Newson clinic

[Puppylucky]

Anyone else a bit disappointed with the support they are receiving from the Newson clinic? Having waited 3 months for my first consultation, I was initially impressed by the supportive attitude of the nurse I spoke to. However my recent follow-up call was very disappointing. She wasn't particularly interested in my experience, particularly the negative impact that the Utrogestan tablets were having on my mood. I had to do my own research into taking it vaginally and her advice on this was very limited. She also recommended testosterone cream, which I am happy to try as I'm still suffering from fatigue and low mood, but I have since realised she gave me the wrong advice about blood testing and monitoring - specifically she didn't tell me that it's really important to check my levels via a blood test in the next few weeks, to ensure the testosterone levels are not too high. My next follow up appointment with her is not for 6 months "to give the testosterone time to work" which again is not in line with advice . I'm not sure if I'm expecting too much but it just feels a bit rubbish. Is it just me?

Do you have the choice of who the appt is with?
For example, can you choose Dr N herself, or a meno trained GP, or a nurse?

Is the fee the same whoever you see?

I'd be a bit disappointed to pay £250 and 'only' be treated by a nurse, as that's a consultant fee.

How did is it all set up?

Yes, me. Got better results going back to the NHS and a different doc after spending £££, waste of money. Composing an email to explain my disappointment with their service.

As I professional I'm yet to see anyone get recommended anything other than a transdermal oestrogen and oral utrogestan. Occasionally I've seen them add in some testosterone as above.

They seem very resistant to deviating from this regime - although I'm just referring to my experience only.

@privateandnhsgp

As I professional I'm yet to see anyone get recommended anything other than a transdermal oestrogen and oral utrogestan. Occasionally I've seen them add in some testosterone as above.

They seem very resistant to deviating from this regime - although I'm just referring to my experience only.

I think that’s true too

It seemed they’d already decided what to prescribe before we’d even talked about my situ

I think my doses of oestrogel were too high initially too

What dose were you put on @hamstersarse?

@privateandnhsgp

As I professional I'm yet to see anyone get recommended anything other than a transdermal oestrogen and oral utrogestan. Occasionally I've seen them add in some testosterone as above.

They seem very resistant to deviating from this regime - although I'm just referring to my experience only.

Yep this.

I think they’re okay. I saw one of their doctors and started with the oestrogel and utrogestan. The difficulty for me was that I have a lot of other medical issues and my NHS consultant wouldn’t speak with the doctor at Newson Health at all via email or letter about an issue I had which meant I was stuck between the pair of them both giving me conflicting advice. In the end I stopped taking the HRT because I felt I had no support with it from my endocrinologist and rheumatologist and these are the people I need to go to if I have an emergency with my complex health issues - and I couldn’t keep affording the £200 every few months for a 10 min follow up with Newson just to stay on their books.

4 pumps!

It made my breasts swell and just no need to have the oestrogen levels of a 20 year old at 46!

@hamstersarse

4 pumps!

It made my breasts swell and just no need to have the oestrogen levels of a 20 year old at 46!

They seem to want to get everyone up to 3/4 pumps. I am 41 and was told to try and get to 4 pumps. I’m not sure if that’s right or not to be honest. I guess being in early menopause means my oestrogen levels should be higher than someone in their 50s of usual menopause age so maybe that is correct.

I do 2 pumps now…much better

The problem with all of it is the lack of good tests to see exactly what your hormone levels are

It’s all guess work really.

Wow that is a lot. 1 pump is 0.75mg. I've recently started on patches at 0.25mg

@hamstersarse

The problem with all of it is the lack of good tests to see exactly what your hormone levels are

It’s all guess work really.

