Just As Well, The Women's Health Podcast - The HRT Cancer Fear: What Dr Louise Newson Says We’ve Got Wrong

Episode Date: August 18, 2026

Dr Louise Newson challenges the belief that HRT automatically increases breast cancer risk—and explains why the type of hormone, the dose, and the individual woman all matter. She discusses: What the famous 2002 study actually found Why estrogen-only and combined HRT can have different risks Why some women need higher doses because they do not absorb patches or gels properly Why menopause symptoms can include joint pain, palpitations, insomnia, low mood and brain fog Why women are still being prescribed antidepressants instead of hormones The difference between progesterone and synthetic progestogens Why a blood test may not tell the whole story Whether HRT can protect future bone and heart health This is a frank conversation about medical misinformation, women being dismissed, and why “one dose fits all” medicine may be failing women. Buy The Power of Hormones here: https://www.amazon.co.uk/Power-Hormones-misinformation-hormones-healthier/dp/1399749935/ref=tmm_hrd_swatch_0 Learn more about your ad choices. Visit megaphone.fm/adchoices

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It's about being able to bounce back. Oikos Pro. Feed your strength. Visit Oikos.combe. For more details. Hello, I'm Gemma Atkinson. And I'm Claire Sanderson. We've just interviewed Dr. Louise Newson, who was brilliant. It's such a good episode of Just as well. If you're a female, you've got your hormones. Louise is the one for you. Yes, so many of you will be aware of Dr. Newsom. She is the menopause underscore doctor on Instagram. She's huge in the menopause space, has been for years, probably the OG, actually, of social media menopause doctors. And she came in to speak to us about all things hormones, including her new book, The Power of Hormones. She also spoke really openly and honestly about the panorama documentary that came out a few years ago, where she was publicly downtrodden on,

she was stripped of being a specialist in her field. There was a lot of negative criticism around her work and what she does and what she advocates for. On the plus sign, she has a huge, huge support for women everywhere who have tried and tested her methods. And all she wants, ultimately, is for women to be able to access hormones when they need them. Rather than it be an umbrella treatment

for women going through perimenopause or menopause, even she told us a story about a lady who thanked her because this lady's daughter was put on the contraceptive pill to treat acne which in itself doesn't make any sense does it so she's really really knowledgeable she's wonderful she's bounced back because she does explain to us in this that it was very personally hard for her as well you know she's worked her whole life to get to where she hears and to have all of that removed just because of one documentary it says a lot that she's still going

and she's so proud about what she believed in and what she knows to be true in the hormone industry and hormone field. She's a huge advocate for HRT. If you're on the fence about taking HRT, if you are taking it, or you think it needs to be optimized or you're not quite there yet in your hormone journey, but you just want to equip yourself with knowledge

to feel better today and tomorrow. This is the episode for you. Enjoy. So Louise, welcome to Jess as well. Thank you for inviting me. I'm so thrilled that you are here today because we first met a long time ago and it was when we were both on the Women's Health Task Force which was across Parliamentary Committee

to improve health outcomes for women's and girls sadly it was disbanded I think it was when Boris got in so that's how long ago it was 10 years I think 10 years goodness me and I remember speaking to you one of these committees was about menopause

and I remember speaking about my own experience of the perimenopause and being misdiagnosed and with depression and then you saying that you would help me. But at that point it wasn't part of the common vernacular it is today. What do you think of the explosion of the conversation around the menopause and the perimenopause? Is it all positive or does it have any negatives?

I think about this a lot actually because at that time it wasn't really mentioned in the media and if it was, it was always then with HRT but that causes breast cancer which it doesn't by the way but I'm just saying this negativity and people didn't really know what menopause was so I think it's good and bad because it's good because more people are talking about it more people are aware that it's more than hot flashes and sweats about the myriad of symptoms women are more knowledgeable so they're more likely to ask for help people are more aware that there are different types of hormones there's a synthetic older types of HRT that are associated with risks and the newer types, the body identical natural hormones that are safe. But it's bad because training for healthcare professionals hasn't improved. There's a lot more women that I hear day and day out that have been turned away. They've been told it's all in your head.

It can't be related to hormones. And a lot of my work isn't just about menopause. It's about changing hormones in all ages. So a lot of women I see have premenstrual syndrome or the more severe form premenstrual. or dysphoric disorder. And so many women, the doors are just slammed for them. So I feel like in one stage it's good that there's more conversations, but the other time it's frustrating because it's still misunderstood.

And then I guess the third answer is there's also this explosion of marketing on menopause. One of my daughters the other days, a bit of a joke, went into boots, and she literally filled up a basket with menopause shampoo, menopause face cream, menopause supplements, and she was going, look at all this. You've probably helped with all these companies because of all the awareness that you've done. And that really scares me as well

because if you read how much money these companies are making and are they really... Can you tell me really that me using a menopause shampoo as a menopause a woman? I mean, it might make my hair look a bit glossier, but it's not going to help my hormones at the end of the day. Do you think the reason why it's been catapulted, like exploded culturally is because of things like social media

and, you know, a lot of people are going off an influencer as opposed to a professional for advice. Yeah, and I think, you know, we do change the way we learn. And, you know, many years ago, the only way of learning was from your doctor because there was no social media or from a magazine or what was in the print. Whereas now people do learn from social media, which is a good and a bad thing because it depends who you're learning from. But some of these people have such big marketing, you know, budgets. They're using influencers who aren't necessarily coming from an evidence place base. And then it's really confusing.

