reading and have zero interest in a meno specialist who fkn panders to gender ideology- so pathetic. Sorry for the derail- good to get off chest!
Also, looks like there's some question as to how beneficial HRT is and it's good to see the GP @WitheringHighs , I think, on this thread acknowledging that HRT is not the magic bullet for all. This is definitely my experience- I've had years trying different permutations of it and it's made me feel consistently miserable- but I've kept chasing that elusive feeling of well-being. No more now and glad to hear it's not just a me thing.
If there are any ladies who've had a surgical meno and are doing well without HRT, I'd love to hear about it!

Very patronising remark from a GP suggesting women expect to feel 21 again.
I just wanted to be able to go about my life without really painful bones, to be able to exercise and go for walks. And it worked, which I'm very grateful for.
Although I accept her assertion that its promoted a magic bullet, but that's just the pervasive desire to over simplify complicated things.

Thanks, and yes, sorry for the derailing into my own health. Without going into detail, I’ve had all sorts of investigations for the fatigue and indeed have been successfully treated for one cause of it, but I’m sure the remainder is down to perimenopause and I have plenty of other symptoms (notably debilitating hot flushes and night sweats) which the HRT is keeping in check. It does seem that fatigue is both one of the commonest and the most difficult to treat symptoms of menopause in general.

Have you addressed the fatigue with your GP. Menopause is not the only cause of fatigue. This is what I’m referring to in my post that yet again ( we saw it in the 80s when HRT became popular) every symptom women suffer during there 40s and 50s is blamed on peri menopause when there are plenty of other real diseases that can cause symptoms.
B12, iron and magnesium deficiency can cause all manner of problems. They are a byproduct of perimenopause due to increasing heavy periods and resulting blood loss. But often only the hormones are address.
I felt fantastic during perimenopause because I had a Mirena coil fitted which stopped my periods ( endometriosis) and prevented the chronic anaemia that had blighted my 30s. Mirena is known to help women cope with peri, so much so that I was unaware of any symptoms until I hit menopause proper.

I do wonder how much fear and anxiety is involved with the massive drive to get every woman onto HRT. We have successfully created a big market for the drug companies overnight based on fear of menopause. The media campaign is totally biased. No one has bothered to canvass the experience of the large number of women who have moved through menopause without problems.

I think we need a more balanced presentation. I’m told that LN is evangelical about HRT because of her own lived experience which she is still struggling with. As clinicians it is important to be completely objective, assuming that every woman is suffering from the same menopause as yourself is dangerous. This often translates as a GP who doesn’t always appear sympathetic. I would rather a GP looks for differential diagnosis than prescribes HRT after a quick 10 min consult because you tick the boxes.

I recently had some concerns about my chronic endocrine condition. My GP was great, he read through my notes prior to the appointment, did a full examination and agreed that we needed to rule out a particular cause before looking for others causes. So he did an extensive blood panel and wrote to my consultant. Within 3 weeks I had completed the investigations and spoken to my consultant. He could have simply put it down to my meds or a recent car accident where I had suffered whiplash, but he took the time to approach it holistically.

I would say that most GPs would do the same but if a patient has an agenda then it is all too easy to be railroaded into prescribing HRT without considering more serious causes of the presenting symptoms. It is all too easy to go in with a check list.

You only have to look at how easy it is to get the weight loss injections, another dodgy area of pharma waiting to cause the NHS problems, to realise that a list of symptoms and a fake BMI can line the pockets of both the online pharmacy and the doctors they use to assess suitability. The appalling thing is that these drugs are globally in short supply and possibly affecting the health of those who genuinely need them to control diabetes.

Hopefully that's reassuring 💐

I have a slight familial increased risk of bc so I understand your concerns.

Weighing up all these factors is so tricky, and so individual.

Thanks. Yes sorry for the merail, but that’s exactly what the doctors have said. They’re not worried about me being on HRT until I’m considerably older than I am now.

