Newson Health and the menopause industry

[ArabellaScott]

https://www.bbc.co.uk/news/articles/cp8e5y4e83lo

Keeping an eye on this. Newson makes an awful lot of money out of HRT.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/when-to-take-hormone-replacement-therapy-hrt/

'As you get older, and particularly after the age of 60, the risks of HRT may start to outweigh the benefits.
This is because you'll usually find that menopause symptoms improve as you get older, so you're less likely to need HRT to help with symptoms. Meanwhile the risk of breast cancer increases the longer you take combined HRT.
If you want to keep taking HRT or start taking it over the age of 60, a GP may recommend taking a low dose, and using patches or gel rather than tablets, to reduce the risk.'

https://www.menopausematters.co.uk/duration-of-hrt.php

'Duration of HRT

Current recommendations are that there should be no arbitrary limits for use of HRT--women can take it for as long as they feel that it is beneficial to them.

Many women have been advised to stop HRT because of concern about risk of breast cancer. However, it should be noted that the association of any HRT and breast risk is very small. Estrogen only HRT is thought to be associated with little or no increased risk of being diagnosed with breast cancer. Estrogen combined with progestogen may be associated with a small increased risk of being diagnosed if taken for more than 5 years after the age of 50, (approximately extra 4 cases per 1000 women aged 50-59 over 5 years) but these extra are thought to be due to HRT promoting the growth of cancer cells which are already present, not actually causing the cancer.

Many women and healthcare professionals have worried for years about HRT and breast risk and while it is important, it needs to be kept in perspective. Being overweight or drinking alcohol can be a bigger risk! Also, the breast risk from HRT which was highly publicised form the WHI trial published in 2002, was not in fact statistically significant.

Many women continue to have menopausal symptoms in their 60s, 70s, even some in 80s and so for them treatment continues to be required. The duration of symptoms cannot be predicted and so neither can the duration that HRT will be needed.

The longer that HRT is taken, the better it is for bone health and may have beneficial effect for osteoarthritis.

A risk that does increase with age is risk of deep vein thrombosis (DVT--blood clot in legs or lungs). Since there is a small risk of DVT with tablet estrogen, consideration should be given to taking estrogen through the skin (patch or gel) when continuing it over age 60 since this route does not increase the DVT risk.'

I think this is part of the issue with coverage on TV programmes which are limited on time and can't go through all the facts about HRT. They speak about HRT as if it's all one thing, like aspirin. I just have estrogen patches as I have had a hysterectomy, my friend uses gel and a mirena coil, others have tablets, patches and progesterone tablets, gel and tablets plus testosterone - there are endless combinations, multiple doses.

Because I am only having estrogen through a patch, my decision to continue or stop after 5 years/ age of 60 might be different to someone else.

Estrogen combined with progestogen may be associated with a small increased risk of being diagnosed if taken for more than 5 years after the age of 50, (approximately extra 4 cases per 1000 women aged 50-59 over 5 years) but these extra are thought to be due to HRT promoting the growth of cancer cells which are already present, not actually causing the cancer.

This is really key.

As is the fact that obesity has a larger risk factor.

I suppose in an ideal world mammograms would happen before starting hrt if women are going to be starting hrt at earlier ages (NICE says from age 45.)

need to also point out there are some women choosing to continue their hrt after bc diagnosis, sometimes while on SERMS such as tamoxifen. Including another gp who specialises in hrt. (I forget her name. Very good on histamine issues.) An oncologist I saw said I could. I decided to try without, partly as it's the bleeding I struggle with.

I’m one of those women who continued bleeding normally (though heavily and inconveniently) well into my sixties, was treated by the NHS (hysteroscopy to see if there was anything untoward, which there wasn’t , prescribed Oestrogel and Mirena). I continue to have cyclical mood swings, cramps and other period-like symptoms, though to a lesser extent, into my seventies. I intend to stay on HRT permanently.
I believe that the original research that concluded that the average age of menopause was flawed, AFAIR the sample age range was narrow, 45 - 55 possibly. The (well-regarded) clinic I attended didn’t seem particularly put out, so I assumed I wasn’t the only older woman they’d treated.
It seems that some people have noticed that the age of menopause can vary significantly, but the narrative is so firmly established that the medical profession is still wedded to “average age 51, anything much after that impossible”.

www.ncbi.nlm.nih.gov/pmc/articles/PMC10557373/

Just a note for info:

'What happens when you stop taking HRT

When you decide to stop taking HRT, you can choose to stop suddenly, but it's usually recommended to reduce your dose gradually over 3 to 6 months.
You may find that symptoms come back for a short time when you stop taking it. This is less likely to happen if you reduce your dose gradually.'

By the by, something from the brilliant doctor-writer Margaret McCartney:

https://margaretmccartney.substack.com/p/has-hrt-propaganda-misled-women

With links to resources.

Actually this is the full article, the other is the one with links to resources,

https://unherd.com/2024/03/has-hrt-propaganda-misled-women/

Great links, thank you.

I should add the article above is co-authored by Deborah Cohen and Margaret McCartney!

Great that your GP is giving you some autonomy and input to your treatment.

By 'too long' I mean where evidence exists to show that risks of treatment go up over time, there will usually come a time where by staying on the treatment, the risks start to outweigh the benefits.

The difficulty is, as you say, in determining where this point is.

Arabella seems to have linked more recent research to show that the age / duration
increase in risk is v small.

Again, I'm not saying HRT should be restricted unnecessarily but we are doing women a disservice if we refuse to consider the known risks as well as the benefits.

Antidepressants are not addictive (stopping abruptly can cause discontinuation symptoms, but this is not the same as addiction, where you need a higher and higher dose over time) and the risks of taking them do not increase over time.