And, you know, when we met Claire 10 years ago, HRT prescribing for menopause was about 10% of women. And now it's gone up to 14% of women over 10 years. 14. 14%. It's not a huge increase. Whereas if I'd met you 25 years ago, it was about 40 to 45% of menopause or women.

So, you know, although we're talking about it more, women aren't been able to access the treatment. And it's gold standard treatment. You know, all the guidelines across the world are very clear that HLT's first line treatment for the majority of women. But the majority isn't 14%. And in areas of deprivation, it's as low as 2%. I'm really surprised at that.

Because I thought quite literally one in two women were on it. Maybe it's the bubble that I work in at women's health. So we're talking about the menopause all the time and was one of the first brands to be publicly speaking about it. in a very open and honest way and I was very open on my social media about my experiences. I assumed that it was much higher than 14%.

It was going up. And then since the Panorama documentary, people have become more scared of hormones. So it's sort of just tails off. So you can see the graph going up and then it's plateaued. And then a lot of people who have been on hormones

very safely, very well, are really struggling to now get it. So I haven't seen the figures over the last few months, but it's not going to be much higher and it might even be slightly lower. but globally it's 5% of women. When you say struggling to get it,

do you mean struggling to accesses from their GP? So GP is refusing to prescribe it? Yeah, wow. Why would it be refusing to prescribe it? Because it's so low or because they want to... So a lot of it is misinformation, actually, and it's really frustrating because a lot of doctors really aren't trained. And they're not just doctors, but pharmacists and nurses

aren't trained in hormone house. So there's this misunderstanding. And, you know, I've been to some quite high... high-powered meetings where people say, Louise, you know, it's really frustrating because women think that their joint pains and their headaches and their sleep are going to improve with hormones and it's just about flushes and sweats. And I'm like, hang on, these are really common symptoms and actually they often will improve. But there's this real resistance and so many women, certainly on the theatre hall that I've been talking to a lot, but women I see in the

clinic say to me that their doctors say they have to try antidepressants first. You know, their mood symptoms are related to their, you know, they need antidepressants, not hormones. And a lot of doctors still say HRT is dangerous. You know, one lady told me last night in St. Orban's at the theatre tour, that her doctor said, well, I can give you this, but I can categorically tell you it's going to give you cancer. Wow. You know, so. That's not nice, is it?

Because she could tell her friends or tell the daughters. So you can understand. Yeah. And if a lot of people, especially if they're living in a rural area, they might only be able to access one GP. So if they're told that, then what do they do? And in fact, one lady, she was an usher in the theatre, was crying last week. And she said, I'm 62. I've been to my doctor and said, that's it.

You're too old. You can't have hormones. So she said, this is my lot. This is how I've got to be. And, you know, that's terrible. And it's really interesting because there are some women who access it really easily. They're fine. And there's some amazing doctors, you know, NHSGPs who are brilliant,

but they don't see the other side. And I suppose I expose myself a lot, firstly because I have a clinic. So people come to my clinic because they can't access care and treatment in the NHS, but also on social media or walking down the street. You know, I hear these stories day and day out. And I'm sure you hear them as well of women really finding it very difficult to access hormones. And in the UK and globally, more menopoles of women are prescribed antidepressants than HRT. And antidepressants have more harms and risks than hormones.

And it's helpful as well that you're a female. So you'll know the symptoms. I mean, it's not all male doctors. My doctor's male. Dr. Sanjay, he's wonderful. But I imagine for someone who, like you say, can only access one doctor and he's a male, and so he's not physically been through the symptoms

this lady's describing, he'd feel horrible for them. I think actually sometimes, and this is a generalisation, but sometimes female doctors are even worse. Really? Because, and I see that with some of the pushback that I get, because it's almost that they haven't experienced those symptoms, so they don't believe that women are experiencing symptoms.

So I see a lot of women who've come from psychiatric hospitals who've had psychosis. They might have had postnatal psychosis or they might have had been misdiagnosed with bipolar and is related to their hormones. Now I've never had psychosis. I've never had a mental health disorder. But it doesn't mean that those women, you know, I can't understand and try and believe them. And the biggest worry that I have is that so many women are just completely gaslit and told it's all in your head and it's not related. And it can't be related to hormones.

just because their doctor doesn't believe it. And I've learned so much in the last 10 years, even since we met Claire, because I've got more scientific knowledge, but I've got a wealth of clinical experience. And when you see pattern recognition in medicine, you know, you prescribe a medicine, you see people getting better.

And it doesn't just happen to one or two people. It's happening to thousands of people. You can't just go, oh, it's just placebo, or it doesn't make sense. And that's why, you know, I've written a lot in my book, The Power of Hormones, what I've done in it, is explained a lot about how hormones work naturally

in our bodies. So rather than saying this is what HRT does, it's like let's just take a step back. Let's remind ourselves that these are hormones that we have naturally in our body and the effects they have in our organs, including our brain. And then people can work out what happens when you don't have them.

Because we have hormone receptors all over our body, don't we? From our heads to our toe. So if we then become deficient in any of these hormones, it stands to reason that it can impact any aspect of our being. Yeah, that's exactly right. What are the biggest myth slash challenges

you encounter around HRT and women fighting to get it prescribed or the fear that women have for taking it? So I think the biggest myth about HRT is what it really is, because even the words hormone replacement therapy mean nothing. Because what hormone is it? It's not being very descriptive. We've got hundreds of hormones in our body. Replacement still isn't right either, because sometimes we give it just to top up. You know, if someone's still having periods, they might have PMDD, and we're just giving them some progesterone for a few days a month, so we're just topping them up.

