Newson Clinic - A cult?

[Ittybittytittycomittee]

Please can you share your experiences of the Newson Clinic.

They have so many doctors and nurses now working for them and the care I have received is so inconsistent despite paying in the realm of what now equates to a thousand pound plus. Each consultation has resulted in conflicting information which has now lead to some gynea issues.

I use instagram and there are so many accounts that seem to fawn over the mere mention of Louis Newson name, it's like she can do no wrong. It feels like Newson Health has become a cult with unsuspecting women being over medicalised with out informed consent.

I'd be interested to hear other ladies experiences.

There are many other consultants doing training that never hits the news. My consultant gynaecologist has offered free talks/information and training on women's health for HCP for years.

Ah no, this was from a Gp friend who was delighted to be upskilled. She found it really good. She even realised she needed topical oestrogen cream herself.

Key take away for her was higher doses of Utrogestan needed for higher oestrogen prescriptions. To be fair I think Dr Currie has done this for years too, but there's possibly more gp practices requesting it, as more women are coming to them for help?

There is a severe lack of nhs consultants in my area, the North East.

@MarshaBradyo No, that's not how it works. The only data that works is double-blind, placebo trials, not observational data. That's the current problem with all the stats at the moment. Much of it is based on observational data (self-reporting from women, and two of the biggest studies that show a risk have been shown to be flawed through their selection of women.) There needs to be a huge research trial and it's unlikely to happen for the simple reason that HRT is dirt cheap to produce and there is no incentive for pharma companies to invest in such trials.

Nick Panay is still pushing for such a trial (he's on a Youtube video saying this) but it would need to be at least 10 years in length, so it won't be relevant to most women who are now in their 50s or older.

I have used Newson and found it brilliant. Life changing in fact (and I don't say that lightly). Once they had prescribed, I took their letter to my GP and they prescribed it all - but previously had been crap. So it worked for me. The nurse practitioner I saw was great.

@WarriorN The British Menopause Society runs courses all year long. Most have been online during the last 3 years. They are very cheap for a GP to enrol- around £100 and their practices should be funding that. They cover the basics of prescribing to much more complex issues re. menopause and HRT.

There is also the annual menopause conference in London that has consultants speaking on all aspects of menopause. Again, it's not a fortune to attend. These courses and events are CPD for any dr or nurse.

We’ll see. It may not be a trial but it won’t stop people considering the situation. From that there may be trials though

Not predicting either way but if the public can talk about it, the press can pick up on it

There may be funding after that for a trial, or still not worth it, but if people find the discrepancy interesting they’ll discuss it.

I was prescribed Oestrogel and Utrogestan privately and I think I was over prescribed oestrogen and possibly the progesterone wasn't absorbing properly. I ended up with endometrial cancer. When I looked into it. I found that there are links between micronised progesterone and endometrial cancer that I wasn't made aware of, and also with a history of problematic periods that potentially also put me at a higher risk yet that wasn't discussed. Arguably, I shouldn't have taken it in the first place, but I did raise issues with the private practitioner and my GP about what was happening with my cycle, but no one picked up a problem.

One oncologist I spoke to thought that there are potentially links around ovarian cancer and HRT as well, although nothing's been proven at the moment as far as I'm aware.

I do think the HRT thing has become a bit of a cult. And I admit I was caught up with it as well. If you say anything negative as a PP said, you get jumped on. I have heard Louise Newson on Podcasts and it's frustrating to only here about HRT and not other ways of managing the menopause, even when people have had oestrogen receptive cancer, she's still suggesting HRT may be possible when many of us are trying to do everything we can to reduce oestrogen.

@SierraSapphire I'm really sorry to hear about your experience.

Maybe you could explain a bit more about what you discovered about endo cancer and micronised progesterone?

To my knowledge, it is safe when used correctly. It would be wrong if there was a known risk, given its popularity amongst specialists (and not just the Dr being discussed here.)

The upside of it is that it has a much lower risk of breast cancer.

I also meant to add that for Stage 1 endo cancer, HRT can be prescribed after surgery. This is in the RCOG guidance on post-meno bleeding and treatment.

