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.

Am I being dense?

Why would the Newson Clinic (of which I am a patient, on within-nice-guidelines HRT medication ) prescribe higher than needed doses ? There's nothing to be gained from it. I genuinely don't understand. Or are the BBC insinuating that it's 'just' incompetence?

I did raise an eyebrow or 2 that there are 4 previously employed doctors that have spoken out....

In this case, the bleeding is likely to have come from recurrence of the cancer in the part of the woman's vagina that was left following her hysterectomy, and confirming or excluding this should have been a priority. The standard medical response would have been to tell her to stop the HRT immediately, examine her if possible, and arrange for an urgent gynaecological assessment.

@JinglingSpringbells
You have criticised some of her drs as being just Gaps. But that's all she is

She comes across as all evangelists do. A bit crazy and lost all reason. Marion Gluck is another one. Just pushing pushing. In MG case it was progesterone. In Newsons case it's oestrogen.

GPs*

I am a clinician, have completed LN's menopause course for prescribers and ran a primary care menopause clinic for several years until recently but have to say I agree with a lot of the criticism in this programme.

I do think menopause was poorly dealt with for years which led to women being undertreated but the immense and sudden increase in awareness, celebrities pushing HRT and women being more educated and empowered to go and ask for it has, in my opinion, led to overprescribing. The Newson list of symptoms on which menopause is diagnosed is very broad (almost anyone of any age and any sex could tick a lot of them) and the push to prescribe and increase doses is risky in my opinion. HRT is an amazing treatment and is the only solution to symptoms caused by low hormones but, unlike what LN says, it can have side-effects (some serious), it doesn't suit everyone and it should, in my opinion, be used as part of a healthy lifestyle alongside dietary and exercise changes rather than touted as a standalone miracle cure for all ills.

@MrsHemswoth The other doctor you suggest "dislikes" LN is Dr Annice Mukherjee. I don't think she dislikes her at all but is, as are many specialist doctors, frustrated at misinformation and she is far more qualified than most to spot it and call it out. She is a consultant endocrinologist (so highly qualified in all hormonal systems, which as you may know all interact and affect each other). She also talks about her personal experience of having breast cancer in her 30s and dealing with a very sudden, very early menopause.
Louise Newson has interviewed her as an expert
https://www.balance-menopause.com/menopause-library/084-menopause-and-health-dr-annice-mukherjee-dr-louise-newson/ and her book is excellent.
This is the one book I recommend to young women entering surgical menopause https://www.themerrymenopause.com/the-complete-guide-to-the-menopause-by-dr-annice-mukherjee
Please don't mistake a highly educated female expert calling out incorrect information in her field of expertise for snippiness

Because many women still report menopausal symptoms after starting HRT so at their follow up appointment it’s fairly common for them to suggest increasing the oestrogen to alleviate these symptoms. It seems to be their standard way of operating and what they did with me and many others.

I kind of trust Kirsty Wark. I dont think she'd make a programme like this if she didn't believe Newson needs a bit if investigation.

There's a theory about 'topping up hormones' vs Replacement. We have a hormone feedback mechanism. The amount might vary depending on whether you are still producing hormones like oestrogen or not at all.

Then you have the idea of hormone resistance. And myriad other things that might be blocking uptake of the hormone at the cellular level. The NHS is generally only concerned about blood work. But you have people with supposed great numbers as far as blood work is concerned, but still feel awful. These people perhaps may need above normal dose. The goal would be to resolve symptoms.

I'm no expert but going by things I've read over the years.

Doctors who step out of the conventional way of doing things do come in for sometimes professional persecution. I haven't watched the program do I don't know. But what I do know is that women gave been suffering for years and continue to suffer and nobody cares or gives a damn generally, until someone takes a rusk upon themselves and starts doing something that might help or work but that is outside conventional guidelines.

This documentary seems a bit peremptory. It ought to be focusing on the abysmal treatment women receive in the health service first and foremost and why they feel driven to go elsewhere, before trying to put women off seeking help for menopause relief (if that is what is may do/is doing )

I am definitely not disputing the expertise of endocrinologists, I work along side them in my AHP role, I have just noticed this from her posts as a social media follower, for some time so it didn't surprise me when I saw her on the panorama programme.