And therapy sounds like it's some, you know, talking treatment you need to be on a couch for or something. So I'm sort of more prescriptive with my language, really, and think about, well, is it progesterone? Is it estradi? Is it testosterone? Because the other thing is a lot of people call synthetic hormones, hormones, and they're not, they're chemicals that have been made to be looked like hormones. So these are the older types of pregesterone.

progestrogens we used to prescribe in HRT, the older types of estrogen, and actually all of the synthetic hormones that are in the contraceptives, they're not hormones, they're chemically altered. The HRT that we prescribe now is the same structure as our own hormones. So it's exactly the same as progesterone, eustodial testosterone. So if I'm with a patient or the words we use on balance app, it's a lot more about progesterone treatment, eustodile treatment, testosterone treatment, because then you know what you're talking about. But the biggest thing, if you say to someone, what are the risks of HRT? They'll always say breast cancer because of this study that came out in 2002. But actually the women that had this small, not statistically significant,

increased risk of breast cancer, actually took this synthetic progestogen, which is in contraception, but not the body identical hormones. So it's an unfounded fear, but that fear is trickled through women, but more importantly it's trickle through healthcare professionals. And then that's why they're still scared, but they're not thinking about the benefits of hormones for symptom control, but also for future health. So to be clear, the type of HRT that I am prescribed currently through my NHS GP is bioidentical. You cannot get prescribed or should not be getting prescribed synthetic. A lot of people still are though, so it's really important for people to check. So if people have the patches, jails or the spray that's only Easter dial, like

it's a bit like food, you can look at the ingredients, which, just says estradiol, then it means it's a bioidentical, the natural body identical estrogen. Some of the patches are combinations, so they might have a progesterogen in it, and that will be synthetic. All the combination patches are synthetic. So normally, we give the eustodial patch gel or spray, and then the progesterone is usually an oral capsule, or we can give it as a pezzary, and there's only one which says progesterone on it. A lot of them, like mojoxyprogesterone, acetate, norathistrone, are synthetic progestergens. And then the testosterone, if it's the gel or the cream that's prescribed, then it will be their body identical

natural testosterone as well. Because my, as I shared with you years ago, my mother had breast cancer younger than I am now. So I was nervous about going on HRT. That said, I have been on it since we first met. So since I was 40. So I have not increased my risk of breast cancer or have I marginally but the benefits out. actually, to be fair. I mean, the studies show that women who take estrogen

have a lower incidence of breast cancer, but those three hormones, progester and estrogen, testosterone, very anti-inflammatory in the body. So if we've got less inflammation, we're going to have less cancer. So not just breast cancer, but other cancers as well. And, you know, we know that,

that women who are on hormones less likely to have all inflammatory diseases, including cancer. So it's not like you've not increased it, you've probably reduced it, which is really important. And why do you think so many, like you said, a lot of GPs don't get that yet? Is it just depending on where they were trained or what stage throughout in life?

Why is there's so many? Well, it's interesting. So a lot of it is because there's no training. And I mean, I wasn't trained. Nobody taught me anything at medical school. But I strongly feel as a healthcare professional, our training shouldn't stop the day we qualify. You know, we constantly need to learn. And actually, we need to unlearn because a lot of what we learn at medical school becomes out of date.

There's new knowledge and everything else. but in medicine it's really difficult because everyone's very busy and it's a bit like a hamster wheel really or just getting through the day and the way we get taught often in medicine is quite sort of hierarchical you get taught by your seniors

so if they say oh Louise we've always done it this way we've always prescribed this or not prescribed hormones then you sort of learn it and think oh okay they must be right I've been quite lucky because I've worked as a medical writer for 25 years so I've worked part-time as a GP for 25 years

and the rest of my time when I wasn't looking after my children was as a medical writer. So I've unpicked a lot of evidence on all sorts of conditions, you know, read guidelines, read the original articles, and I've written books on evidence-based medicine because it's really important that you know what's going on. And I'm quite inquisitive and a bit curious,

so I'll always be saying, but why? So even with the HRT, but what are you talking about? Is it HRT or is it synthetic hormones, knowing the difference? But when I sort of talk to other doctors, they're like, oh, I don't really understand, I don't really know. And in medicine, if you don't know, it's easier just not to do anything somehow. But that's not always the best for your patient. Gat health is a big topic here at Just as well.

And you've probably heard me talking about how and why I look after mine. As the UK's number one, live and active bacteria supplement, Sim Prove has made a real change to my gut health in the three years I've been taking it, including more energy, better sleep and an improved immune system and noticeably less annoying lingering coughs and sniffles. It's now a solid part of my morning routine and proves how one small change can make a big difference. You mentioned the Panorama documentary.

