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[Gnatty]

I was quite surprised to see one of the BBC online headline news items this morning. It looks like her clinic is being investigated for prescribing high doses of HRT. And she has lost her accreditation with the British Menopause Society.
Although on reflection maybe I am not so surprised. People were starting to speak out on Instagram etc.
What does everyone think about this?
Pretty bad timing for her as she is in the middle of a UK tour.
-------------------------------

Menopause Matters has released a statement regarding the Panorama programme.
Here's the statement as a pdf
View/download the statement here.

[Gilla999]

Not surprised, for the reasons you mention.

My experience of menopause doctors, having paid to see about 5 different ones over the last 5 years, is that they have their own "camp" or fixed mindset. You get those like Louise Newsom who just think ESTROGEN ESTROGEN and MORE ESTROGEN and then you have others (eg Marian Gluck clinic and Lara Briden) who think Progesterone is the answer to everything. Akin to Louise Newsom I know of places promoting incredibly worrying high doses of Progesterone daily as the answer.

Incidentally I experience the same thing when it comes to women generally... people want to help and it's human nature for people to feel what worked for them will work for others. But the reality is there is no fixed answer and such high variability between women and what their bodies need. For some, Estrogen will be the answer. Many others can't tolerate it at all (there is not yet enough of this being discussed, but I imagine it will come in time).

Will be interesting to see how things pan out for Louise Newsom

[Minusminnie]

I think that you have to question anyone that you go to privately for any health aspect.

I will be watching programme later.

[Rumbaba]

I am one of Newson's patients, and I am on a super high dose.  I have regular blood tests, and my levels are not super high, so absorption is the issue.  Its taken me 6 years to get to a good place, I really hope I'm not forced to come down.  My mental health was on the floor before I got here

[Gilla999]

And that's it isn't it - for some women absorption really is the issue and they should not be denied treatment and just left to suffer. But it isn't the answer for everyone and I think the concerns which have been raised by previous patients of her clinic seem to indicate that their experience was just more and more Estrogen being prescribed even when their levels were high, which IF true, is worrying.

[Gilla999]

Sorry just one more point - I also think there is a wider conversation that needs to take place about perimenopause and how different it is from post meno. People like Davina McCall have done a great job of bringing awareness to post meno and how beneficial HRT is and taken away some of the myth and stigma surrounding it. But perimenopause is characteristically very different from post meno - often levels of Estrogen surge to very high levels at the same time as Progesterone dwindles, and it's actually this imbalance which causes many women problems. Adding in more Estrogen on top just isn't the answer for a lot of women and I don't think there is enough conversation happening around that yet. I've also observed friends of mine in their late 30s declaring that they "want HRT", under some misconception that it's going to help with weight or skin etc etc, without understanding that it's a drug and adding it in when it's not really needed can cause so many problems. All of the publicity around HRT was definitely something that needed to happen, but I worry sometimes that it has created some misconceptions for women on the younger side.

[Gnatty]

Yes I agree and I think I fell under the magic spell too. Namely that it was a cure all for everything.  There is a narrative on certain Facebook groups ( Surgical Menopause one comes to mind ) that more is always better. And so when something goes awry it's tempting to think your dose isn't enough. I have actually found that isn't the case for me. As a recent example, I increased my Sandrena dose to 3mg a few weeks ago. Couple of weeks in, sleep went wrong and started getting palpitations. Dropped back down to 2mg and hey presto back on an even keel. I do need to add in estriol cream at a lower dose but that's fine, it does a great job and it's going straight where it's needed!

[Gilla999]

I've had similar experiences Gnatty, through trial and error where I often assumed when I had a symptom that it meant needing more Estrogen, and then found that it actually wasn't the case and felt worse etc. HRT saved my life, I probably wouldn't be here now if it didn't exist... I just think it's not always straightforward (especially in peri vs post meno) that more is the answer and caution is needed.

I also 100% agree that "established guidance" doesn't cut it, especially with something as individual as women's hormones and concerning a topic which is so under funded.

[CLKD]

NICE have a lot to answer for.  Especially when children for example do well on a specific medication which saves repeated Hospital admissions.

Personally I know that I have been lucky in the main though I do wonder in hindsight whether my severe anxiety in my mid-late 30s was peri.  But ADs have seen me OK thus far.  Though there is much discussion in the media about the amount of anti-depressant medication that is prescribed, particularly since lockdown.

