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.

Some women just use oestrogen though without progesterone. Those of us who have had a hysterectomy don’t need progesterone.

Lifestyle changes can help but protein or beans is not going to help your atrophy. Also if you’re in such a pit of doom that everything seems hopeless and you’re too anxious to do anything, hrt can give you the “oomph” you need to implement lifestyle changes.

She is not well respected by breast surgeons and oncologists.
She has given some very dubious advice re cancer risks and HRT post cancer treatment. She also quotes a lot of “research” carried out on her own patients which are a far from random group.
I know a number of women who have seen her but have lost confidence.

I think Newson is a grifter, she’s always had one foot outside of GP looking for something more glamorous. I hadn’t heard of her until I went to a conference a few months ago where she was speaking. As a medic myself her talk made me angry because I found it deliberately misleading. She completely glossed over the risks of HRT, saying ‘they’re the safest drugs I prescribe’. I mean GPs prescribe things you can buy over the counter so that’s patently untrue, plus there is an established cancer risk which is why they are contraindicated in women who have had certain cancers already.

I felt she was manipulative to her audience of mostly non-medics, because she said how terrible the claim was that women who are wheelchair-bound cannot have HRT. On the face of it this sounds like a truly awful case of disability discrimination, but she failed to mention that this would be because of the increased risk of blood clots (DVT) that someone immobile and on HRT would have. There might be little or poor quality evidence for this, I don't know, but she should have said so if that was the case.

I also felt she presented an ideological view of the post-menopause state as ‘hormone-deficient’, requiring lifelong ‘replacement’ of hormones. Now I am totally open to that point of view and would be very interested in research exploring that. But currently it is not evidenced... therefore I think that view should be couched in those terms. Encouraging women to stay on HRT lifelong (as she said she would do) is quite radical. So in that way this treatment feels almost experiental. It's not like she's conducting a randomised controlled trial on all the women that she treats at her clinic. I don't have anything against the radical aspect but I do against the ideological aspect.

While women's health is so politicised, in any direction, we lose out. I want the same well-researched, evidence-based treatment for any condition that I would have if I were a man with cardiovascular disease.

This is just not true. I have exercised all my adult life, slim, healthy diet. I had no problems with periods during my life and healthy pregnancies. But when meno hit my joints ached terribly, my sleep was appalling and the brain fog, anger and low mood left me feeling like a totally different person. Within 24 hours if HRT the joint pains stopped, low mood and fog lifted within a week.
Please don’t make such sweeping generalisations. HRT also has many protective factors which I value as much as the ability to loose the meno symptoms.

I had 6 months of sweats and feeling a bit angry. Now it’s over. I haven’t taken anything but ovestin to keep atrophy at bay. I eat nutritious food, fast 18:6 and walk lots. I’m 53 and 3 years since last period. Feel really good.

Yes, I took Setraline for about a year. At the time, I felt fobbed off as I wondered if I should have been given HRT but my GP won’t prescribe it for non-physical symptoms. I have joined a gym, shifted my diet towards much more plant-based and low carb, and lost a couple of stone. I just feel better in myself.
I stopped the Setraline as I also felt I was just medicating life circumstance issues rather than there being actually anything ‘wrong’. Too much responsibility all around and not enough time for myself; a leadership role at work where I am facilitating colleagues to promotion whilst remaining static myself. General exhaustion with it all.
That’s not to say that HRT is not necessary for other people or should not be prescribed when necessary.
But I genuinely have concerns with a view that all women need medicating through menopause and are somehow deficient as a result of menopause and only HRT can resolve that, and then there are menopause cafes springing up at work and things like that. I feel like I already battled through all the inequalities of having children and being a single parent and now there is a whole industry around menopause which suggests another barrier to get past, even only in people’s perceptions. I don’t want to have my life stage and age a focus of attention at work or elsewhere just because I am female.

I think one of the things that is problematic with the messaging in the last few years, which I was fully on board with, is that it's possible to stave off dementia and bone density issues with exercise alone. And even build bone density.

