To kick off menopause awareness month, BBC Panorama aired a 30-minute exposé on the menopause industry. A summary of the programme also appeared on the BBC website.
Unfortunately, as is usually the case when the media breaks a news story about how women are potentially being harmed by certain menopause industry practices, the Panorama menopause programme left many women feeling more confused and worried about how they can best navigate through midlife change.
Perimenopause and menopause are sensitive times but they don’t have to be confusing. Suffering is also not inevitable. I’ll share more about that towards the end of this post.
The Panorama programme was divided into two sections. The first examined the claims made by manufacturers of menopause supplements and other non-medical menopause products. By teaming up with the Centre for Evidence-Based Medicine in Oxford, Panorama investigated 15 different types of products and found a lack of robust scientific evidence to back the manufacturers’ claims in all but one.
Shocker 1: The elephant in the room
As menopause awareness has increased, so has the demand for solutions. Unproven claims are being made about many products from herb-based meno gummies to…HRT!
Which unproven claims will cause the most harm?
If a woman tries a menopause supplement and she doesn’t see an improvement within a month, she’s unlikely to continue buying that product. The damage done here to an individual could be from around £10 to £50 and hopefully she’ll be more wary of meno products in the future. It’s not nice that women are being convinced to buy so-called solutions if they don’t work, but at least the customer is unlikely to have put her health at risk.
Compare this situation to what has become the norm around HRT. In recent years, HRT has once again been marketed to women as a panacea.
HRT is not a panacea.
Large randomized controlled trials have shown that in natural menopause, HRT can sometimes (but not in all cases) help reduce night sweats and hot flushes, and some genitourinary syndromes of menopause. What about chronic mental health conditions? No. Preventing dementia? No. Preventing osteoporosis decades after menopause? No. Reducing the risk of heart disease? No. Or any other disease? No!
So, why do so many menopause celebs including doctors make these claims?
I wish the Panorama team along with the Centre for Evidence-Based Medicine had asked that crucial question. The promotion of HRT as a cure-all was the elephant in the room!
As opposed to the menopause products that were under scrutiny in the programme, and found not to be breaking any guidelines, every time HRT is promoted to consumers in the UK, it’s a violation of advertising laws that restrict the promotion of prescription-only medicines to the public.
Unfortunately, the regulators are asleep and the media, including the BBC, are in on the game. The media regularly allow the illegal promotion of HRT on their platforms.
All medicines, including HRT, come with risks (just read an HRT product insert to find out what they are). If a woman is taking HRT for supposed disease prevention (as many are these days, thanks to the illegal and relentless promotion of HRT), she won’t receive the benefit she desired because HRT can’t deliver it.
In addition, there’s a chance this woman won’t implement other lifestyle practices that have been proven to prevent disease, because she believes that HRT has her covered. This then increases the woman’s risk of disease AND exposes her to the risks that are inherent to HRT. In total, these risks can amount to a lot more harm than money wasted on meno supplements.
Back to the Panorama menopause programme.
The second section of the programme exposed the practices of the largest menopause clinic in the UK, Newson Health, which is headed by a menopause doctor who many will have seen on TV and across social media.
The Panorama team spoke to 15 women who had paid for consultancy services with Dr Newson and other doctors at her clinic. All of the women claimed to have experienced health complications following treatment recommended by Newson Health doctors. 13 of the women believe their complications were due to the high doses of HRT prescribed to them. The team also spoke with doctors who were formerly employed at the clinic and expressed concern over the prescribing practices carried out there.
During the programme, we heard the story of Paula, who was prescribed oestrogen patches and progesterone tablets while in her 40s by Dr Newson (while the latter was working in another private practice). After starting treatment, she witnessed her symptoms become worse, not better. Paula describes how the doctor doubled the dose of her prescription (which then became twice the licensed limit). Paula’s mental health seriously deteriorated and she experienced heavy bleeding.
We also heard the story of Rachel, who experienced worsening symptoms while on HRT prescribed to her following consultations at the clinic. During a series of consultations for which she paid over £2,300, Rachel’s oestrogen dose was tripled while her progesterone dose was halved. Rachel developed severe pelvic pain and was diagnosed with endometrial hyperplasia, a thickening of the lining of the womb, which is considered an early sign for the possible onset of endometrial cancer. In the programme, Professor Janice Rymer, Chair of the British Menopause Society, described how the dosages of HRT that Rachel had received, put her womb at risk.
Anyone who’s familiar with the menopause industry in the UK, couldn’t have been surprised that women who turn to Newson Health for support are often prescribed double or three times the maximum levels of hormones recommended in UK medical guidelines. This was reported on by Barney Calman for The Mail on Sunday in 2023. Since that time, according to the Panorama programme, the British Menopause Society (BMS) withdrew their accreditation from Dr Newson because of concerns around her prescribing practices.
Shocker 2: Women are being treated as if their bodies function without logic
Considering the history of medicine, this isn’t such a shocker, but still.