You did come under a lot of criticism in that documentary. It was uncomfortable viewing, especially for someone who knew you personally. And, you know, I found it uncomfortable. I was upset for you. I noticed the groundsful of support you got from your patients and your audience, which must have been hugely comforting at the time

because I imagine it was a distressing period. for you. The criticism you came under was the over-prescribing of HRT. What are your thoughts on that and the potential damage that can have? Well, I mean, I'm not going to dwell on panorama because it's been horrendous. Yes. Not just for my organisation, but for me personally to have other doctors openly criticising when they hadn't even audited my practice. They have no idea what I do. So it was hearsay really what they were doing and they picked three patients out of 50,000 to criticise. Just to put it into context for those people that haven't seen the program and you can't find it anymore. They've completely taken it off the internet, which

says quite a lot, doesn't it? Anyhow, we know that women need different doses because when I was talking about the Easter dial, it goes through the skin. And we know the skin is a barrier. If you put your sun cream on, you don't want it to go into your circulation. So it's very crude, actually, the way we prescribe hormones as a patched and all spray. And we've known for decades that some people don't absorb the same amount through the skin as other. Not just for Easter but for other medications as well, like fentanyl or nicotine patches. So we've known that for many years. And we know that for about a quarter of our patients,

they don't have adequate symptom control and absorption of their easterdial through their skin with the maximum licensed dose. It's only the maximum licensed dose doesn't really mean anything. In medicine, we prescribe a lot of licensed. We individualise care. So we published data on it, actually, to show that about a quarter of our patients need a higher dose. It's very basic pharmacology.

But we have known for decades that individualisation of doses is really important because if women don't have the right dose and they're not absorbing adequately, then they can have symptoms and they can have more inflammation in their body. So actually it was completely unfounded what they were doing, but they were doing it because, and I know it because I've got subject access request from the British Menopal Society who were the people involved in the programme. For eight years they've been trying to take me down. and so this was just an excuse really another thing

and it was making very sensational television but what it's done is it's really confused and harm people and we've recently done a survey of 800 women asking them if they've been finding it difficult to be prescribed the dose of hormones that they need and a lot of them have been coming back actually over 50%, 56% have said that their GP's now refusing to prescribe them hormones that they've been on for many years

and we've known there's a paper that came out in the 1980s that showed that women were given higher doses of oral estrogen so it's quite an old paper but very high doses in psychiatric hospitals with psychosis and it really improved their mental health and we don't know what dose is right for people because not enough studies have been done but just focusing on a dose of a natural hormone

it just seems ridiculous where most people can't access anything I mean, as they said in the Panorama program, the British Menopal Society have stripped me from being a specialist. But we also have to put that in context because they're not a regulatory body. They're just a charity who've made up this specialist status. But actually the bigger picture of it, I mean, obviously they've harmed me, but it's not about me.

They're harming so many women by this confusion. And what they're also not being clear, and it wasn't clear in the program, that this is just a natural hormone called eustodial. ethanol esterdial that's in every single combined oral contraceptive other than one, is ethanol estradiol, which has a much greater affinity for the receptor, which we've known as associated with cancer since the 1979,

the World Health Organization put a report out saying it's associated with cancer, and contraception are given to 65 times more women than HRT. So if we're going to be like really making a sensational program about the harms of hormones, we should be looking at the synthetic hormones. This was very much a personal thing rather than an academic problem. And it's just been a shame because they've really sort of picked on the wrong hormone and the wrong reason, really, to scare people away from hormones.

There's never been any data, no one's published any data showing that I've done any harm. But we've got a lot of data that we've published showing the benefits of individualising care. We do that a lot in medicine. You'll meet three different people with diabetes. They'll be on different doses of insulin. You'll meet four different people with underactive thyroid gland. They'll be on different doses of thyroxin. And that's exactly the same of the way we prescribe Easterdial.

And the irony is, really, just to end this, is that when I started my HRT 10 years ago, I didn't really feel any better. And I thought, oh, shame. I really hoped that I would be feeling as good as everyone else says they're on HRT. And then my consultant, who was the chair of the British Menopause Society a few years ago, he said Louise I've done your Easterdine level and it's really low

you're not absorbing so I'm going to double your dose so he prescribed me a double dose that was twice the higher of the licence dose and I said to him at the time Nick I've never prescribed a high dose before he said it's just basic pharmacology you're not absorbing and I said oh yeah you're right the set patches don't

stick on very well so I've been using a higher than licensed dose for the last 11 years and when I challenged the BMS six months before the documentary and said why is it that he can prescribe that and I can't. You know, you're saying that you're stripping me being a specialist because I prescribe a higher than licensed dose.

And their answer was that he's a consultant gynaecologist and I'm only a GP. And I find that really distressing. And I have written about it in the book, this sort of whole hierarchy of medicine. You know, I chose to be a GP so I could look after my children, but I've still had distinction in every exams. I'm still clever. I've still got a brain.

I don't really understand why gynaecologists have this sort of control over over women in the way that they have done for many years and it just doesn't help. It's not a power game when we're trying to help people. There's millions of women suffering. You know, there's 1.34 billion women globally who are menopausal. And I've already said only 5% of those

are accessing treatment globally. So they didn't pick on the wrong hormone. They picked on the wrong woman. Yeah, they did actually. Yeah, that's what they've done. I mean, I'm not a specialist, not a GP, nothing. But for me, it is common sense that, like we said on the podcast earlier

if someone's on the same dose of, you won't give the same dose to someone you know, if you've got, it's just obvious. Even something as minuscule as CalPol or CalPol 6 plus, you give them different doses because they're at different stages and we monitor our patients as well

you know. We do blood tests to check the absorption, we do a really detailed symptom questionnaire and but it's not also just about eustodial, you know, the other two hormones are really important and you know we're sometimes increase the dose sometimes we'll reduce the dose sometimes we'll change from a patch to a gel

we started using a bit more cream actually and you know it's all about the absorption I've changed from patches to a cream and my dose I'm using is so much lower because I'm efficiently absorbing it but again it just shows its basic pharmacology yeah yeah it's a game of treating everyone as a small man or treating everyone as the same woman and it doesn't work like that it never will