It's just so very hard to find out how in my experience. It was the cancer exercise books that taught me the bits and bobs I needed. Then other strength advocates

It was also on mn where I read about the Scarborough diet for bone density (various herbs fruit and veg that have been shown to help.)

I also felt she presented an ideological view of the post-menopause state as ‘hormone-deficient’, requiring lifelong ‘replacement’ of hormones.

Yes, I found that a very startling viewpoint.

I'm fit and healthy and still suffered really badly.

Please don't make menopause into a competition.

Fwiw HRT gave me my confidence back - so much so that I retrained in a completely different field and even got a degree in it.

Being slim and healthy is great, but that doesn't preclude you from menopausal symptoms. Look at Davina McCall!

Some people asking about blood tests - my best guess is that private clinics are more likely to prescribe testosterone (which IS licensed for low libido but which may GPs do not feel comfortable prescribing) and it is important to make sure a patient has adequate oestrogen levels otherwise the testosterone is just converted to oestrogen anyway. Therefore blood tests important. Or, alternatively, you believe a woman is not absorbing oestrogen well enough transdermally, so want to give her unlicensed doses, maybe you want to check oestrogen. Since GPs are generally not giving unlicensed doses of oestrogen and less likely to prescribe testosterone, BTs are not so helpful. Particularly in a pre-menopausal woman whose levels will be fluctuating anyway.

Sorry I'm on my phone and can't scroll back easily - someone asked what symptoms HRT doesn't help - it is more that symptoms are being ascribed to menopause more and more and often there are other things going on - like a bit of age-related joint pain, or stress from being carer to three generations and still working, or real pathologies that are being missed. HRT may help if they are really menopausal symptoms - but if it doesn't, it may be that the net needs casting wider.

HRT is not licensed for osteoporosis prevention outside of premature menopause, I believe? although it can be used around meno age. There's a good BMS leaflet on it. I don't really know why - probably because trials haven't been done in older women? Main thing is to have plenty of dietary calcium and Vit D and lots of weight bearing exercise, and if you have major risk factors (teenage anorexia or malnutrition, long smoking or heavy drinking history, steroid use, some rheum diseases, strong family history...) bring that to a conversation with your doctor.

You sound like you have been on quite journey @WarriorN and yes beans (and LizOR) are great!

My bone specialist recommends HRT for bone density.

Exactly!
It's an opt-in topic for GPs to choose to learn about.
Yet 50% of the population will be affected in some way and very likely seek medical advice due to the changes their bodies are going through.
It's insane.

Quite frankly, I'd much prefer to allow my body to follow its natural path, albeit prematurely, and to not force feed it hormones it no longer produces. I have no desire to turn the clock back, I just want to protect my future health and I think most women would feel similarly. I think for those who have severe symptoms then HRT is probably the right thing for a season but unlimited dosing and for infinite periods? I am not convinced.

I did risk assess, considered options but went for HRT. I think what changed my mind about the safety was developing hormone positive bc and large fibroids within 3 yrs of starting HRT. My breast surgeon would neither confirm nor deny a link with HRT but I got the strong impression that it was a common denominator in her work. Certainly when I asked a large group of women with bc if they had had a similar experience, postmen bc while on HRT, within an hour nearly 50 women replied with the same experience.

No one is recording the incidences. Most of the advice is from historical trials where HRT was only prescribed to post menopausal women.

No data is available for HRT use in normal perimenopausal women ( this does not include women who have had premature menopause, surgical or iatrogenic). And certainly no data is available for the high dose HRT being prescribed.

What shocked me was just how high a risk we have of developing bc regardless of HRT. So although HRT increases the risk by a very small amount, the risk is already 1 in 7.

This is why I am interested in HRT, if not now then in the future. I dont have massive symptoms at the moment but am in peri, memory, dry skin, VA (have pessaries for these), dizzyiness/vertigo, aches and pains, all managable at the moment.