This is where I had issues. My endocrinologist and rheumatologist deal with figures / blood tests. I was told by Newson Health that there isn’t a definitive test to tell if you’ve gone through the menopause and that it’s important to treat the symptoms. They say - and I think NICE guidelines say this as well - that you don’t need to have blood tests to begin HRT. But my endocrinologist ordered a specific blood test to see if I’d gone through the menopause and said what Newson said was rubbish. My blood test came back showing I wasn’t producing any oestrogen but that I hadn’t gone through the menopause either! So I was more confused than ever. (I have a pituitary tumour and autoimmune issues which make all this super complex). So the endocrinologist basically said I can go back on the HRT if I wish but at the same time there’s nothing to say I’m actually menopausal and also, that potentially the oestrogel may create issues with my prolactin levels re the pituitary tumour. Newson Health didn’t really understand any of this and kept wanting to discuss this with my endocrinologist but he flatly wouldn’t - and they kept telling me to stay on the HRT. I’m not sure that’s correct, not without proper regular monitoring.

Lost faith in all of them to be honest….!

@Level75

Wow that is a lot. 1 pump is 0.75mg. I've recently started on patches at 0.25mg

Interesting! I knew it was a lot but that absolutely confirms 4 pumps was too much. My breasts literally swelled, like when your milk comes in!

@Bagelsandbrie

I hear you.

I was initially such a huge fan of HRT and it definitely made me feel better. But a year or so in I feel like it’s been total guess work and I’m getting urges to quit completely and see where I’m up to now naturally and go for a nutrition approach for a while.

I don’t know what happens if you just quit though?

[quote hamstersarse]@Bagelsandbrie

I hear you.

I was initially such a huge fan of HRT and it definitely made me feel better. But a year or so in I feel like it’s been total guess work and I’m getting urges to quit completely and see where I’m up to now naturally and go for a nutrition approach for a while.

I don’t know what happens if you just quit though?[/quote]
It’s all a bit of a mess isn’t it.

I just stopped. I had a “period” (bleed, maybe not an actual period) about 2/3 weeks afterwards and then nothing after that. The only symptoms I had return were hot flashes which yeah it’s annoying. But otherwise I don’t feel much different. I’ve actually asked to be seen by the menopause specialist at my local NHS hospital but there’s a very long wait. But at least I know all my care will be somewhat co ordinated, rather than no one in the NHS wanting to talk to Newson or taking their advice seriously.

They're sort of both correct.

NICE Guidance (and remember it's GUIDANCE, not gospel) says not to routinely check this and the information yielded is often of limited value particularly when close to the perimenopause.

Normally IF bloods are checked FSH and LH are requested, along with oestradiol levels. I'm oversimplifying but FSH and LH in particular can vary wildly depending on when the blood test is taken and can look completely normal even if the woman is clearly perimenopausal. However if, for example, both are through the roof then that's strong evidence for the menopause. Bloods also have other important uses such as ruling out thyroid issues which can completely mimic menopausal symptoms.

In general they're not used to guide things like the strength of treatment (e.g. Number of pumps) and symptomatic response is used for this.

As I professional I'm yet to see anyone get recommended anything other than a transdermal oestrogen and oral utrogestan.

I think this is a slightly unfair comment in some ways @privateandnhsgp because for years, women have asked for/ hoped for good treatment with HRT. It's bit like Drs can't do anything right :)

According to research, Utrogestan is the safest (breast cancer risks) and gel can be adjusted easily (and lower clotting risk than tablets.)

But it's taken many years for it to become the new 'gold standard' .

I've been on HRT for a long time (over 12 years) and was put on Oestrogel by a good meno consultant straight away but that was quite unusual at that time when most women were on a) tablets or b) patches.

Utrogestan doesn't suit all women. I was told that when I started using it.

Blood tests- mine showed post meno before using HRT which was a joke as I went on to have periods for 18 months. My dr joked that is shows how unreliable they are, but the test was part of a bigger health MOT not for menopause.

I did once ask for another blood test to check estrogen levels and was told they can fluctuate daily depending on when the last dose of gel was applied, how much was absorbed etc , and to go by symptoms.

I get the impression that some of the posters here who use the Newson clinic are younger than I was when I started HRT ( almost 53) and they may need more estrogen.

@JinglingHellsBells

As I professional I'm yet to see anyone get recommended anything other than a transdermal oestrogen and oral utrogestan.

I think this is a slightly unfair comment in some ways @privateandnhsgp because for years, women have asked for/ hoped for good treatment with HRT. It's bit like Drs can't do anything right :)

According to research, Utrogestan is the safest (breast cancer risks) and gel can be adjusted easily (and lower clotting risk than tablets.)