I'm not saying this is something you may be interested in, but it's for other women who may be reading.

Here is a meta-analysis that identifies that micronised progesterone has been found to increase risk - one study found that this was only in use over five years - but part of the narrative at the moment is that you can be on HRT until you die - www.mdpi.com/2072-6694/12/8/2195 - one study says that that micronised progesterone and oestrogen "significantly" increases the risk of ovarian cancer.

I also meant to add that for Stage 1 endo cancer, HRT can be prescribed after surgery. This is in the RCOG guidance on post-meno bleeding and treatment.

This is what I hear a lot, but whatever the research says, there are lots of us who are actively reducing our oestrogen to reduce the risk of recurrence, and it often feels like there is still pressure for us to take HRT regardless of how we are feeling, and we can end up feeling like we are unreasonable for not taking it. There's so much stuff I've read or listened to that is about the menopause but it has absolutely nothing in it for me because I can't take HRT - I've stopped bothering now, e.g. Louise Newson was on The Happy Pear podcast, which I thought might be good because it's about vegan food and natural health, but it was almost entirely about HRT.

In the meantime it's really difficult to get good information about alternatives, and people are scathing about the use of other drugs, particularly low dose SSRIs or SNRIs when there is evidence that they are nearly as good as HRT in reducing hot flushes and as a result improving sleep.

I wonder if the results of that meta analysis is why they're suggesting higher doses of Utrogestan now if on higher doses of oestrogen?

Thank you for posting that link.

I'd need to read the stats in more detail than I have time for just now.
It's a meta analysis so it's possibly not finding out anything new.

It's been known for a long time that there is a small risk of hyperplasia with HRT but the biggest risk factor for EC is being overweight/ obese, and most women who do have EC are not on HRT.

Surely you can use SSRIs etc for flushes if you have decided not to use HRT?

This appears to have been published after the meta analysis and seems to contradict it?

thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

Synthetic progesterone in the mirena for example does seem to stop all bleeding. So that could be a key factor. They're suggesting x3 utro on sequential and x2 continuous for higher doses.

I agree the key factor is that research is based on 5 years.

Is the form of progesterone in combined HRT patches (ES in my case) known to be well absorbed? I know some women dislike it, I don't have an issue with it. But I recently changed where I placed the patch and it stopped the bleeds for two months which did concern me.

I wondered if the progesterone was being properly absorbed, or if this patch really needs to be on your hip? (I had tried it to the side of my navel as I was so sick of it rippling up under my underwear).

Surely you can use SSRIs etc for flushes if you have decided not to use HRT?

It's not really an issue for me, but it was picking up a PP point about the negativity and sometimes outrage on forums about anti-depressants being suggested because people are set on HRT when actually they are worth exploring.

I agree the key factor is that research is based on 5 years.

I think there's a lot of over-simplification around HRT. I got caught up with it. I had no obvious risk factors for endometrial cancer, other than when I dug into the literature, a history of disruption of my cycle, plus the HRT, and knowing what I know now I wouldn't have chosen to take it. I certainly don't think saying that you can stay on it for your lifetime is backed up by enough evidence, and for lots of us who've had cancer, any doubt can be enough to be risk averse.

That’s interesting. I was originally on two pumps of oestrogel and daily utrogestan. I did increase my oestrogel to three pumps for a while. But no more than three, so not a huge dose. I had to come off utrogestan and have a mirena instead because the utrogestan simply didn’t seem to stop me developing hyperplasia, originally feared to be the atypical, dangerous, type.

I have had a mirena for the last two years but still have some signs of the fortunately less dangerous non-atypical hyperplasia. I have six-monthly hysteroscopies but have been warned that if I still have signs of it next time on is carried out (January) a a hysterectomy may be recommended. I don’t want to come off HRT as I am otherwise fit, not overweight and healthy and feel the oestrogen benefits my overall well-being.

It seems that some uterine linings are very awkward about responding to progesterone. I always had very short periods pre-menopause and wonder if there’s something about me and progesterone that just doesn’t work.

