I watched this last night but wonder if she will have made things worse by stirring up more media attention.
We need to look at intent. I believe that LN has had good intent and that it’s not all been about money, however, she does appear to push oestrogen as the holy grail because of her own personal success with it. She appears to ignore any other opinions that it does not help all women, with the assumption that they are just not having enough of it. To make such public statements of safety, this is what needs to be proven using double blind placebo research, not just untested accounts of her patients.
The BMS’ intent seems to have been fuelled by some angry NHS doctors (who do not have the same access to monitoring that private clinics do) who do not agree with blindly increasing oestrogen doses and facing patients every day demanding it.
Nick Panay seems to have been dragged into it, unwillingly, due to him also prescribing high dose oestrogen off licence. However, the big difference here, is that he is not publicly recommending this practice to peers or shouting it to the media. (Although I stand corrected if he does promote it).
Having Liz Earle (a non-medic) challenge Panorama is fair enough, as both are media entities, but surely medical ethics needs to be challenged by actual medics? if I did not know anything about oestrogen and listened to this video, I would be convinced that oestrogen was 100% safe in any dose, as she said that there was no evidence of it ever causing womb cancer. Of course it’s impossible to measure this. She did not mention breast cancer at all, which is slightly easier to measure for oestrogen positive breast cancer but, even that, how you can ever know for sure. So we have to accept that there is no way of testing for this, rather than accept safety based on there being no evidence.
She also compared the high levels of oestrogen in the pill for younger women with HRT estradiol for older women. Of course, synthetic oestrogen cannot be compared, particularly when we have extremely high levels of natural progesterone when younger. Not sure if any of you have seen the updated menstrual cycle chart but the old one had the non-comparable measurement of progesterone missing from the Y axis, which had made it appear that oestrogen was higher than progesterone in the follicular phase, which never was the case.
I think it’s a shame that this has turned into a 2 sided public row (which the media love!) which, as already stated, is affecting those currently on higher oestrogen with GPs now suspicious. Perhaps it will be the case that going forwards all women on higher dose oestrogen will require womb scans and more frequent mammograms, which would not be such a bad outcome if it does protect them better. Why this was not done as standard by Newson Health, (and Nick Panay if this is the case) still puzzles me as all of this could have been avoided.