BBC1, 8PM Tomorrow (Monday 30/9). Panorama - The Menopause Industry.

[SebastianFlytesTrousers]

Documentary presented by Kirsty Wark investigating the multi million pound global menopause industry.

Should be interesting.

The problem as I see it is that NH do not test to check absorption and it is in fact notoriously difficult to check via blood tests anyway. There is an assumption at NH of non resolution of reported symptoms = increase dose. This is not elegant prescribing. Symptoms can in fact also be caused by a) a dose that's too high b) fluctuations c) something that's unrelated to menopause.

I can't self-refer to a menopause clinic in Glasgow. All referrals must go through the GP. IF you can get your GP to refer you, and it's a massive IF, then you can expect to wait 18 months to be seen.

It looks amazing. And I’m aware of that doctor. Wonder what the wait list is like to get access to him for free!

I suspect many of these clinics unfortunately have a long waiting list.

I've been going there for 7 years - back when I was first referred I had to wait 3 months. Dread to think what it is now. But there are (better qualified) alternatives to NH for the same sort of money.

@Delatron in my experience of knowing people referred to the menopause clinic on the NHS it is the women who have some sort of complicating factor - a family history of breast cancer, or some other issue which means the GP doesn't want to deal with it. If you're a bog standard menopausal woman who just wants to speak to an expert, then you have no chance of even being referred, you just have to take your chances with GP's expertise (or lack of it).

Yes @KnottedTwine that makes sense. Hopefully things will change and more women can get access to these clinics.

There is a menopause clinic at the Chelsea & Westminster hospital.

They take patients from all over England with a GP referral.

It is for complex cases around menopause, where GPs aren't able to handle them. As @KnottedTwine it's not for the usual run of the mill patients.

https://www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics

This whole topic is very interesting. I don’t live in the UK and my menopause advice comes from my highly experienced gynaecologist. I would quite like HRT, partly to aid weight loss, but can’t have it for medical reasons which I do accept are valid. Who do normal people see in the UK?

I attend the NHS menopause clinic at Glasgow Royal Infirmary (surgical menopuse - other complex health issues). There is a huge waiting list. Unfortunately Sandyford no longer take self referrals. Dr Naomi Potter does have a private satellite clinic based in Newton Mearns if you're interested in going private.

You're confusing patches and gel.

The total amount of estrogen in 4 pumps of gel is 3mgs.
This is 4 x 0.75 mgs.
1 pump of gel is 0.75mgs.

Patches are in micrograms (mcgs) and are absorbed over several days (changed twice a week.)

You can't compare patches and gel/tablets.

Most tablets are 1mgs of estrogen (daily) or sometimes 2mgs.

As someone else explained taking baseline hormone levels are pointless, you'd need to monitor for ages.

I feel like I get a great service from NH - they take very detailed questionnaires of your symptoms and how they have changed from the last appointment- do you get that on the NHS? Maybe you do.

My friend tried to get testosterone on the NHS and had to answer REALLY intrusive questions about why she wanted it. All she wanted was her sex life back. She got the testosterone and the sex life back in the end but it was very hard to do indeed.

I'm not convinced there's anything wrong with NH but haven't seen the programme. I think HRT is fantastic and it's great that not as many women are suffering like they used to.

I was consulted by the BBC to speak about my journey. Some of what I'[ve said is being used. I was made quite sick by the off licence doses, given with uninformed consent. Everything in the progrmame is 100% spot on. I could tell you so much about this clinic and this megalomaniac.

@SebastianFlytesTrousers I am muddling through with my own research and a GP who is pretty good at just prescribing what I want, within limits. I am a less complex case as I have had a hysterectomy and therefore don't need progesterone, just oestrogen. I did have an online consult at the start of all this with a private GP with a special interest in menopause and she was very good, gave me the knowledge I needed to approach my GP and ask for a prescription.

I'm
A Newson health patient and after some years of monitoring and tweaking and watching and waiting I'm finally at the sweet spot (for now) but I have been classified as a poor absorber.

It's really annoying, but THANK GOODNESS I had the money to go privately to see someone. My GP is on the better informed side but there is only limited scope and time for this to be sorted.