no a medicine is a science and an art you know the science is having that academic knowledge, but the art is individualising care, and that's what somehow has been lost in medicine because it's very guideline-driven. And a lot of people come to us, and they have lots of different medical conditions. And that's why, as GPs, you know, we're used to making more than one diagnosis or excluding other conditions. It's really important. So we all know that misogyny is deep-rooted in healthcare. What you're describing, your experience at your clinic and generally women's experience of menopause care is another example of medical and misogyny. Yeah, and I didn't realize it was as bad as it was and I was talking to someone the

other day and she said, Louise, I'm a GP. It's really difficult. It's really hard to get the training, blah, blah, blah. And I get that. But what I don't understand in medicine is why people are so rude to women and why they don't want to listen because I was taught very early on at medical school that it's always in the history, Louise, you ask the right questions, you'll get the right answer, but you must believe your patients when they tell you something. And it's, some of it's about training, but some of it is just about being rude or not being rude to your patients. A number of women that have been spoken to, like someone last week, she's 22, she's got endometriosis, she wanted to ask about having natural progesterone because it's very anti-inflammatory,

different to synthetic progestogens. And her consultant said, absolutely not, but I'm going to give you three choices. One is you can have a marina coil. The other one is that you need to get pregnant, or I can just remove your womb. and she said all that pain is just in your head maybe you exercise a bit more but it's like why like it's see in medicine

I don't know everything but I'm very happy to say to a patient look I'm sorry I don't really understand you know you've got all these symptoms it might be this it might be that I'm going to get some advice from another colleague I might do a test let's work it out and I think that's fine we're human beings

we're not robots so we don't need to know everything but it's just this sort of binary you know I've had patients that have told me they're doctors one lady the other The day said to me that she felt really prepared. She had download balanced that. She had the symptom questionnaire. She had lots of information.

And she said to the doctor, I want to talk about hormones. And I've learned quite a lot from listening to Dr. Louise Newsom's podcast. So the doctor folded his arms and said, right, that's wrong information. And she's a terrible doctor. And he marched her out of the room. Like, you know, this shouldn't be happening. It's 2026. You know, feels wrong.

It's almost like, I don't know, because the information you're supposed, spreading, he's helping so many people. There's this underlining, like you say, it's personal. Jealousy? It wasn't for the bigger picture of healthcare for women. It was, why should she get all the glory? Why? No, that's, yeah.

But you know, there's enough work to go around. And I'm not doing it for glory. The more people who know, the better. Yeah, absolutely. And a lot of my work is about knowledge and choice. You know, I feel like, and I'm very clear in the book, I'm really a storyteller. I'm just telling people the information.

in an evidence-based way and then they can make choices that are right for them. I'm not ever saying to people, you have to take hormones. Like I would never say you have to exercise, but you have to know that not exercising is probably not very healthy for you. Or I don't judge my patients who are drug addicts

or who smoke, but they just need to know it's not probably the best thing that they can do. Knowing and trusting your supplements is incredibly important. Thankfully, Sim Prove has plenty of science behind it with over 40 years spent research in how to improve our gut health. And because it's liquid,

Simpro's live and active bacteria can reach your gut in 10 minutes. It's no wonder 94% of people trying it feel the difference. What you're doing in a way is democratising healthcare because not everyone

are able to go and see a private menopause specialist or a private GP. I saw a private GP two weeks ago to have blood tests because I've been struggling with my symptoms again because I know book an appointment with my GP

will take a long time and when I get there you've got such limited time to persuade them that you do need these blood tests and then God knows when these blood tests will take place and whether you get the results, etc.

So you are providing the information to at least empower these women with the knowledge that they can advocate for themselves. And people don't like that and I know they don't like that. I had a meeting with the Royal College of GPs

a couple of years ago and I'm a fellow there I used to work there many years and I said I don't understand White, where this sort of antagonisms come from. And they said, the problem is, Louise, there's so much in the media and it's fueled by your work. And women are now asking for hormones instead of other people that need to come to us with back

pain and headaches. So they're blocking appointments. And I was like, well, don't shoot the messenger. It's not my fault that we're in such a dreadful state with hormonal care. But, you know, if they did do better investment and give women the hormones, that those women that wanted them at the right dose and the right type, we know that women feel better so they're less likely to come back with symptoms but also their future health will improve and we have to be really mindful of this and this is where i'm a more of a physician i'm not a

gynaecologist as you know but the last 10 years of a women's health is often in poor health so these you know inflammatory diseases osteoporosis heart disease dementia autoimmune conditions cancers you know neurodegenerative diseases like multiple sclerosis Parkinson's they all increase when we don't have hormones and we need to really be mindful of that because if we reduce the incidence of those conditions we're going to be reducing the demands on healthcare for older women which is really important well society and systemically as well it's a it's a benefit to all of us because the percentage rate of menopause or women who drop out of the workplace because they are struggling with their symptoms is shocking it's very high but it's also a lot of people are taking long-term

sick but also we did a survey a while ago and this was on NHS employees and you know that 40% of NHS employees are men and palsal women and 37% of women couldn't afford to reduce their hours but they wanted to so you can't tell me they're going to work and thinking right I'm going to do the best day ever but also like I say a lot of my work is PMS and PMDD so a lot of women I speak to have really severe symptoms for three or four days a month which you could think oh it's only three or four days a month, but you times that by 12 months a year, then you've got a month a year where they're really not working properly. And so many women tell me who are in their 20s, I've gone to a different university because I didn't get the grades because my A levels

were on a day just before my periods. I didn't complete my degree, so now I'm doing a different job. And I see a lot of women who are in their only 20s with PMDD. My daughter has it, and she's been transformed with the hormones. But one of her friends, I just saw her at a concert recently, and she's one of my patients. And she came up to me and she said, Louise, I just want to tell you, thank you, because you've completely transformed my life, but I just want to ask you one question.