I don't want to derail the thread, but have you spoken to a doctor about your concernn about genetic isk of bc? They can advise and offer genetic testing/mammograms if necessary. As your mum was 70 though it's probably unnecessary (I'm not a Dr though! )

I’m worried about my risks (BMI 28, mother had breast cancer at 70) but I take it because it was that or be unable to work in the career I love and had just reached my goal level at. In fact without it I’d be so fatigued and unwell I doubt I could work at all and I’m single with no family support so... I’m trying to work on my weight, but it’s hard when (despite the HRT) I generally feel too fatigued to exercise. Before perimenopause I was a fit gym bunny with a BMI of 23. So it’s worth it for me. But I do worry, and I’m certainly not going to start taking experimental high doses.

Thank you for this post, it hits the nail on the head on each woman having to really balance her own approach. Personalised medicine as it were. We all have different histories, risk appetites and aspirations and fears for the future. There is no one size fits all. The problem is that nhs GP doesn't have time for this in depth conversation for the most part, when you go private be that LN or others, they should be able to spend more time explaining all this. I feel informed but aware that research is evolving and so my information is only as good as what we know now and that may change.

You are correct. From a medical perspective the menopause is just one of many factors that may have a minor roll in the process of aging.
But with the current trend HRT is seen as a cure all. The reason LN is coming under fire is that she is prescribing higher and higher doses to treat these symptoms when they don’t respond to the advised doses. There comes a point when there is a bit of a cross over.
If you google symptoms of low oestrogen and compare them with symptoms of too much oestrogen the list is pretty similar.
HRT is still in its infancy and LN is making the school boy error of increasing doses when there is poor response. Since many of the symptoms of menopause have a huge differential component, blinkered focus on menopause is poor medicine.
Before embarking on HRT a robust evaluation of all the symptoms should be undertaken to rule out more serious conditions.
In addition, the possible side effects of HRT should be addressed. I had no idea that HRT would fuel the growth of fibroids, which usually shrink post menopause when they are no longer fuelled by hormones. I suffered from debilitating sciatica as a result of multiple large fibroids causing pressure on nerves in my lower abdomen. Just one possible outcome.
Also that breast cancer is not the only cancer risk that is slightly increased. We talk in terms of statistics, the reality of being one of the unlucky percentage is very different. LN reassures women with risk assessment but those numbers are real people and you can be one of them. Something that I didn’t fully appreciate until I was diagnosed out of the blue. It’s very easy to be flippant but time and again on the support sites I use new members arrive with the same question, “why me?” having done everything right, diet, exercise etc. they are angry and confused that it has happened to them. We know that it is generally bad luck but so many of them are also asking the question “ is it my HRT?”.

There is currently no reporting system if you are diagnosed with bc while taking HRT, the data is derived from trials and studies which may be flawed simply because candidates for the trials are often heavily screen and not necessarily an example of the general population. For example anyone with a history of bc in the family may be excluded.

I took HRT for four years before being diagnosed with bc. Even with hindsight I would still have taken it because it was the best choice for me. However, I may not have taken it for as long. Evidence suggests that the longer you take it for the greater your risk of bc. This is something not addressed by LN, she uses the overall risk.
Taking HRT for 12 mnths does not increase the risk however after 10yrs your risk is significantly higher than at 5yrs. The risk is accumulative. This is often a difficult concept for people to understand so is simplified to overall risk.

I had radiotherapy which caries a risk of causing leukaemia. The risk is longterm so I may develop it in 20yrs or so. I’m 60 so for me , developing another form of cancer in my 80s is an acceptable risk. I may have looked at it differently if I had been 40 at diagnosis.

I was 53 when I started HRT, I’m sort of glad I didn’t start HRT any earlier.

Risk assessment is a personal process, it’s complicated. Maybe we should simplify it with some kind of formula that gives you a number so you can visualise your personal risk. It certainly helps post cancer treatment, to put a figure on your risk of the cancer returning. But there is so much more data available on relative outcomes with bc treatment. HRT is still a bit of an unknown.

I know lots of women have a terrible time with the NHS over menopause, but just to counter with a positive: I’m in perimenopause and have been on HRT for 2 years now. In that time I’ve lived in two different cities and been to two different GP practices and seen many different individual GPs for it, and also been referred to an NHS gynaecologist for a related issue. My care has been superb. I have never been refused nor discouraged from taking HRT, the doctors have worked with me to get the right (licensed) dose and type and the risks and benefits clearly explained.

I know other women haven’t been so lucky, but I just wanted to counter the narrative that NHS GPs are uniformly rubbish at this - they aren’t, and if you’re suffering menopausal symptoms it really is worth trying them before paying anyone for help.

