The Dr Louise Newson Podcast - 12 - HRT, misinformation and navigating the menopause media minefield with Kaye Adams

Episode Date: June 21, 2025

'I'm a journalist, and I'm always trying to make sense of stories... that's just how my brain works. But I've never been able to make sense of this one... the whole HRT story, the information women are given, and the choices we make based on information we're not entirely sure about. I've always felt that was just unsatisfactory. So that overview from you, I have found really, really interesting’.In this week’s episode, Dr Louise Newson is joined by broadcaster and journalist Kaye Adams — a familiar face from ITV’s Loose Women and host of the How to Be 60 podcast — for a candid and deeply insightful conversation about navigating menopause in your sixties, the vital role of hormones, and the ongoing confusion around HRT (hormone replacement therapy).Drawing on her background in pathology and neurophysiology, Dr Louise unpacks decades of overlooked science showing how hormones like oestradiol, progesterone, and testosterone influence everything from brain function and inflammation to bone health and dementia risk. She explains how hormones deficiencies can create a perfect storm for disease, and why understanding their role at a cellular level is crucial for women’s long-term health.Together, Dr Louise and Kaye address the persistent fears around breast cancer and HRT, revisiting data from the controversial WHI study. Dr Louise explains how misinterpretation and media panic have caused widespread confusion and lasting harm to women’s health. Dr Louise also highlights the significant reductions in risks such as cardiovascular disease and osteoporosis that HRT can offer, questioning why compelling evidence is still often ignored by mainstream medicine.Kaye shares her personal reflections and doubts as a woman navigating healthcare in a landscape clouded by misinformation. Their discussion becomes a powerful call for clearer, evidence-based communication, encouraging women to feel empowered, not frightened, when considering treatment.Available to watch on YouTubeWe hope you love the new series! Share your thoughts with us on the feedback form here and if you enjoyed today's episode, don't forget to leave a 5-star rating on your podcast platform.Email [e-mail] with suggestions for new guests!DisclaimerThe information provided in this podcast is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. The views expressed by guests are their own and do not necessarily reflect the views of Dr Louise Newson or the Newson Health Group.  LET'S CONNECT Website: Dr Louise NewsonInstagram: The Dr Louise Newson Podcast (@drlouisenewsonpodcast) • Instagram photos and videosLinkedIn: Louise Newson | LinkedInYouTube: Dr Louise Newson - YouTubeCONNECT WITH KAYE ADAMS Podcast Website: How To Be 60 with Kaye AdamsInstagram: Kaye Adams (kayeadamsofficial) • Instagram photos and videosSpotify: How To Be 60 with Kaye Adams | Podcast on SpotifyYouTube: How To Be 60 with Kaye Adams - YouTube

On the podcast today, I've got Kay Adams, who's a well-known presenter of loose women and a journalist. We talk a lot about what it's like being menopausal in your 60s, whether you should be taking hormones or not. What questions you might be asking yourself and your healthcare provider. Lots to think about. And she's certainly gone off after the podcast to reflect a bit more. So thank you for coming. Last time I spoke to you was on a screen because I was on your podcast, actually. Yes, you were, weren't you?

That was a couple of years ago when you took questions. which was great. Yeah, it's really good. Which is interesting because obviously my postcard decided to be 60. So I wondered how my demographic would, you know, which direction they would go in. But there was so many women, as you well know, thinking, right, okay, here I'm at that age, what am I doing? Or people whose symptoms have persisted and were saying, I thought we came through this thing. Yeah.

And they hadn't. So it was really interesting. Yeah. I think it's really interesting because a lot of the conversation, Well, it's always been, but it seems to be more at the minute, that the menopause is a transition. It's a process. It's something we go through. I've recently been in America and I met a whole group of great women in New York and they were like, oh, gee, I'm through my menopause.