I was like, yeah, sure. She said, is it really legal to feel this good every day of the month? And it's, like, it's really lovely, but then I was reflected thinking, is that sad that as women, we sort of expect not to feel great every day of the month. And so it's just normalised that you feel a bit rubbish a few days before your period,

and you can't do the same exercise, and you might sort of have more sugar craving, And all this, all I was giving for all, I am giving for this lady, is progesterone, just a natural body identical progesterone, neutral gestan, for four days a month. So I'm just topping up her progesterone, because you get this big progesterone drop before your periods. There's very simple medicine, but, you know, just seeing the way,

and she's a French horn player, you know, her life has really improved. So it's very simplistic. It's good as well to arm women with the questions they can ask if they need to, because a lot of the time, like you were, saying when you were going through perimenopause earlier on it was never spoken about now it is in mainstream media which is brilliant but so it just gives women the confidence and you know I certainly believed at one time that perimenopause or menopause was just irregular periods and you get hot that's it so I used to think I wonder what the fuss is about if that's all it is yeah and then now

knowing what we know about symptoms like we had a lady on who said she had heart palpitations it was Kate Roham didn't she? She said at one point she thought she was dying every single night. And I look back now and think my poor Nana, who would have gone through all that, and my mum and my grandma. But what advice would you give to any woman who, you know, is having lots of different symptoms,

but he's unsure of who to turn to or if it is the menopause? Because women were so busy, we're so stressed, we've got, we're spinning plates. So a lot of the time we're told, just slow down a bit. Stop doing the kids tea and stop looking after the other. and stop doing all that and it's like well you know we can't always no the most important thing is you know download balance the free app and we've got the symptom questionnaire there and if someone

it only takes a few minutes to fill out those questions because then it's all those symptoms together so if someone's got you know palpitations they've got joint pain they've got headaches they've got urinary symptoms low mood then think could they all be related because as you say the hormones go in every part of the body and then just ask yourself do you think it could be related to a It's a very simple question, but women are quite intuitive. And if they think it is, the answer is probably yes. And then the next hurdle, like you say, is who do you go and see? So, you know, usually people go and see their GP, but ask, is there a doctor that specialises

in hormones? Is there someone that has a special interest? And then just be armed with knowledge. If someone wants to take hormones, then think about the three different hormones. Go to your doctor, and I know it's only a short consultation, but say, look, I've worked out my symptoms. I think they're related to my changing hormone levels. I would like a conversation with you about hormones.

If the blood drains from that doctor's face, just say, look, I'm wasting your time. I'll go and find someone else. And you can have a second or third opinion. Sometimes people come to our clinic, not because they want to come and spend money, but they can't get help elsewhere. We write very detailed letters,

and then the GPs are more confident because then they're feeling better. They know what to prescribe. A lot of GPs go, oh, thank goodness, you've been to the Newsom Clinic. Okay, I'll carry on prescribing for you. And that works really well. because it's really like investing in your future.

It's not just like booking a holiday which you might or might not enjoy for a couple of weeks. This is really long-term health. So we've got to be, I think, as patients, responsible for our own health. And also if people are on hormones, are they on the right dose and type if symptoms are returning.

It's really, really important, but also someone that understands the importance of everything else as well. You know, when people have their hormones balanced, we spend a lot of time talking about which supplements to take or maybe not take the type of exercise, their lifestyle, all of those things feed together. And that's really important as well.

That was going to be my next question. For anyone who was still on the fence about wanting to take hormones, is there anything they can do in terms of their lifestyle to help make things a little bit easier? It's a good question. But one of my problems really, or one of the things that concerns me, so many people think that if they exercise,

and I've heard other doctors on podcasts say, oh, if women exercise really well and eat well, they'll minimize their symptoms. Now I tell you, I've seen so many women who are really healthy and then it hits them like a cliff and they really deteriorate. Other people can be okay with minimal symptoms. So you can't predict and I really don't feel because yes, your muscles will make some hormones

but not enough to replace the ones that are missing. So it's not a sort of either-or approach. It's looking at everything together. I can't imagine anyone's saying to someone who's got an underactive thyroid gland. who's overweight, who's tired. Like, why don't you go to the gym a bit more and then we'll talk to you about thyroxin?

You'd give thyroxin and then you talk to them about the gym and everything else as well. But I think, you know, people need to really realize there are two main reasons why people prescribe hormones. One is for symptom control. And as a doctor, it's fine to enable people to feel better. But the second, and I think most important the thing is to improve their future health.

And we have to really take a step back and think, well, actually, there are more risks to women of not having hormones than having them for their future health. because one in two women will have osteoporosis. So hormone replacement therapy's license is a treatment to prevent osteoporosis. You know, as doctors, we're encouraged to prescribe

blood pressure lowering drugs and statins to reduce risk of heart disease. Heart disease doesn't affect 50% of population. So we need to sort of think a bit about how can we reduce our risk of dementia and osteoporosis and diabetes and cardiovascular disease? Yeah, cardiovascular disease is number one killer globally. So we need to just think differently, really, I think.

You mentioned that your muscles make hormones. So the more muscle mass you have, the more hormones you produce. Yeah, our muscles are metabolically active. And there's been really frustratingly little research. As you know, there's a little research down in anything that's positive for women. But we know that our muscles do make hormones. And so it's interesting, isn't it? So some people who are going to the gym and exercising more probably are producing, you know, some hormones.