It's not just that, it's all the health benefits – helping to reduce heart disease, osteoporosis, diabetes and dementia because it reduces inflammation.

Even I can now see that that is such a simplistic framing of a really complex area.

All those things are very separate conditions. And there is more or as much evidence for lifestyle factors (depending on which condition you're looking at.)

Exercise in particular is extremely anti inflammatory. That's why cancer and heart op patients are encouraged to do so. It is definitely much harder to exercise on the same way as you did when you're younger. And the more deconditioned you are, the more you need to build up very slowly. But that is the same for men and women generally

Women also need to follow very different guidelines for exercise to men, based on their physiology. For example women must eat within 30/40 mins after a proper workout/ heavy lifting, as well as a small amount before. If you're actively exercising, intermittent fasting is not helpful. "Time restriction" is fine - which is just normal eating, have a break over night for 12-13 hrs. Women also need a decent breakfast. I found Stacy sim's advice extremely helpful on all this. And feel I could have done with knowing about it all a decade ago as peri started.

I've had to hide and unfollow some social media people/ groups because the shouting about hrt being "the only thing to work" is really distressing (as I believed that thanks to LN) and I now know is BS. She was right to re start the conversation and campaign for women to access via the nhs. But that's very different to some of the claims she makes.

NICE evaluated all the AVAILABLE scientific evidence, which is not relevant to this discussion, because there is no scientific evidence on the benefits/risks of oestrogen doses above the licensed dose for menopausal women.

I think it will be available soon on YouTube.

I think she has found an open niche, or a chasm more likely, in the NHS regarding the lack of menopause knowledge amongst GPs, and has capitalised on it (excuse the pun). Add to that the social media phenomena, and she is THE menopause doctor. Too much marketing and too little substance.

Indeed LN uses her patients as Guinea pigs resulting in somewhat biased data.
Prior to her setting up business she had published nothing related to the menopause and has no specialist training in endocrinology so is a bit of a charlatan.

HRT doesn’t prevent HRT it merely slows down the process. As per normal LN has oversimplified the message.
She also claimed that it was safe for breast cancer survivors to use HRT. She’s not blessed with a great deal of common sense.

That is your case. If every woman comes here to defend her own menopause experience and not acknowledge that others have different experiences and genetic/medical/social background, and that a doctor can quote a few articles and "a wealth of data" (her own data, without peer review) to justify her high dose off-label prescriptions of oestrogen, this thread will be very long and a bit useless.

Yes, women can do whatever they want - so? Nobody is saying they can't take HRT.

Ah, I wasn't questioning the concept of HRT to help Osteoporosis being accepted (I said so above).

I was questioning using Louise Newsons own app as a reference on a thread discussing her approach - it's hardly going to be unbiased (that's not to say that it may not also be true).

Quoting 5 studies is not strong evidence, but anyway, under 'Similar content" come all the other factors that will determine bone density: eating healthy, daylight and vitamin D and so on. As I said before, if you don't have an overall healthy lifestyle, HRT won't protect you from osteoporosis, heart disease, dementia, diabetes, depression and a lot of other diseases. Bottom line: having a healthy lifestyle is the main factor for ageing well, and this is because we can change our lifestyle. The other main factor, genetics, can't be changed (yet).

I hope that you are aware of NICE’s operating remit
The National Institute for Health and Care Excellence (NICE) helps practitioners and commissioners get the best care to people, fast, while ensuring value for the taxpayer. We do this by: producing useful and usable guidance for health and care practitioners.

They are housekeepers not scientists.

Their guidance is often frustrating for prescribing practitioners since many useful medications are not available. However they do keep some of the more maverick prescribers in check.
Unfortunately the use of some really revolutionary cancer drugs , the expensive ones are not available for the small number of patients who would really benefit from them because of cost cutting.
I’ve seen posts by women on mn in their early 40s asking if the mild aches and pains and fatigue are perimenopause. No you are just aging. HRT will not cure aging, it will just make the journey through meno easier to deal with. We will all get old eventually and a low dose of sex hormones will make no difference.

No it really is very widely accepted
https://theros.org.uk/information-and-support/osteoporosis/treatment/hormone-replacement-therapy/