It's like, are you? Well, you're not dead, so you can't be. And they're like, what do you mean? And it's like, well, you know, if you actually look at the definition of the menopause in the traditional sense, it's a year since your last period. So it's only one day. Right. Do you know what I mean? Or is it a day or is it an hour?

Is it a second? Like, no one really defines it. I mean, it's just rubbish, actually, being defined by your periods. Do you know what I mean? Yeah. It's so archaic and it's so somebody in an ivory tower deciding this will fit into some diagnostic criteria so we can tick that box as doctors, you know, Mrs. Adams, have you had your period? No, it was 11 months and, you know, two days ago, well, come back in 28 days and I'll give you this diagnosis. Like, it's stupid, isn't it?

And also, lots of women don't have periods, you know. If you've had a hysterectomy or you've got a marina colon, how then do you know? So, but then the conversation is, well, what is menopause? And we know, obviously, a hormone levels decline. They reduce because our ovaries don't work as we age, usually. So then once those hormones are low, they are low forever. So it's not just about symptoms. And I think that is a big issue in my mind because I'm a physician, not a gynaecologist.

So I'm not actually thinking about it. periods all the time. I'm not thinking about the gynaecological organs all the time. I'm thinking about every single cell and organ in the body. It's very interesting thing to say actually because you know it tends to be defined in terms of symptoms doesn't it? Do you have hot plushes? Do you have low mood? You know and are your joints taking? Have you got brain fog? Et cetera. Those are the symptoms of menopause and I suppose for me one of the big decisions that I had to to take was I don't feel, though friends contradict me on this all the time, I don't feel that I had particularly marked symptoms. You know, in the sort of terminology that I'm sure you would say his old hat,

I didn't have a bad menopause. And yet I did go on HRT relatively late. I think I was maybe 57, 57, the years were all by. You know, but well past that point. And, and I was, I was, maybe 57. And, I suppose to a certainly extent I've always had an element of not guilt but should I really be on this stuff because I didn't have terrible hot flushes

okay I had a wee bit of night sweats it wasn't too awful did have a bit of brain fog to be honest but my brain is back my brain is definitely back I'm always waking up in the middle of night I remember that name and I had very low mood for six months That was the most marked thing.

And that was very much around the time of my period stopping. Right. But, you know, compared to what you hear from some women, it was mild. Yeah. So why am I on HRT? See, this is a great question. I'm so pleased that you've brought it up, actually, because lots of people say this.

And because, you know, a percentage of women do have a dreadful time, and I mean really dreadful. And we often hear about those women because improving their symptoms is literally life-changing. or life-saving sometimes, then people that have mild symptoms almost feel guilty. But you see, the other thing about menopause

is it's not just symptoms, it's about low hormones, and those low hormones are biologically active in our body. So with those hormones, it helps reduce inflammation in our body, it helps keep our organs really healthy. So the other reason for taking hormones is reducing our risk of inflammatory diseases,

of which they're a load. And the commonest is osteoporosis affects one in two women, but also heart disease, increases by around a factor of five when we're menopausal. So we're five times more likely to have a heart attack. Commonest cause of death in women globally is heart disease and dementia. If we don't have our hormones, we have an increased risk of dementia as well. But we also have an increased risk of type 2 diabetes, clinical depression, schizophrenia, autoimmune diseases, Parkinson's, cancers.

Like the list goes on and on. And I'm not trying to take a dig here, but is there a medical consensus on that? Yeah, we've made it for decades. And this is what's really interesting, actually, because I'm talking about hormones here. I'm not talking about HRT. I'm talking about how our hormones work in our body. So I've got a pathology degree as well as medical degree. Pathology is the study of disease.

