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.

The overwhelming risk is prolonged exposure to oestrogen. So early onset puberty combined with late menopause significantly increases your risk. Alcohol another significant factor.
Recent study regarding weight suggests that the age that you are overweight is significant. So gaining weight post 40 is much less of a risk than being overweight in your 20s and 30s. This is more worrying since obesity in young women is much more prevalent than 20-30 yrs ago. Are we looking at an explosion of bc in the next few decades?

Or oestrogen getting into the eco system in the last few decades.

It is complex and as I mention above it appears to be age specific. Being a fat 40+ yr old appears to be less of a risk than being a fat 20 yr old.
I speak as a fat 60yr old who has had bc. Although my risk is due to a benign endocrine tumour I was diagnosed with at 21. Forty years on research has provide a firm link between the condition and bc so at least I can blame it on something.

@Angrymum22 Another area that needs massive improvement is providing women with the information needed to assess their own highly individual breast cancer risk profile. There are several good online risk assessment tools but should probably be utilized under the guidance of a HCP.

Breast density is an important risk factor and impacts the accuracy of mammography screening, yet this information isn't routinely made available to women in the UK. That really needs to change.

It doesn’t help. I had endometriosis premenopause and during the 1980s many foods would trigger the pain. Once they banned hormones in livestock feed I had far less problems. I also avoid tinned foods ( the tins are lined with oestrogen mimicking resin/plastics.
It has also been blamed for falling sperm count/health.

That is very interesting @Angrymum22 . BOTH my daughters have been referred for urgent laporoscopies with suspected endometriosis. No one in our extended family as far as we know has had period problems and i did wonder about modern diets.

Well, look - people get caught up like that about medical stuff all the time. Why couldn't it happen with HRT?

It seems just the sort of thing pharmaceutical companies love to push, because almost half the population could be given the drugs they are selling. It's potentially a huge market.

That doesn't mean there aren't legitimate uses, or women aren't really affected, but it's also the kind of scenario where we should be especially wary of markets being manipulated when it isn't in the best interests of patients.

I'm not sure why HRT would ever NOT be in the best interest of a patient. If it works, it's life changing. If it doesn't then just stop taking it. Noone is forcing anyone to do anything.

That's a very strange argument.

Why? Noone is forcing women to take HRT. If you go to the GP with awful menopause symptoms then HRT will almost certainly help. If it doesn't help then you can just stop taking it. Its not addictive!

It might, what counts as awful is subjective though. There are also contraindications, risks, and side effects to consider. And improvement isn't always due to the drug, it can be the placebo effect.

There is a reason it's not OTC medication, you are recommending inappropriate prescribing practices.

No, awful is not open for discussion. If a woman feels awful then she feels awful. It's not up to other women to decide whether she should or shouldn't feel shit.

Tish tosh, @Blanketyre ! You don't need HRT! You just need to pull yourself together, put your big girl pants on and do some yoga and positive thinking! And if you're really not managing your menopause with self-care (and you really should, because any decent woman sails through it), then be prepared to beg, plead and battle with the GP who will do their very very best to put you off.

FUCKS SAKE.

I don't think anyone here is arguing that women who need it should be prevented from accessing HRT.

Rather that it is worth being mindful that some doctors are prescribing it in a way that its not licensed for (very high doses for many years) and which doesn't seem to take account of individual risks, also that its in drug companies interests to encourage women to take it/ play down any risks and that that is worth keeping an eye on.

Also, for some women, the risks are likely to outweigh the benefits. Of course they could stop taking it if they like but they probably shouldn't be in it in the first place , if that is the case.

True though that it's not reasonable nor helpful to tell someone who feels shit that they don't feel that bad really (GP basically said this to me, that I don't feel bad enough to qualify for HRT. Fuck off, I feel terrible! And they wouldn't say that to a man re a male problem, I bet).

I have heard LN say that it’s not medication it’s replacing hormones that you’re deficient in. That’s all well and good if you’re below menopause age ( surgical meno or early) but you shouldn’t have those hormones post 60. What long term studies are there of women aged 60+ on long term hrt?

My GP says she's happy to give me HRT until I'm 80. I have a prepayment certificate so it costs me about 20 a year.

State pension age is now 67 Women are leaving the workplace before that age due to debilitating menopause symptoms. They are maybe more likely to stay in the workplace if HRT helps. I dont think its a coincidence that this is being advocated for women over 60 at the same time state pension age has gone up.

IMO if women over 60 want or need it they should have it but i dont believe this is a coincidence that these two things have happened at the same time.

But the cancer risk of all those extra hormones is significant surely?

That doesn’t really pan out because if only 15% of women take it, the effect on state pension age would be minimal.

I wish I could find the link, but I read about the older study of HRT and bc risk, the one that caused the panic, was apparently over estimating the risk because the participants were older, and on it for longer than is now recommended.

I'm sure I read that 5 years under age 60 is what's now recommended (as risk starts to increase if used for longer/ older women). so if Newson clinics are prescribing wildly differently to that (and it sounds like in some cases they are, and at much higher doses than naturally occurring oestrogen) then that could be cause for concern.

I wouldn't necessarily assume that, about men.

Malingerers are a thing. And they are a problem for doctors.

And there are also people who become convinced that their problem has a certain cause, when in fact it's clearly not that at all. There is a woman who comes into my workplace daily who is constantly blaming her health issues on her celiac disease which is apparently caused because her sister feeds her meat. Her doctor apparently does not believe that is her problem, because he is a foreigner.

It's really not always as simple as the patient knows what is best.

In the US there is a huge issue with patients getting ideas from drug advertisements.

What has this story about the woman in your office got to do with women being prescribed HRT?

My GP said I could be on HRT for as long as I wanted.

Not sure how you measure whether someone's been on it for 'too long'?

We don't insist people are only on anti depressants for 5 years, despite anti depressants being addictive

I will be using vaginal estrogen for the rest of my life. Because atrophy isn't going to miraculously reverse itself. As for the patches, will take it as it comes, but I wouldn't be horrified to be on them for a long time.

From my experiences with breast cancer consultants....

It's not so much the oestrogen as the progesterone. My consultant said this. (Women without wombs on oestrogen only have a lower risk of bc. But I don't know what happens if there's already an oestrogen positive breast cancer cell there.)

Higher doses of oestrogen require higher doses of progesterone. They have the data up to a 100 patch and equivalent. The synthetic progesterone is a known known with a very slightly raised risk. As with progesterone containing contraceptive pills - but the older you are the higher your risk of bc.

They don't have data for body identical progesterone iirc. Or it may be the same. But in my experience it can be a tricky one to use in hrt - some people find it makes them very groggy, some find it's not strong enough.

Women who have first pregnancies after the age of 30 are at slightly higher risk due to the hormones, as with any woman older than this and there's an increased risk within the first 10 years after a pregnancy. Due to the natural hormones.

Mirena is very effective- I wasn't allowed that even though it's a localised dose. Incase a stray cell is floating around and fancies settling in my bones and gets 'fed.'

Then there is also the issues around endometrial cancers and other hormonal cancers which can be impacted by too much oestrogen without the right progesterone level.

But this seems to have been lost in translation with the programme.

So lower doses can more safely use lower doses of progesterone.