Is it logical to suggest that if symptoms worsen (not remain unaffected) following the start of treatment, one needs to double down on the treatment rather than stop the treatment and try other methods to support a patient?
Are we mistrusting menopausal women and their bodies? When a woman’s body sends a clear signal that a certain treatment is not what’s needed, should any doctor insist the body needs the treatment in higher doses?
Strangely, many of the HRT-or-nothing celebs like to wave the feminist flag. Respecting the intelligence of women’s bodies is Feminism 101.
Shocker 3: Women are actively being encouraged to up their dose beyond recommended guidelines
Senior doctors interviewed in the Panorama menopause programme suggested that increasing the dose of HRT beyond licensed amounts might be considered in rare cases. By contrast, Dr Newson, in at least one of her books and elsewhere, has suggested that since some women appear to absorb hormones poorly, it might be suitable to double or triple the licensed dose. Newson Health stated that from their own research, this could occur in one in five women.
Dr Newson’s books and her social media posts are largely targeted at consumers. Why is the dosing of any medicine beyond standard guidelines considered a suitable discussion in the consumer realm?
Most menopausal women who are taking HRT cannot possibly independently assess the risks that may arise from increasing their dose. Could viewers of the media put out under Dr Newson’s name conclude that if they’ve tried HRT and they’re still suffering, the next logical step is to try more?
What’s to stop a woman from sticking on two or three oestrogen patches instead of one, or increasing the amount of cream or gel she uses? Where on earth are the regulators?
One doctor who used to work at the clinic stated to the Panorama team:
“The solution to any health issue was always to prescribe HRT or to increase the dose of oestrogen.”
Could such an approach resemble a religious belief in HRT, or a profit-driven one?
An undercover Panorama reporter recorded two consultations with Newson Health clinicians while posing as a menopausal woman already taking the maximum licensed amount of oestrogen. During the consultations, as higher doses were discussed, the reporter wasn’t informed that the safety of a higher than the recommended dose of HRT hadn’t been established. In addition, this was not made clear in the follow-up information sent after the consultation.
In other words, there was a clear absence of informed consent, which is designed to alert patients of possible harm from all treatments, especially untested ones. Other former patients of Newson Health shared how they were also not given informed consent.
Shocker 4: Can a lack of clinical trials to determine potential harm be seen as evidence that procedures are safe?
During one of the undercover consultations with a clinician at Newson Health, the reporter was told not to worry about the proposed higher than licensed dosing levels because among other things, Dr Newson uses three patches, with a combined dose 300mcg of oestrogen (in other words, three times the recommended maximum dose).
In interviews, Dr Newson has shared her own experience of having a hysterectomy, and discussed the lack of information available to women before such operations.
While a hysterectomy increases a woman’s risks of numerous conditions and diseases, endometrial cancer, a cancer of the lining of the womb, is not one of them.
When hormone therapy was first prescribed to women to ease menopause symptoms, mid last century, oestrogen-only therapy was given. In 1975, The New England Journal of Medicine published research that uncovered a sudden increase in cases of endometrial cancer that coincided with the rapid rise in the use of estrogen therapy.
In 1980, a research paper published in The American Journal of Public Health claimed that the surge of endometrial cancer cases created the largest epidemic of disease that had ever occurred in the US, as a result of medical intervention.
By the 1980s, it had become standard practice to offer women, who had not undergone a hysterectomy, combined HRT with progestin added to protect the womb. These days, progesterone is often prescribed instead of progestin.
Before 1975, no large clinical trials were carried out on oestrogen-only therapy because that’s the way medicine (and in particular medicine for women) was managed. Since 1975, there have been no large clinical trials where oestrogen-only therapy has been given to women who have not undergone a hysterotomy, because of the known high risks of harm. No ethics committee should allow such research to proceed!
Considering what we know about oestrogen therapy, isn’t it a little strange to use Dr Newson’s personal dosing levels as justification for giving other women (including women with a womb) high doses of oestrogen?
Panorama also quoted Dr Newson as stating that “there is no evidence to link higher doses of oestrogen to an increased risk of long-term harm.”
Sometimes, it’s worth remembering the central principle of medical ethics: “First, do no harm.”
One former Newsom Health doctor who left the clinic because of the prescribing practices stated to the Panorama team:
“I have concerns that the continued current opinion and directions offered by Dr Newson will, in time, cause women harm.”
A follow-up article to the Panorama menopause programme helped reveal the possible extent of harm being done. The article was published in The Stratford-upon-Avon Herald, a local newspaper serving the town of the first Newson Health clinic (opened in 2018). The article quoted Dr Karl Oláh, a consultant at Warwick Hospital specializing in gynaecological cancer and minimal access surgery. Dr Oláh has worked in gynaecology for 30 years and is also an editor for the British Journal of Obstetrics and Gynaecology.
Dr Oláh stated:
“My concerns with the Newson clinic go back over five years as a result of the number of women that I was seeing with irregular bleeding on HRT.