Which ones is it? And progesterone and testosterone and testosterone. Yeah, but, you know, our brains make those hormones. They're not just ovarian hormones, which again is a real myth. People think those hormones are only made in the ovaries. And that's why I find it a bit weird that everyone gets referred to gynecologists. One of my doctors who works with me in the NHS as well, she's telling me this morning that she's not allowed to prescribe testosterone to her patients in the NHS.

They have to be referred to a gynaecologist. It doesn't make sense. Why? It's just making the problem last longer, isn't it? And you know how many people, I mean, there's like over half a million women that are unwatingly. to see a gynecologists, gynecologists shouldn't be making a decision about a hormone that's made in other areas of the body as well.

So if you're, so Gemma and I go to the gym a lot and we lift weights. Gemma's in great shape. I'm a no, thanks, thank you. Yeah, I'll own now. I was about to put myself down, but I won't. Yeah. But I had blood test recently

and I was told that my estrogen was fine, my progesterone was fine, and I wear a patch and I've got the marina coil, but my testosterone, was a fifth of what it should be. I was really surprised because my muscle mass is 44% which is, for a 48-year-old, is, well, according to online, exceptional. So I'm going to take that as well.

So I was surprised, A, that I'd managed to get myself to that level of muscle mass with low testosterone and B, I thought the fact that I had higher muscle mass would be creating testosterone. Yeah, not enough. So testosterone declines with age, usually from the late 20s, really. And it is made in the ovaries, but it's made in the adrenal glands and, like I say, the brain as well. So there will be some conversion of testosterone and some of the tissues as well. But it is very common that people have low testosterone. And people that use the gym are metabolically more active.

And often as people get fitter, you sometimes see that they need more hormones. So I've got some patients who are marathon runners or they do, you know, ultra sport. And then just before their race, they often need more hormones because that's what our body would naturally do. You know, all our hormones work together. So if you need more cortisol, you'll need more progesterone as well. And the marina coil isn't progesterone. So a lot of people who have a marina coil still have progesterone as well because it has really important effects on the muscles, on the bones, on the brain and the metabolism as well.

So I thought the marina coil was progesterone. It's a synthetic progestogen. So it works on the womb, but it has a synthetic chemical progesterone. It's not actual progesterone. So increasingly we see people and we give them progesterone as well because it has really important effects on the body, the natural hormone, whereas the marina coil is just about keeping the lining

as a womb thin and working as a contraceptive. Wow. I never knew that. Yeah. I thought it was the progester of my HRT protocol. Can I ask a question quite personal? You might not want to answer it. Are you aware that coil's there?

No. Because again, just from things I've read, I'm frightened to death. I'm not on any contraception. Obviously then, you know, I've been with my partner nine years, so to be honest, thought of having sex, I'm like, no, that's gone.

But do you know it's there? No. The pictures of it look really painful. No, no, don't. I'm not aware of it at all. Yeah. No. I've always just wondered how it goes, how it's inserted. Because like, I know it goes high up, but for example, if you're walking around

with a tampon, you occasionally go, ooh, I'm aware that's there. But you wouldn't, oh, yeah, sorry, but you don't have periods on the marina coil anyways. You wouldn't wear a tampon, so it wouldn't. No, I'm not. aware of it. Do you find women are aware of it? Your patients? No, usually. No. I mean, but it can cause side effects because although it works predominantly in the womb, the womb is

very basculature, so there's lots of blood vessels, so then it gets into the rest of the body. And so some people are very sensitive to synthetic progestergens. So some people find their mood isn't as good with it, and they can get other side effects as well, but because it can block the normal progesterone receptors. So it does work differently. It does work in a systemic way, even though it's more localised on the womb.

But like I say, it doesn't work the same as progesterone, which is, I've written a lot in my book about how those hormones work, especially progesterone. Because I was prescribed the coil because the oral progesterone tablets were giving me terrible headaches. So I was told this was the next best thing. So is there another option available to me that's not taking... So some people think that they can't tolerate progesterone, and we have to be really careful again with language,

is it the progesterone or is it a synthetic progesterone? you probably did have progesterone orally, but if you started it when you were perimenopausal, you would have had your own progesterone as well. But with time, our hormones decline. So sometimes people haven't tolerated it before, then you try it again and they feel that it's so much better for them. The other thing is when you have it orally,

it gets metabolized into the body. Anything we put in our mouth gets metabolized through our liver. So it gets converted to other metabolites of progesterone, like alopregnolone, and people sometimes can react to that. sometimes we can give progesterone as a pezzary or suppository or there's a progesterone cream. So there's alternatives that people can have as well. And it's a lot more beneficial to have the natural progesterone

rather than any synthetic progesterogens. But like I say, some people like the marina because they don't have periods and they need its contraception, but then having progesterone as well can be really beneficial. What about women who've got through menopause without needing to take anything? Should they then be taking them? them in later life anyway or if they feel okay are they okay to just crack on so it's a real personal choice that's the most important thing people it's up to them whether they take hormones or not

but if you think about for example raised blood pressure hypertension most people don't have any symptoms but we treat raised blood pressure and lower it to reduce risk of heart attacks because cardiovascular disease is so common the same with hormones if someone has symptoms or not they're still going to have benefits for their future health so a lot of people say actually, I don't think I've got symptoms, but I'd like to take it because I know it reduces risk of heart disease and osteoporosis for example. But then when they're

on it, they often go, wow, I'm sleeping bellow, I don't have any joint pain, I've got more energy, I just feel happier and myself. So symptoms that they might have just put to life or often they realise they're related to their hormones. And we see a lot of women in their 70s and 80s who want to start hormones because there's lost generation of women.