However, I want protection against dementia and osteoporosis which is what I have learned HRT can do. What I dont want is my migraines coming back again which more or less disappeared at the age of 47, almost overnight.

Oestrogen is known to be really important for bones, especially late teens and early 20s, but if you can't take it there are other things that can be done.

Testosterone is too apparently, I read somewhere the spike women get around ovulation is really important.

It's having informed choices that I feel women don't have. Throughout life.

I saw a great (private) GP doctor in Cheshire who spent an hour going through what I was going through. She felt symptoms like abrupt awakening at night, aching joints in the morning and feeling panicky, irritable and crying were all oestrogen connected. To set the context, I’ve never been panicky or irritable or any of those things before my fifties. She gave me a prescription then recommended I just go via the NHS if it worked. Within days I started to feel normal again and over the next few weeks back to normal. I also was very sore during sex so she gave me Vagifem and said even if systemic HRT wasn’t for me to use the pessaries. Well I’m still on HRT, don’t have aching joints or painful sex (no need for Vagufem as the gel seems to work) and while I still wake in the night, it’s no longer abruptly wide awake. No panicky anxiety with driving-and I can concentrate and hold down my job. Unfortunately, she no longer does f2f but spends time educating other GP practices on women and the menopause. My surgery’s menopause clinic is run by an AP nurse and are happy to prescribe HRT-or advise on other methods to cope with the menopause-obviously if a woman is sailing through, they won’t need the services. But I still think LN is very focused on HRT to cure everything-when many women don’t want-or need it. But they should have access to it.

I’m genuinely glad it has worked for you and am very sorry if my comment upset you. That’s great your symptoms have gone, but that doesn’t mean it is for everyone. I object to the current public opinion and sweeping statements that every peri and menopausal woman needs HRT and that’s the only thing that will help all of us and that we must all take it for the rest of our lives. Can you not see how odd that is? And that drug companies are rubbing their hands together at the prospect?

I don't think there is any big push to take HRT is there? There's more awareness of menopause. Which is great.

I'd love not to have to bother with it tbh! I'm sure women aren't desperate to take medicine every day if they really don't need it! I do need it.

Sorry I'm on my phone and can't scroll back easily - someone asked what symptoms HRT doesn't help - it is more that symptoms are being ascribed to menopause more and more and often there are other things going on - like a bit of age-related joint pain, or stress from being carer to three generations and still working, or real pathologies that are being missed. HRT may help if they are really menopausal symptoms - but if it doesn't, it may be that the net needs casting wider.

This was exactly what my wise and patient GP picked up which the Newson specialist entirely ignored. Maybe it's a kind of confirmation bias? A back-to-front attempt to make a collection of fairly general symptoms fit the cure?

What shocked me was just how high a risk we have of developing bc regardless of HRT. So although HRT increases the risk by a very small amount, the risk is already 1 in 7.

Yes I don't know that originally.

What I worry about is that if more women are on hrt, and for longer, more women are going to get that diagnosis while on it and have to go through that shock of coming off it. If they're healthy and well on it, fine. But they need to know they could be ok without it with time if they have to come off.

And so what are those other tools? That's not being talked about enough.

I got the impression from the bc nurses that they're seeing more women who are on hrt and have to support them with coming off it, on top of the breast cancer. I was a howling wreck. My local team now employ a menopause specialist gp because of this.

However, I want protection against dementia

there's actually more evidence around exercise improving risks of dementia than hrt. I now know thanks to Liz.

I believe Newson blocked her.

x.com/liz_oriordan/status/1458431648920477697?s=46&t=A2fpFNgDRyXF2d6ye97wEA

And this one

x.com/liz_oriordan/status/1513606043821092864?s=46&t=A2fpFNgDRyXF2d6ye97wEA

Agree @Blanketyre id much rather not be on it. But I need to be on HRT as my mental and physical state without it was very poor.

it’s not a competition. There’s no gold medal for not using HRT. Raised awareness is a good thing.