We are all well aware of the hierarchical nature of medicine, doctors in particular (from my own experience working within the nhs for many years) , probably don't like a GP such as Louise Newson, becoming such an "authority on menopause" ?! while consultant endocrinologists, the experts in hormones, should hold that space?! Tell me I'm wrong! This is said somewhat tongue in cheek, however, I don't know many endocrinologists working in menopause clinics? Or indeed a doctor who is a consultant in menopause? From what I've read, Louise Newson has a degree in pathology before her medical degree, worked in hospital medicine for many years before becoming a GP and specialising in women's health and eventually menopause. To me she offers valuable experience and knowledge that is lacking in the healthcare system!

• Dear lord the grammar! Big fingers on a small keyboard!

I dont getwhy this is eing presented as ahatchetjob on Newson clinics. Mosof it was about supplements, which most people know are flaky. I take HRT prescribed by my GP and am perfectly happy with it. I have annual scans and mammograms (that i pay for). All is well.

No, the first third was about supplements. Two thirds was HRT,

I’ve just sat and watched this and I can see Louise Newson and the Newson clinic have put posts up on their Instagram about it now. I’m curious to see what happens next. Do we think this is going to be the end of her reign as menopause “queen”?

It would be interesting if this led to more research into the prevalence and the optimal management of failure to absorb/respond to transdermal HRT.

It would be. But I wouldn't hold my breath.

@MrsHemswoth I don't dispute anything you say about the hierarchies, etc but genuinely don't think that is at play here. I have seen LN pulled up numerous times on social media on information that could be seen as misleading or misinterpreted both by the big guns of menopause like Jen Gunter, Lisa Mosconi and Annice Mukherjee and by the small fry of GPs and other clinicians. I pointed out an error on a social media post a while ago which was completely ignored as are almost all others

Endocrinologists who have an interest in menopause like AM have a great advantage over clinicians in commercially run clinics as we now know too much oestrogen can affect the thyroid and cause symptoms similar to underactivity like weight gain and fatigue (which is easily then misinterpreted as menopause symptoms) and oestrogen dominance affects sensitivity to insulin so the systems interlink and increasing HRT is not the solution.

I agree that Louise offers a valuable medical view that has been lacking but my concern is that she has become too evangelical with HRT, suggesting it cures all ills and there are no negatives which, in the long run, is just as detrimental as the poor treatment that went before

I'm not surprised I remember when she was just nobody I live not far from Stratford. I was diagnosed very young by NHS with premature menopause around 10 years ago. I was watching her 'businnes' growing very fast recent years from nothing to UK best menopause clinic. When I rung ages ago to ask about treatment she pick up the phone.
The prices for treatment are shocking and I had a contact with a few women who were paying for it but quickly recognised is a money 'digging'
I have good care from NHS and I can't complain. I was always surprised why she is so popular...

Because many of us have had shocking “care” from the NHS and have plenty to complain about?

It wasn't easy for me I had 5 years of going through different HRT to find right one. But I was also educating myself on menopause and changed my lifestyle to help myself.

But you still can’t understand why women who are fobbed off by their GP choose to go private?

Change the GP

You do also realise that changing your gp is not easy in many places?

Dr Annice Mukherjee is amazing. It's worth listening to podcasts she's on

She doesn't demonise hrt but she puts it into perspective

The prices for treatment are shocking and I had a contact with a few women who were paying for it but quickly recognised is a money 'digging'
I have good care from NHS and I can't complain. I was always surprised why she is so popular...

@Menone From your post it sounds as if you're maybe out of touch with fees for private medical care.

The fees are within the range for a private consultation. IMO they're a little on the higher side for a GP appt but if someone sees a consultant within the Newson Clinics, they're average.

The going rate for a first consultation whether that's in a local private hospital or Harley St, is around £250-£300.

Hrt should be on the nhs and easily accessed,

I was even given testosterone but with appropriate testing and monitoring and only because initial tests showed a very low level.

We are in this mess because the nhs hasn't been doing due diligence for 50 % of the population