What's wrong with listening to the patient? How they are feeling ie the clinical picture?? They do with other conditions requiring hormones?
I have had my dose slowly increased and monitored over time including blood tests, DEXA scan too. I've tried oestrogel, then Lenzetto, now Everol patches but have higher than the licensed dose. I take Androfemme - which has made me feel so much better.

It shouldn't just be those who can afford it!!

Has the licensed dose changed over the years? When will it be reviewed?

Just because someone is prescribed an amount, doesn't equate to receiving the dose.

I feel that symptoms should be a big part of assessment and management.
For me, I always know when I'm not getting enough because I start getting joint pain along with increasing anxiety and dull headaches. A friend of mine gets irritable, anxious but severe itching and night sweats.

We are individual!!! And being
Treated by the majority of medical professionals like we have something that's being overblown and we are making a meal of it!

I have had an endocrine issue (thyroid) which seems nice and straightforward for doctors to manage - they do very basic blood test and increase or decrease based on results. The GP has NEVER asked how I am or whether I have any symptoms etc they don't have time! It feels like many GP's wish we would just zip it 🤐 so they can just look at blood test results all day and stop whining!

Newson health approach feels more holistic- they take time to ask about other symptoms, use a screening tool and score it ALONGSIDE test results as oestrodiol is notoriously unreliable alone.

Quite honestly, I can't waste 10 plus years of my life while I have no quality of life until someone does proper research or updates guidelines or decides menopause is interesting enough for funding to be found etc etc!

My clinical picture is that I'm a lot better on what I'm taking which has been tailored to my symptoms by a GP with a specialism in menopause under NC - who sees MULTIPLE women weekly so gets a good idea of what's going on as oppose to my GP who Can't be ar$ed and has no time and is scared of doing the wrong thing due to excess pressure and drama so will just do what she's pressured into by certain loud voices on insta and Panorama!

There are women on here who have long been pushing high doses of oestrogen as the fix all cure. It's really irresponsible and having had huge issues with menorrghia and thinking I was progesterone intolerant (I wasn't I just needed to find one that suited me - cyclogest) it caused me huge problems and now my periods have returned to a much more normal level. I wonder how much I needed progesterone and NOT oestrogen to the extent I thought. No one should be prescribing these doses without monitoring of lining and checking levels throughout the month over time. I don't care what people say about symptoms it's too inexact and can cause histamine reactions and if you're having probs wiht adenmyosis or endo it's not good. Wild West it is. And that's not even taking into account mental health effects of it all.

I don't have an issue with Newsom clinic per se and think they prob help many but there's a reason why primary care is key and if it's not joined up you're left to figure out so much for yourself

My friend tried to get testosterone on the NHS and had to answer REALLY intrusive questions about why she wanted it. All she wanted was her sex life back. She got the testosterone and the sex life back in the end but it was very hard to do indeed

There are still misognistic attitudes that persist about women and sex. Even more so when its older women.

I think pushing for higher doses if appropriate - but only if appropriate is difficult to just pushing for high doses full stop? At Newson Clinic, for me, it was a very very gradual increase over 2-3 years with lots of app and monitoring

Interesting.
How did the BBC get your confidential patient info?
Did they put a request out via the media for women treated by the clinic to come forward?

It's worth bearing in mind that 'the Newson Clinic' is in fact several clinics across the UK now and there are over 100 GPs working in those (and some consultants.)

Presumably those doctors make their own individual decisions on prescribing.

The programme pointed out that NHS doctors will prescribe off licence as well.

It has not been shown to be unsafe - but it hasn't been shown to be safe either, because of a lack of studies.

It is an utter SCANDAL that these sorts of clinics are even needed in the first place. The fact that they are is testament to the shit service many of us receive on the NHS. I bet that's not raised in the documentary

Not even mentioned.

And most of the women they were speaking to sought help in 2020. Now what might have been happening then?

I personally disregard the issue of thickened womb linings being a precursor to cancer. This is bull xxxx and just being used to frighten women from using HRT much as breast cancer used to be used to frighten us. I had a thickened womb lining and had a procedure to remove it in the early days of taking HRT.

Giving women facts isn't anything to frighten them, it's treating them like adults with brains

Sorry, but that's completely absurd.