So I spent my whole time doing the degree learning about inflammation and the way that our cells work to protect us and keep us healthy. I learned a lot about how when our cells don't work well, we have this increased inflammation. we have increased risk of cancers, increased risk of cardiovascular disease dementia, like how it works in a cellular level, like really geeky, like right down to the cells. And we have these cells called macrophages,

which really are like our gatekeepers for inflammation. So if we're fit and well, everything's going fine, then it's stopping inflammation. Anything that might eventually turn to cancer, it's gobbling those cells up and like giving us new ones all the time. Whereas if our environment

changes. So if you smoke 20 a day, those cells are going to be exposed to chemicals that they don't want. Then they might mutate. They won't work as well. The macrophage has become quite angry and inflamed. And then they turn against some damaged tissue. So we know it's no, it's not rocket sites, isn't it? Smoking. Too much alcohol, not exercising, inflammatory diet. Sometimes genetics, like if you've got poor genes, then you're going to have this increased risk. But guess what? those hormones will change that microenvironment. So if you have low estradiol, you've got increased inflammation in your body. And we've known that since the 80s.

We've known that for many, many years. That's the way the hormones work. We also know that progesterone and testosterone are the same. But also in our brains, for example, I'm very interested in neurophysiology, the way our hormones work in our brains. The hormones are made in our ovaries, for sure, but they're also made in our brains. And that will reduce with age. and our hormones will help the nerve pathways to work.

They help the neurotransmitters, the sort of transmission of chemical messages from one part of the brain to the other. They'll help reduce inflammation in the brain. They help the blood flow in the brain. So that in itself is really important. And then when you think, oh, hang on, dementia is far more common in women than men.

Why is that? Is it related to their hormones? And we know that men with low testosterone own, far more likely to have dementia as well. So like what is going on here? So this is where it's like basic science has forgotten because everybody's thinking, oh, HRT, should I take it, should I not take it? I'm really confused. Are my symptoms bad? What type of HRT am I on? But if you go back and think, what do those hormones do in our body? And the problem is in some ways is that we're living so much longer as women. In the Victorian times, we didn't really live very much longer past

our last menstrual period. So we didn't have this like, oh, I'm sitting here in my 60s thinking, do I take hormones or not? But I sometimes say, when I'm teaching like other doctors, when they say, oh, well, it's just about symptoms, I often compare it with raised blood pressure. So if someone had hypertension, raised blood pressure, they often don't have symptoms. They might have a bit of a headache, but usually they have no symptoms. And as you know, every doctor always changes to blood pressure.

So if your blood pressure is high, we can. Give blood pressure lowering treatment to reduce the risk of heart disease and stroke. So if you had raised blood pressure, you probably would feel quite happy taking a blood pressure treatment. And I would say to you, well, as long as your blood pressure is high, we'll continue the treatment. And you'll go, yeah, okay, it's not causing any side effects, I'll crack on. So lowering blood pressure will reduce the risk of a heart attack by about, depends on the drug, between 20 to 40%. you taking HRT lowers your heart disease risk

by about 50%. So it's more effective than taking a blood pressure lowering treatment. I mean, it's really interesting to listen to you rhyme off all those various ways that hormones impact on your body and, you know, the beneficial effects

it can have. Because, you know, aside from the gill and should I be, whether, I mean, and I think a lot of women will be in my position. The single, single reason, that I am nervous of it is breast cancer. And not even just cancer, because of course, you know, your cells, you know, any cells could sort of turn, particularly specifically breast cancer.

That is my single... You're absolutely right. It's the biggest reason why people don't want to take hormones. So this again, I'm really happy to explain. And I sometimes play mind games and I think if I was a Martian, If I was like from outer space and I came and I didn't know the evidence, I didn't know any science, I didn't know any medicine, I would then be asking a few simple questions. So here it goes. In 2000, year 2000, about 12, 1 in 11 women had breast cancer. H.R.T prescribing was about 30% of menopoles of women in the UK, about 40% in the US.

So then this study happened, 2002, HART prescribing stopped because people were scared about breast cancer. So now 23 years later, about 14% of menopoles or women take HRT, so half here. In the US, it's about 5%, so it's really fallen off a cliff. So do you think breast cancer incidence has increased or reduced? Well, they should have reduced.