Thyroid function also springs to mind.  'within normal limits' may not be 'normal' for those suffering with severe symptoms.

[Emmia49]

Dear Gilla 999!

I couldn't agree with you more!!!
I've been thinking about posting about my own experience with crazy perimenopausal hormone fluctuations for a while now.

I am 49 years old and my periods are every 22 days, very light and last only 2-3 days.
I have been struggling with night sweats, chronic insomnia, and very loud tinnitus for 1 year now.
This spring, I felt anxiety for the first time, which made me unable to function anymore, so I quit my job.

My gynecologist prescribed me HRT lanzetto spray 2 pumps and utrogestran 200mg for 12 days in the evening during the second part of the cycle. My levels of estrogen at the start of therapy was 16 pmol/L, progesterone 0.3 pmol/L, FSH 53.

After 1 month my symptoms only got worse. The gynecologist then advised me to increase the spray to 3 pumps. After 3 weeks, the symptoms continued to worsen. Then she advised me 4 pumps. My condition worsened to the point where I was getting absolutely no sleep and my anxiety was through the roof, mood swing  horrible! Even the night sweats were back and tinnitus worsened.

Then the gynecologist changed my therapy to trisequence tablets, but did not inform me about the possibility of progesterone intolerance. Within 1 week I became so depressed that I even thought about suicide.
I stopped everything and decided, even though it cost me a small fortune, to monitor my  hormones in a private clinic for a whole month according to the phases of the menstrual cycle.
Hormone monitoring was performed 1 month after stopping HRT.

I was shocked at how hormones fluctuated from one extreme to another.
At one point estrogen levels was 475 pmol/L, then 122, then 48, then 68, then 178. Progesterone fluctuated from 0.3 pmol/L to 7.2, FSH from 53 to 7.2, then 22 to 8.3.

I realized that as long as I am in perimenopause, when my hormones fluctuate to such extremes, I will not be successful with any HRT therapy.
I'm sure that experimenting with HRT would be torture for me at this point.

What I want to emphasize is that there is not enough talk and research about HRT during perimenopause, when hormones are in constant chaos and, unfortunately, for some women, the increase in estrogen does not help. For me it was horrible experience!

Please take my writing as my personal experience, because I do not want to convince anyone that HRT is bad or not to try it.
In my opinion, it is necessary to help women in perimenopause in a different way or with a different approach, which all specialists dealing with menopause should first discuss and decide which is the right way.

I wish all the ladies who are in peri to menopause all the best!

[CLKD]

I wonder whose side the British Menopause Society are on ............ 



Oh the good old CQC   


Also: how many women whose lives have been saved or improved have been interviewed?  Until there are blood tests that >looking for word here< it will continue to be a bit Trial and Error.

DH is now reading the article.  "They are out to get her" is his comment.
Modify message

[Gilla999]

Emmia thanks for sharing your experience - it's very interesting to me because it matches mine almost identically, but I won't hijack Gnatty's thread by going into it here    I completely agree with your comments re perimenopause and not enough conversation, studies or funding around what happens to hormones during that time (vs post meno, which is a very different hormonal situation).

I'd be interested to know if Louise Newsom's clinic takes blood tests to look at hormone levels before/while increasing to very high doses. I completely agree that blood tests aren't the only thing to rely on and symptoms are equally as important, but blood tests (for all things) have a place and are there for a reason (they have been very helpful/reliable for me) and I would imagine if you are putting a patient on high unlicensed doses that you would at least want to verify.

[Taz2]

This is the article https://www.bbc.co.uk/news/articles/cp8e5y4e83lo

Taz x

[Mary G]

I wish the BMA would investigate/denounce the two destructive HRT studies that set millions of women back years when it comes to menopause treatment.

If the NHS treated menopausal women properly, fewer would need to go to private clinics. They don't routinely offer women transvaginal scans either which results in a lot of cancers and other conditions being missed.

[CrispyChick]

Gilla and Emmia - snap.

Those of you that have read any of my posts over the last few years will know that this too has been my issue.

I've never been to the Newson clinic because my body let me know very early on that estrogen hrt during my peri - was not for me. And I have definitely been led to believe that estrogen is pushed there. But then, so it is on the NHS. It's all they can offer us peri woman, despite, like Emmia found - it can cause a lot more problems.

But in general, pre or post meno, one size does not fit all.

Really interesting to see your month's worth of testing Emmia - absolutely highlights what terrible fluctuations some of us are experiencing and nothing out there to help. 🥲