But it's taken many years for it to become the new 'gold standard' .

I've been on HRT for a long time (over 12 years) and was put on Oestrogel by a good meno consultant straight away but that was quite unusual at that time when most women were on a) tablets or b) patches.

Utrogestan doesn't suit all women. I was told that when I started using it.

Blood tests- mine showed post meno before using HRT which was a joke as I went on to have periods for 18 months. My dr joked that is shows how unreliable they are, but the test was part of a bigger health MOT not for menopause.

I did once ask for another blood test to check estrogen levels and was told they can fluctuate daily depending on when the last dose of gel was applied, how much was absorbed etc , and to go by symptoms.

I get the impression that some of the posters here who use the Newson clinic are younger than I was when I started HRT ( almost 53) and they may need more estrogen.

Hi, I'm not disputing this as a first choice.

It's exactly what we use as first line.

However they seem very hesitant to move away from it when it doesn't work or suit. HRT and medication choice should of course be individualised to the patient, I think most would agree on that...

However they seem very hesitant to move away from it when it doesn't work or suit. HRT and medication choice should of course be individualised to the patient, I think most would agree on that...

I don't know how we know that, except by the few posts here. Very few women actually use that clinic, in terms of percentages.

If that is ALL they do offer then women may as well ask their GPs for it if that's what they want to try.

I think the main issues on the forum at least, are women struggling to get HRT at all, not being given a choice, not being allowed to have Utrogestan by many GPs, and many GPs not having a clue about meno and HRT. (Yourself excluded if you are a GP.)

I think there are different prices to see a nurse or doctor. I’ve had a couple of appointments, the follow ups are nearly as much for half the time, but overall have found it helpful and hoping to now transfer to NHS care which they’ve been supportive about. They want to check my testosterone levels every three months but then my main issue is very low testosterone (0.3 when I went and now 0.7 but apparently supposed to be 2-3).

Hi Thanks for all the responses - interesting to see some agreement. It is cheaper ( not much) to see the nurse, but totally agree the 2nd consultation felt like half the time for the same price. Also had the same experience with breasts swelling due to advice to try and get up to 4 pumps of Oestrogel. It got so bad that I couldn't lie on my front, but the nurse just reccomended evening primrose oil. The thing I take most issue with though, is lack of blood tests. Not so much to establish if I am in meno, as that's pretty obvious, but to check on hormone levels as I undertake treatment. It feels like because I am in London and won't be testing at the Newson clinic, this whole area has been left to me to check on the requirements for and manage.

@Puppylucky There are some very good meno gynaecologists in London who have been around much longer than the Newson clinic.

Are you young and having an early menopause? That's one of the only reasons you'd be advised to use 4 pumps as younger women need more.

I've used gel for over 12 years from a gynae consultant much more experienced than those at the Newson clinic. I don't have blood tests other than one right at the start when I was being checked for other things, not to do with menopause itself. You don't need blood tests, because the way to use gel is to use enough to control your symptoms, but not so much you get bad side effects.

My dr told me to start with half a pump and work upwards, to get symptom relief. For me, that was between 1 and 2 pumps- 1.5 pumps was ideal.
Why don't you drop back if 4 pumps is too much?

@JinglingHellsBells

Thanks for that. My 4 pumps was way too much. I’m going to actually try 1 pump for a couple of weeks and see if that is actually enough. I’ve been on 2 for a month or so and breasts have recovered and no symptoms returned so I might see if 1 is enough!

I was disappointed with my experience too. I feel the GP could have told much more about what to expect.

I went there because I thought I'd get a personalised experience. It wasn't.

Especially knowing the common first line recommendation for medication I wish I'd asked my GP for that in the first instance and saved all that money, especially including the private medications.

Hi @JinglingHellsBells No I'm not young - late 50's but the whole vibe from the nurse has been to push the dosage up to a max of 4 pumps to ensure you are getting the full benefit. With regards to blood tests I'm sure they aren't essential for standard HRT but they are for testosterone according to the information leaflet in the box as the side effects of too high levels are so unpleasant - and in some cases irreversible. Not information the nurse actually passed on!