Precisely, but it's not. It's now about one in seven women. So firstly, that tells you that not all breast cancer can be related to HRT, because a lot of women take it without. The other thing is the commonest group of women who get breast cancer as a generalisation are postmenopause or women. So women who are menopause or not taking hormones. If the hormones were a problem, younger people who have higher levels of hormones, natural hormones in their body, especially pregnant women, would certainly have this increased risk, which we don't see. So the other thing is, which is the saddest thing in my mind, is the misreporting of this study. So the WHO, the Women's Health Initiative study, you know, the media reports breast cancer, breast cancer.

And then they put this black box warning in the US and over here we've got this warning. You know, you're only opening up your patches and it says risk of breast cancer. And it's just been the biggest car crash to women's health because they didn't analyze the data initially properly before it went out to the the media. Like I have never known a media press release of any other study that's been done. And was it a single study? So it was a big study. It was a big study. It was a billion dollar study. But what they did was they were trying, everyone knew how beneficial HRT was. They knew in the 1940s that it was beneficial for bones. In the 1970s, they had this great conference showing, guys, it reduces risk of heart disease, diabetes, obesity, dementia. I've read all the minutes from the

meeting it's like people would just bring it on bring it on wonder drug it was so people were taking it was it was a number one selling drug in the US it was just incredible and then they thought well actually if menopals are doing so well let's try it in older women so then they decided in their wisdom to give it to older women to see if it had the disease preventative effects but the average age of the study was 64 starting HRT but also a lot of these women were overall weight, a lot of them had had heart disease. And they were given, this is the big thing, they were given the wrong type of hormones. So they were given the conjugated equine estrogens, so pregnant horses urine estrogen,

which contains far more than the estradiol that's in patches and tails. But the biggest mistake was they were given a synthetic progesterone called mojoxypogesterone acetate, which is a man-made artificial progesterone, which, by the way, is in loads of contraception. And that is the hormone that increases clot risk, increases stroke risk, and probably, because it wasn't statistically significant, increases breast cancer risk. When they followed the women who'd had a hysterectomy and only had estrogen, even though it was a pregnant horse's urine estrogen, they had a 22% lower risk of breast cancer. But that didn't make a press release.

It wasn't on the front page of the papers. but that's, you know, good quality studies. But also the other point that you make about contraceptives, I mean, I went on the pill when I was 17, and I think I was on the pill until my mid-30s, never gave it a thought, you know, never gave it a thought. And clearly it's a hormone treatment, isn't it? But at no point, did I concern myself?

I think younger women think about it differently, and I don't know what's happened, because that boat has sailed for me, clearly, because my daughters talk about it differently from the way that I did but when I was going to university I was the same you went on the pill

yeah I mean I was the same I went on it and I looked back and I was like why why was like because I didn't know but even as a doctor I didn't even realise there was a difference between natural and synthetic hormones because no one taught me

you see because it's called progesterone only pill but it's not progesterone it's a synthetic progestogen we talk about combined pill estrogen and progesterone it's not it's well there's one type that contains Eastadile but most people don't use it

so most of it is synthetic so it's even worse because it blocks the receptor so your natural hormone doesn't work and it doesn't help the inflammation in the body so it's actually greater risk yeah I know it's incredible but the other thing about the study

what they didn't say and they did have the data from the start was breast cancer like this breast cancer risk was so not it wasn't statistically significant anyway, but there was a 30% reduction in bowel cancer in this study. Like, that's really important. No one talked about that, but they also showed that there was a reduction in osteoporosis that affects one in two women.

And, you know, osteoporosis is really important that we need to protect our bones. Because if you have an osteoporotic hip fracture or you were diagnosed with breast cancer, which do you think has got the worst outcome? Well, I think it's the hip fracture. Yeah. Then one in five women after an osteoprotic hip fracture died in that first year. That's far greater mortality than any type of breast cancer. Yet, you know, because we're not thinking about it the same way.