I bled constantly on the minipill @Abra1t - I looked into that too and found that no one seems to be sure why this happens, which was surprising. I was advised by the private nurse to up my oestrogen but I got incredibly painful breasts and also some vertigo, which I didn't link at the time, but stopped when I stopped HRT.

I'm sorry to hear about your experiences SierraSapphire. I also hope in the future there will be more research so women can make better informed choices.

It would be interesting to see what the findings are in 5 years time if women are being encouraged to stay on HRT long term. I'm loving my HRT, everything feels better on it, not just the hot flushes, and I'm worried about feeling shit again if I have to come off it in 4 years time, as I've been on it a year. The first GP I spoke to was a big advocate of LN, as she knows her personally, I've looked at a lot of her FB videos, but I'll go back and look at some of the other videos recommended on here for a balanced view.

The data is already out there for risks on HRT for less than 5 years, 5 -10 years, 15 years and more.

There are women in their 80s and 90s on hrt , and my consultant mentions it sometimes. If it was that dangerous, drs would not prescribe 'Do no harm' first rule of medicine.

The endometrial cancer risk is very small if HRT is used correctly.

Menopause specialists would rather women used progesterone that was safer for breasts, even if it comes with a slightly higher risk of EC, because the latter is completely treatable when caught early.

(I've been told this.)

@SierraSapphire I completely get your thoughts on HRT and I'm sorry you had that diagnosis. But the point about the alternatives is they do not protect bones, heart and brain. They alleviate the symptoms of meno but nothing else.

There are more women in old age who die from complications of hip fractures (or live with painful disability for years) than all female cancers.

All drugs, or using no drugs, have risks. It's always a balance.

I’m on my first month of 150mg Estradot and vertigo and sore boobs describes my experience to a T. Ugh.

Thank you for replying @JinglingXmasbells. I could contact Newson to ask for blood test and I’m sure they’d give me one - for a fee, and another consultancy fee too. But I don’t know if I’d be satisfied with their interpretation of it, given they have been happy to prescribe ever increasing doses of oestradiol without one. I don’t think they offer endometrial scans and they’ve certainly never talked about it as a thing one could or should do. My Utrogestan dose has remained the same from 50mg estradot through to 150, no talk of upping it.

Sounds like I need to find a consultant.

Nice, could you try that Gp again? Ask if there's one more clued up now?

I really get your concerns. Sorry you are worried.

They do offer scans as shown on their website www.newsonhealth.co.uk/new-patients/#pricing but it's not clear if they 'contract out' and send women somewhere or they do them at the practice.

150mcg is high and (I am guessing here) that you should have more Utrogestan, as 150mcg is not a recognised dose. OR at least an annual or 6-monthly scan.

Not all women respond to estrogen the same way. It's evidently to do with how many receptors we have in all areas of the body that are stimulated by estrogen.

I've always had scans, roughly once a year or 18 months, to check everything out, partly as I'm still on sequential (out of choice and for various reasons) and I have my ovaries checked at the same time.

I'd have a chat with them and refer to the BMS guidance on using more progesterone with higher doses of estrogen.

Very interested to have found this thread. I started going to the Newson clinic in January 22 and was prescribed evorel 100, utrogestan and androfemme. It all started off well but I started getting heavier and more painful periods after 8 months leading my gp to refer me to a gynaecologist. I had a biopsy and mirena coil fitted. I no longer have the heavy period but I have spotting most days. I’ve got the mirena coil with progesterone in it t and having to take 2 utrogestan tablets every night. The gynaecologist and the gp say the oestrogen prescription is too high especially since I swapped to oestrogel as it gets absorbed better. Im now under review in 6 months to see if the spotting stops. I’ve reduced my oestrogen to 2 pumps instead of the 4 prescribed by Newson health to see if that helps. The gynaecologist and gp are very good and their concern is the utrogestan may mask more sinister conditions such as endometrial cancer. I feel that I’ve been carried away on the hype of the Newson train of taking higher amounts of oestrogen than I actually need. I’ve now started to question why I was put on such a high dosage. The only risks they spoke of was a tiny fraction higher of women developing breast cancer than if you weren’t on HRT. No one said it could cause endometrial cancer.