And millions of women have missed out of hormones because these unfounded fears of that dreadful study from 2002, and some of them are mothers of our patients and it's amazing the difference that it can make to them and cognitively as well but also physically, you know, we want to stay strong as women we really don't want to fall over and break a bone

due to osteoporosis so any ways to improve our health but again it's a choice and I'll often say to people you can try it and then make a decision whether you want to continue it or not I think some people are scared because they think once they're on it they've got to be on it forever like of course you don't

and it only lasts the day that you use it So if you stop taking it, it's going to be out of your body. So, you know, again, it's easy to make a choice of something when you've had it because you often don't know what you're missing until you've got it back. So for steps for anyone thinking, after listening to this, contemplating, would you say a blood test first to see what hormones they're lacking in? Not always because if people are perimenopausal or they're having periods and they might think they've got PMS or PMDD, then hormone levels can really fluctuate.

So a lot of women are going to blood tests and then they're told it's normal. but they might be normal the time of the blood test, but 10 minutes before, two days after, the hormone level is going to change. So the best thing is seeing someone who really understands hormones. Like I say, do that symptom questionnaire, asking your head, do you think it could be related to hormones? And in the book, I've written about the whole reframing of menopause,

PMS, PMDD, postnatal depression, like we don't really need to use those words. Because what we should be asking is, am I progesterone deficient? Am I testosterone deficient? You know, like you said, your Easterdiles okay, but your testosterone's low. So rather than thinking am I menopausal, it's like, do I need testosterone? Do I need progesterone?

And then it just changes the conversation, really. And that's really important. Then we do sometimes do blood tests. And we also do blood tests to make sure there's nothing else going on. Because I don't want to blame tiredness due to low testosterone and find someone's got low iron or they've got an underactive thyroid. But it's seeing someone who can understand because blood tests are any part of their consultation, really. Did you know that 80% of customers confirm a reduction in bloating since starting SimProve?

If, like me, you're dealing with regular bloating, SimProve gets to work instantly in a quick 70 milliliter shot. Want to try it? SimProve are giving new UK customers 50% off their first 12 weeks subscription. All you need to do is use the code just as well 50 at checkout. Valid for new UK customers only. So Louise, the conversation has evolved rapidly in the... last decade, what do you hope will happen in the coming 10 years and where will we be in 20, 36? Yeah, I would really, really love it. If everybody who wanted hormones could have them without a battle, that's all.

I just think even that would make such a difference to the health of women. Yeah, it's good. It's a good one to round up on. Yeah, well, it's been a joy. Thank you so much for coming in to see us. Thank you. Thank you for continuing to use your voice and platform. Despite that, I think the fact that you're still empowering women

and screaming all the knowledge from the rooftops, and with this book as well, you've got your clinic, your app, the Instagram, I think you have to keep doing it because, you know, it takes a village to raise people up and you've got a massive village behind you of women screaming with you. So, yeah, keep doing it. Thank you. Before we let you go, we do have our quickfire questions.

Oh, yes, this is the fun part. Yeah. So me and Claire are coming to yours for tea tonight. We've just decided what are you going to make us? I would probably cook you a kedgery actually because I know I've got macrol in the freezer. I've got peas in the freezer. I've got rice.

We have someone that delivers eggs for us and I know there's some eggs at home. So it would be, and I've got herbs. So it would be really easy to just make your kudgery. Does that be all right? Yep. Lovely. Perfect. You go into a desert island for one year and you can only take one thing.

What would it be? It would have to be my hormones. Yeah. It's because I couldn't function without them. I absolutely couldn't function without them. And I have a cream now that's got all three hormones in them. So I could just take my one cream. That's all.

Otherwise my brain would go. And my muscles would go. I get really bad joint pain and stiffness if I don't have the right hormones. And then I couldn't do yoga. So I'd be pretty useless without my hormones. Practical answer. You can only drink one of these for the rest of your life, coffee or wine. But I don't drink either.

Do you not? No. That's an easy one. That's easy. I'm really dull. I have water and I have herbal tea. Because I have bad migraine. I really care for what I eat, what I drink.

I've really played. It's a devil and it's a sort of blessing and a curse actually to have migraines. I would love never to have migraines again. But it means that I can't just have a sweet treat. I can't just have coffee because it will trigger it. So no. So I'm fine with neither. What's the last thing that made you belly laugh?

Oh, God. I really don't laugh very much. I'm really quite miserable most of the time. My daughter's been, I've been watching that program, what is it? What's it called where you, the celebrities don't laugh. That's it. That's made me really funny. That's made me laugh actually because it's so ridiculous.

So that's, and it's, because you're not expecting to laugh, it's quite, yeah. Yeah. So probably that. And the final question, what's one thing someone who's listening now can do to make themselves feel a little bit better? Oh, they should share how they're feeling and talk to others. But do something about it. Don't just share and normalise the conversation. Even if it's not them suffering, find someone you know who's suffering

because someone somewhere will be having hormonal changes and won't even know it or they won't know how to get help. So help someone else. Helping other people is just the best feeling ever. And on that note, that's just as well, Louise News. Thank you so much. The book's available now, The Power of Hormones. And do come in again and see you.

Yeah, thank you so much. Thank you. Thanks.