So was it a great conspiracy or what? Yeah, well. Wouldn't. Yeah, we begin talking about that, yeah. Yeah. But it's, but also now we don't even prescribe those types of hormones. But the problem is, when you look at some of the guidelines, you look at some of the evidence, they'll lump it all together. And they'll say there's a risk of stroke and clot and breast cancer in HRT.

And then me being really geeky, he's like, hang on, which type of hormone replacement? Are you talking about the synthetic or the natural? And it's completely different. The other thing that they found in the study, which again wasn't really reported externally very much, There's if women did develop breast cancer taking HRT, their outlook was better, their prognosis was better. Wow. Which again is really important.

If one in seven of us are going to get breast cancer, like it's one thing having the diagnosis, but there's another thing actually dying from it. I think the other thing that contributes, though, to the fear factor is that generally you hear if a woman is taking HRT and then is diagnosed with breast cancer, the immediate advice is to come off the HRT. So, I mean, that signals to people that that is the problem.

Of course it does. Of course it does. But again, that's fearmongering because everyone thinks that estrogen causes cancer because we talk about estrogen receptor positive breast cancer. But we have estrogen receptors all over our body. So if you have an estrogen receptor negative breast cancer, it's actually a worst prognosis usually because the cancer's mutated the cells. So the receptor status has lost.

Right. So we've got estrogen receptors everywhere on our body. And then some of the treatments for breast cancer do block estrogen, but there are different types of estrogen. And that's where it gets more complicated. So the type of estrogen that's in pregnant horses urine, but also type of estrogen that we produce if we don't have our natural estradial is eStrone, which is very inflammatory.

So some studies have shown that it's the eStrone, not the estradiol. So if you're not having hormones, a lot of people put on weight. the fat cells produce eStrone, which increases inflammation, more likely to have breast cancer as well. So, you know, it's really interesting, isn't it? And it's such a shame that our natural estrogen has been labeled as a carcinogen.

Like, how does it cause cancer? Like, do you know what I mean? This out of space sort of, you know, Marshall that you're thinking about, like it doesn't, like, why would any other hormone cause cancer? And that's been the, real problem and you're like you're right people people are scared but I as a menopause woman I'm really scared about osteoporosis that's my big fear actually especially of my spine

because if I fall over and fracture my hip hopefully I'll get over it I'll be the four out of five that will keep going yeah but on this on my spine like what do you do then when you've got these micro fractures and I I also used to every week go and visit women in nurse it's always women in nursing homes and they'd be sitting and they'll be rocking a bit and they've smell of incontinence And I just thought, I just want to do everything I can to reduce that risk. Yeah, avoid that. Yeah. Yeah.

And they might have dementia as well. Yeah. Yeah, precisely. And I've just done a presentation for some healthcare professionals about the risks of not having hormones. And I think this is a conversation that needs to be had more actually. It's like not controlling your blood pressure. You know, you don't have to take treatment, but, you know, your risk of heart disease will increase. But especially the risk to our brains as well is the biggest, you know, the brain is the biggest.

you know, the brain is the most important organ in our body. And, you know, the diseases of aging are the same as the diseases of inflammation, are the same as the diseases related to low hormones. And I think this is the thing, when people almost like you're saying, you feel a bit guilty taking hormones or do I stop, sure you can stop. But the studies do show that in the first year after stopping HRT, there's an increased risk of clot and heart attacks. It's almost like the body's used to this reduced inflammation.

inflammatory state and then without hormones it increases inflammation. Wow. Which a lot of people don't realize. No. But also you'll have that accelerated bone loss. So you'll lose a lot of bone, this increased risk of osteoporosis will occur. So would you take it for life? Yeah.