“The Newson clinic approach was to give very high doses of oestrogen with a progesterone that could not cope with the increased ‘workload’, and often the use of testosterone – usually without good reason. There has been an increase in the number of women undergoing operative procedures to investigate bleeding in the menopause.”
Medicine practiced safely should not lead to more medical procedures.
Shocker 5: “This is a hormone, it’s not a drug!” What?!
From the late 1930s until today, clinicians have been wary of treating healthy women with hormones. Hormones, even those labeled as bioidentical, are powerful and (on an individual level) unpredictable agents that can cause emotional and physical disruption.
Although today’s bioidentical hormones are produced from more pleasant-sounding substances than the urine of pregnant mares (which has been used to produce the older forms of oestrogen therapy), bioidentical hormones are still created in labs and are not food! They come with product inserts that detail possible side-effects. They have to be trialed and given to women via a prescription because, just like all medicines, they come with risks.
The Newson Health clinician who is heard in the undercover consultation stating, “This is a hormone, it’s not a drug!” is on trend with many meno celebs who are trying to rebrand the medicalization of perimenopause and menopause as a “holistic approach!”
HRT is prescribed to women, not sold in health food shops, for a reason! HRT is not a “natural supplement!”
Shocker 6: Who’s hunting who?
“It’s a witch-hunt!” declared Dr Newson’s fans on social media in the days following the Panorama menopause programme. The exposé left many women in shock, but that’s because over recent years, rather than the concerns among many doctors being voiced in public, there has been a strange silence around the practices of Newson Health.
Dr Oláh told the Herald: “My general reaction was ‘it’s about time’. The programme was a good account of what every gynaecologist in the West Midlands has been saying for over five years but, in large part, been too afraid to voice out loud.”
Why are doctors, including ones in senior positions, too afraid to criticize prescribing practices that are potentially placing large numbers of women in harm’s way?
Shocker 7: It’s all the fault of the NHS!
Apparently, two wrongs make a right to many in the menopause world.
A successful brand that is centered around one person, must offer benefits to consumers, otherwise it won’t grow its profits. There is no doubt that Dr Newson has helped bring discussions around perimenopause and menopause more into the spotlight. Many women appreciate someone on TV and social media talking about their symptoms and struggles. By adding fear of deficiency and disease to the mix, women’s menopause problems have appeared even more dire, making an authoritative figure offering a supposed solution more attractive.
When we feel not like ourselves as many do in perimenopause and menopause, a promised quick fix via a patch, gel or pill seems the way to go. If the quick fix comes under scrutiny, resistance will naturally arise. It’s as if hope is being washed away.
One of the former doctors from Newson Health pointed out it was the speed of growth of the company that became problematic – it appeared to leave no time to pause and reflect on how patients were potentially being harmed by the prescribing practices.
In the UK, there are numerous examples of media darlings who were viewed as caring and trustworthy in the public eye, while behind the scenes in the turmoil of a rapid rise to fame, they lost their way.
Newson’s defenders focused on the benefits she’s offered women and how incapable the NHS has been in meeting women’s health needs. If the NHS was doing a better job, women wouldn’t need to turn to private clinics.
This is true but CANNOT justify potential harm done at private menopause clinics. Two wrongs do not make a right.
Newson Health told Panorama that it “strongly refutes” the “characterisations” from their former doctors. It stated that it operates a “responsible audit practice” to ensure “patient safety and consistent levels of care.”
Is it time for a different way?
Although many women now feel stuck between a rock and a hard place (the underperforming NHS and the UK’s most famous menopause doctor whose prescribing practices are, according to the Panorama programme, now under investigation by the health regulator, The Care Quality Commission), there is an alternative path through perimenopause and menopause that allows women to avoid disappointment from systems and individual doctors.
It's possible to stay away from the rollercoaster ride of HRT management, HRT shortages, unpredictable levels of care and HRT-related scandals.
It all starts with taking sovereignty over our own health.
Yikes! I know this sounds like the long route, but considering how complicated and unpredictable the medical route is, it’s actually a smoother path, which promises health benefits way beyond midlife change.
So much of the modern menopause discourse encourages women to seek solutions and “hormonal fixes” outside of themselves. However, one of the points of perimenopause and menopause is to encourage transformation within.
Women often tell me “I’ve tried everything! I eat well, exercise and tried numerous herbs, and I’m still overwhelmed with symptoms!”
Yet, until we honestly examine our emotional and spiritual wellbeing along with what we eat and how we move, we will struggle to feel like ourselves during these sensitive years of change and even beyond.
The divine intelligence in your body wants to preserve your health and is, through symptoms, nudging you to make adjustments. You can try to suppress symptoms but your body will continue talking to you until you understand how to calm the internal chaos that so many of us live with, in innocence.
No woman needs to feel like a victim to her hormones, which cannot go crazy because it’s impossible to disconnect them from divine intelligence! In addition, no woman needs to feel like a victim to her genes, or her past, and certainly not to the NHS or any doctor.
All healing takes place from within, including when we desire to heal our perimenopause and menopause symptoms. A glorious sovereign journey awaits, if you are willing to take the first steps.
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