This site seems really helpful:

https://mymenoplan.org/

This thread has been so useful, thanks Arabella and all PP's.
Feel like I've learnt more here about meno/hrt and the risks/potential benefits associated with my personal situation than I have in a decade of brief 10 minute appointments with a variety of GPs.
The power of women having an honest conversation is not to be underestimated 🙌

That's great to hear, Threewheeler1.

Article here from Milli Hill:

https://millihill.substack.com/p/hrt-who-do-we-trust-in-a-wisdom-vacuum

I'm not in the UK, but I have friends in the UK and my awful perimenopause experience was shared in an online UK forum. I was so desperate to find answers to my debilitating symptoms that I felt I needed to talk to other women having this experience, and not just local doctors, who had very different approaches and opinions (not based in scientific evidence) about this subject. My few female friends and acquaintances were too young or too embarassed to talk about menopause, my mother was dead, and my sisters had very different experiences during menopause, from what I could gather, because they didn't speak about it - one of them almost died during a hysterectomy operation that no one bar her partner knew about. I've read and participated in many useful discussions in that forum and made some long lasting internet friends. Eight years on and I still have hot flushes but I have learned coping mechanisms that have helped and they no longer bother me. I don't know if my other symptoms (joint aches, depression, peripheral neuropathy) are due to the lack of sex hormones, ageing, lack of proper physical exercise, pollution, probably all of the above and more. The forum is still on and kicking, but it's basically about HRT now. I don't post any more. I'm not on HRT, for 3 reasons: it's very expensive here, I am hypersensitive to medicines and drugs in general, and I don't think HRT is safe enough for me, as I have underlying conditions (genetic, not manageable with diet, lifestyle, etc). I have been following the menopause/HRT debate in the UK for these last 8 years and I can say it's been an eye-opener for me, not just regarding all the information that I have gathered since I started my perimenopause rollercoaster journey, but also regarding how humans are easily manipulated by other humans through social media, and under the 'expert' label. I didn't like Louise Newson's approach from the very beginning of her menopause expert career. I don't know her personally and my understanding is based on her published material (mostly online). She uses phrases like "All about menopause, The truth about menopause, HRT should be taken forever, The definitive guide to menopause, All women should take cyclical progesterone as this better replicates the hormones in our younger years" and so on. These are not scientific terms (all about, all women should, the definitive guide, forever) and they can mislead people into thinking they are being told the 'truth' when there is no such thing in evidence based science. She's a doctor who became a celebrity, Davina McCall is a celebrity who plays doctor, like many others in this menopause industry business, they seem to be too good to be 'true'. I hope there is going to be a third way that's not all pro or all anti HRT and that each woman try to educate herself before embarking on another rollercoaster following the advice of a doctor or a celebrity just because they have a thousand or a million followers on social media. Unanimity and stupidity go hand in hand.

Had an ultrasound on Tuesday and got the results today. Polyp on my cervix and womb lining slightly thicker than it should be. So im looking at a hospital appointment and possible hysterocopy. All because i took HRT for three months and came off it two weeks ago due to a heavy bleed. Keep getting asked when my last period was and i KEEP saying i had three very light bleeds which lasted less than a day in 2022 and ive been on the mini pill for nearly three years which stops periods so i may not even be menopausal or post menopausal yet. I wish id never touched the fucking stuff

I’m sorry you are going through this but how on earth do you know it is connected to HRT?

In contrast, I’ve been on HRT for over 20 years, with no adverse effects, if anecdotal evidence is worth anything.

Patches followed by oral HRT improved mood swings and reduced cramping and heavy bleeding (which I’d had since puberty) for about 15 years, until I started bleeding very heavily and unpredictably, when I was investigated, nothing nasty found, and I was put on Oestrogel and the Mirena, with which I’m happy.

Because the HRT nurse told me its likely it was and the rest of it is a precaution

I had a polyp on my cervix when I was pregnant with my middle child, a long time before started HRT.

Its the womb lining they want me to have the procedure for.

This https://virginradio.co.uk/the-chris-evans-breakfast-show/154865/dr-louise-newson-menopause-hormones

“So, heart disease, osteoporosis, dementia. That's where we've got to wake up and think, what are the risks of not having treatment? Rather than all this debate for 20 years of, like, ‘What are the risks of HRT?’ But it's natural hormones, so of course, they're safe. We're designed with them, so just replace them."

Are "natural hormones safe"? How much is safe? That's what the Panorama programme is questioning. Louise Newson seems to think it doesn't matter. Her rhetoric is the same used by some companies selling compounded hormones and phytotherapy supplements, if they are "natural" they can do no harm, which is obviously a fallacy.

She's also adamant that without HRT a woman is bound to have heart disease, osteoporosis, dementia, "what are the risks of not having treatment?". Nobody knows what are the risks, so she thinks it's a gambling game, and she is betting on high doses of oestrogen to solve all these complex health conditions that are influenced by many other factors.

She has found a niche opened by the NHS crisis, added a pinch of salt (empowering women) and pepper (destroying the menopause taboo), and now she thinks is banquet time. Her UK tour "Hormones and Menopause - The Great Debate" is supposed to be the climax of her successful social media performance, now a bit sour after the watchdog concerns have been broadcasted. I have no doubt she will survive, lots of fans out there to support her. Numbers matter, unfortunately, much more than individual experiences, like the ones of those ladies interviewed by Panorama.

So no one has diagnosed that its from HRT and I bet she wouldnt put that in writing either

It’s not natural to have those hormones after menopause. How does she know that won’t cause problems?

This is why HRT isn't generally prescribed for the rest of your life, just for 5 years or so to get you through the fluctuations of menopause which is what causes the problematic symptoms.

But that apparently LN advocates for having HRT for as long as you like, which comes with risks (discussed upthread).

Edited for clarity