Yeah. I mean the guidelines are you review people every year. If benefits outweigh risk, then you carry on. And for most women the benefits do. And it's the same way, like if you had an underactive thyroid gland, we would give it for life. if you were type 1 diabetes, we would give you insulin for life. Actually, if you had raised blood pressure, we wouldn't necessarily do it for life because your blood pressure might come down.

But again, that's why thinking about as our hormones are biologically active throughout our body. And I think because it's always been associated with periods, associated with flushes and sweats, people don't realize the other symptoms. And we see a lot of women in their sort of 60, 70s, they say, oh, I'm through the menopause, I'm fine. And then I say, well, what's your sleep like? And do you get up at nighttime to have a week? Oh, yes.

Oh, I'm bit stiff in the morning. And I've slowed down a bit. And, you know, I've had six urine infections this year. And, you know, then you give them hormones because they, you know, to try. And then six months later, they're like, wow, you know, this is, I never thought I could feel like this. Oh, my God, you've given me food for thought here, I can tell you. But it's important to think, no, isn't it? I mean, I'm very much, like, it's about choice.

I have, I'm not going to lose sleep. I hate to tell you whether you're. take hormones or not. But it's, I would lose sleep if you stopped it because you felt bad because you're in your 60s that you're taking it. Do you see what I mean? Yeah, no, it has to be an informed decision, doesn't it? Absolutely. But I think, I often say to people, look, one in seven of us will get breast cancer. And if you get it, actually, firstly, like I say, your prognosis is going to be better. And there's always treatment options, but it doesn't mean that your HRT has caused it because if you're on body identical hormones, there's no evidence to support that.

Yeah, it's funny actually, sadly, a friend of mine has been diagnosed recently who was on HRT, and it was the first question she asked. And again, I mean, that's the thing. HRT is always in the frame. You know, if they're looking at a list of suspects, if you think of it that way, then it's always going to be, you know, there in the identification line. So that was her first question. And I think the response she got was, no, it probably didn't cause it,

but given that it is now there, it will feed it. that was a line yeah and again there aren't any good studies there's studies for a while actually that when people have eustodial in their system the cancer doesn't grow quite as quickly

and it sort of calms it down because it reduces inflammation and before they had tomoxophen high dose tablet estrogen was a treatment for breast cancer and I've seen these amazing pictures of like really quite disfiguring breast cancer it's coming out through the skin

and resistant to any other treatment they didn't have the drugs that we have now this was in the 60s and 70s and people given really high doses where they felt quite ill because the doses were so high and there's cancer just shrunk you know you can't see it it's amazing

and that's when tomoxophen started because tamoxifen actually increases estrogen as well as blocking some of the estrogen receptors but a lot of people don't realise that either I mean you know obviously you understand it from a medical perspective but I mean

even in the explanation you've given for lay people, it is immensely complex. And at the end of the day, as lay people, we rely on the medical profession to take all the information, to read all the studies, and, you know, to understand it, and then present it to us in a way that we can understand and make sense.

And, you know, well, my job is, so I'm a journalist, so I mean, my job is to communicate. And I do find it enormously, frustrating, like from my personal point of view and professional point of view that I think most women out there will say, something's not quite right here. It's really

hard. And they're not entirely sure what's not quite, there's just, it just doesn't smell right, it doesn't sound right, you know, there's just something off about this conversation around HRT, but they're not quite sure what. And I think from that point of view, I think all women

have been let down because at the very basic level, you know, I think we're very fortunate in this country, aren't we in a Western world, but we're at least entitled to reliable information, professionally appraised and, you know,

communicated in a way we can understand it and believe it. Yeah. And I don't think we're getting that. I absolutely agree with you. It's a really noisy space, actually. And then, you know, we haven't even talked about testosterone, which causes even more confusion.

And, you know, I'm like a really annoying inquisitive two-year-old like if something doesn't fit with me and I've done it in all walks of medicine is I go back and look at the evidence but I also go back and think how does it work in the body what's going on like what are the mechanisms and then it's really easy to unpick but I've worked as a medical writer for 28 years and I've written books on evidence-based medicine so I'm I'm like annoyingly fast at reading data and understanding it and and looking at like which is the good studies and which are the bad studies and and who's got bias and who's written this and what are their conflicts.

Because all of this builds up a picture, but most doctors haven't got time for that. You're, I mean, you're not a lone voice. I mean, there's lots of people who agree with you. But having said that, you're probably slightly outside the mainstream. Does it frustrate you or how do you feel about the fact that there is still a large body of the medical profession that is skeptical, despite, you know, a new understanding?

And I'm sure you know the story of Simmelweis. Do you know the story of Simmelweis? He was an obstetrician from the late 1800s. All right. Friend of Edelweiss. Yeah. So he was very interesting because they quickly realized that the women who are having babies from midwives, the women and the babies had a lower mortality than the male obstetricians that were delivering them.

And they couldn't work out why. My mum was a midwife. I think I might know the end of the story. So they didn't know about germs then either. But what the male. obstetricians, of course, did all the autopsies. They did all the post-mortems. But they weren't wearing gloves and they had very dirty aprons.

But then when they would deliver the babies from the mother, they wouldn't wash their hands and they would keep their aprons on. So I don't need to tell you that there were germs flying everywhere. So he suddenly realized that the women, obviously the female midwives were not allowed in the autopsy room. And so they, you know, usually washed their hands and did whatever. So then he just said, well, handwashing is. was going to make a big difference.

And they said he was mad. They said he was ridiculous. They stopped him going for medical conferences. They stopped him working. They stripped him from his license. He ended up beaten to death in an asylum, actually, in a straitjacket. And look, what's made the biggest difference, you know? And so with a lot of this, you know, a lot of it is just basic science.

I'm not talking about a new drug. I haven't, you know, made pregnant horses urine. I haven't made an artificial hormone. I'm just talking about how natural hormones work in our body. So I have enough insight to know that I'm not doing anything like out there. Yeah. I'm not controversial. I'm gestating facts.

But I can see quite sometimes how he went mad because I do drive myself mad sometimes thinking, well, what am I, what have I like learned that others haven't? Like it's almost like there's this willful blindness where people don't want to like look the evidence. They don't want to look at basic physiology because they're too busy saying HRT is dangerous without actually understanding why they're saying that. I do think about that with you sometimes though. I mean it's interesting that you say no no no no you're going mad but there is a sense of frustration from you because you've kind of been on the scene for quite a while. They've been so you know different documentaries and of course Devinas documentary was was a big one and you know

I think there is a much bigger conversation out there than there was. certainly 10 years ago, but it still feels as if there is a level of resistance. And to be, you know, upfront about it, you know, maybe looking at you, they're like, oh, this, whatever. And I just wonder how you respond to that. Yeah. I probably won't answer you, honestly, because I'll just get upset. But, you know, I think the other thing is, you know, I don't work with farmer.

I don't have any conflicts. I haven't got another agenda for any of this. Yeah. And I think that's a really big issue. and you know, you can just see the number of menopause, supplements, and everything else that's going out there. I think the big thing that is changing there is that women are making choices for them.

And, you know, I do yoga most mornings and do a headstand. I don't expect people to do that. But if they do, they'll feel great and it will really help them. I take hormones because I want my brain to function and I'm scared of osteoporosis. I don't mind whether people do it or not. Do you know what I mean?

Yeah, absolutely. And I think this is where medicine's changing because, you know, journalists you see like people who have access to information they didn't have before and for some doctors they find that very threatening most yeah we do have access to a lot of information but we don't always have the skills and knowledge to interpret that information and that's a big difference and that's where we need you know the medical profession to do that job for us and to do it in a way that we can trust and i i i don't think we're getting that to be honest and i think that is a great shame and and it just

I'm sure it happens in other spheres of health, but I can't think of one that's quite as wide-ranging. I can't tell you another medical guideline that is mostly ignored. You know, all the guidelines, national, international, it doesn't matter what you read are menopause. They will say first-line treatment for menopause, for the majority of women, is HRT. Globally, 5% of menopause or women are taking it.

So if you read a blood pressure, guideline... Well, here's the thing from a journalistic point of view then, what stands out to me on that is why because as you say the pharma business is the most lucrative isn't it i think in the world so surely if pharma if it was one entity felt that it could make zillions and millions and trillions

they won't make money out of hrl t though because the natural hormones they are just natural they can't they can't make a different version of them they're off-paintant so they're dirt cheap so the only way of making money is a new new menopause treatment that won't be hormonal. Right. Now, this is interesting. So then that puts it into another sphere, you see.

So the HRT and the form that you would personally recommend is not necessarily a profitable drug. No, it doesn't cost much money at all because when I, if I was making a drug, like Viagra, for example, you have the drug and it's called, it's a trade drug. So it's not generic. And only that drug company can make. They've got their secret recipe. Yeah.

And it's usually, depending, it's usually a couple of years or so, and then it goes generic and anyone can make it. So the other name for Viagra is Saldanafil. They always have the weird names for the other ones, so no one remembers, so you always go to Viagra. But then it means other drug companies can make it. They'll still make money, but they won't make as much. And it's like any drug treatment is like that.

But because it's a natural hormone, you can't call it something else. It's estradiol, it's progesterone, it's testosterone. It's testosterone. So it's cheap. So why is farmer? You're going to make far more money out of other drugs. That is really. I've never heard that before.

Yeah, there you go. So that is interesting because as you say, when you look at the menopause supplement market, it is vast and growing by the minute, isn't it? Yeah. And a lot of money has been made there. Absolutely. Billions and millions.

Because you can sell anything as a supplement because it's not a drug. So there's a lot to think about But I'm wondering At the end of this There's three take-home tips I'm just wondering What three things you might have learned on this podcast

That you can take home with you Okay well That is number one I have to say Because You know I mean So I'm a journalist And I'm always trying to make sense of stories You know that that's

That's the way that my brain works And I've never been able to make sense of this story you know, in terms of the whole HRT story and the information that women are getting and the choices that that we make based on information that we're not entirely sure about that. You know, I've always felt

that that was just unsatisfactory. So that overview from you I have found really, really interesting. And, you know, they say that about so many things in life, don't they follow the money? If you want the answer, follow the money. And so that's my number one. that's where the money is

well I mean that in my six days and you know not conscious of any terrible symptoms of the menopause that actually I can still look at it as something and I don't know what I'm going to do to be honest

I mean I will probably go for some kind of I've had blood test taken recently actually for a different reason and touch with everything everything seems fine. But, you know, it's good to check in with your health. So, you know, and I don't think you should be casual about these things. So, I mean, it is something that I'm going to think about. But you've given me a lot of food for thought in terms of where I am right now in my life.

And my feeling was, oh, I should probably think about coming off it. Just based on that sort of looming shadow. You know what I mean? Yeah. Enough of this now. So there you go. That is number two. and what is number three?

Well, sadly it comes down to, you know, women may be not getting the information that they need and deserve, you know, and that's something that we should all be really concerned about. Because flipping to the other, my two daughters, one's 22 and one's 18, not going to reveal their contraceptive choices. But, you know, obviously, you know, I'm interested in their health going forward.

And when I think how casually I took the contraceptive pill, I really didn't think about it. Has it had any negative effect on my long-term health? I have absolutely no idea. You know, I mean, it was just like convenient, lovely, thank you, off I go. And for them, I would hope that they would have more information in terms of the choices that they make. And so they sort of feed into each other.

don't they? Absolutely. Knowledge is power at the end of the day. Thank you for joining me. It's been great. Yeah, no, that's fascinating. Thank you. Subscribe to my newsletter for exclusive insights and updates on new episodes.