The Dr Louise Newson Podcast - 13 - HRT after 60: myths, facts and finding your own path with Ann Newson

Episode Date: June 24, 2025

In this week’s episode, Dr Louise Newson is joined by her mother, Ann Newson, for a candid and deeply insightful conversation about HRT after 60, as requested by some ofour viewers.  Together, Dr Louise and Ann address the persistent fears around breast cancer and HRT, revisiting data from the controversial 2002 WHI study. They also explore the crucial differences between the older forms of synthetic HRT derived from pregnant horse’s urine and today’s body identical hormones, which have the same molecular structure as hormones produced by your body.Ann reflects on her own journey with menopause, shaped by a generation that ‘didn't talk about health issues... periods were “the curse” and menopause was just “the change”.’ She shares powerful memories of struggling through exhaustion and that at times, coping was simply putting ‘one foot in front of the other’. Together they explore why stopping HRT after the age of 60 should be an individualised choice. Ann also shares her own experiences, frustrations, and how hormones could have possibly impacted her relationship with her daughter, without even realising it. With warmth, humour, and wisdom, this episode champions the importance of informed choice, patient-centred care, and the right to feel well at any age. Read more about HRT in later life on Dr Louise’s website here, and an article on the difference between natural and synthetic hormones here.We 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! Disclaimer The 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 Newson Instagram: The Dr Louise Newson Podcast(@drlouisenewsonpodcast) • Instagram photos and videosLinkedIn: Louise Newson | LinkedIn YouTube: Dr Louise Newson - YouTube  Resources  https://www.drlouisenewson.co.uk/knowledge/hrt-in-later-life-or-after-menopause 

On the podcast today, I'm with my mother, and we're talking about taking HRT as an older person. Of course, I don't mention her age, but lots of times she's tried to have her HRT taken off her by various GPs. So we're just talking about choice. It's a good episode, and I hope you enjoy it. So you're here in the studio. Last time we did a podcast was a while ago, and we did it actually on my sofa at home, didn't we? That's right, yes, and I wasn't expecting to do it. I came downstairs and we're doing it.

Like, oh, wait, I'm not ready. And now we've asked because by popular demand, we have had a lot of questions from people that listen to the podcast asking about, no disrespect, older people, what happens? Excuse me, I'm going to interrupt you right from the beginning. I like the word maturer, not older. Okay. Because I think things like cheese and wine improve with age,

so I'm hoping I am. Yeah, of course you are, mother. Yes, thank you. So lots of people have actually asked, I'm over the age of 60, is it too old to take HRT? And I know I'm not allowed to mention your age and I'm not going to.

But someone said to me yesterday, Louise, you are nearly 55, so your mother is going to have to be over 60. Well, I was a child bride. Yeah, but even so, pretty hard. So I'm just really keen to, like, unpick it because I see lots of women and I speak to lots of women

who have missed out, if you like, on HRT because lots of the listeners know about this WHOHI, the Women's Health Initiative Study that came out in 2002. And HRT prescribing was really high and it was increasing. But it fell off a cliff because of the misreporting of this awful study. So lots of women. Yeah. So lots of women then were stopped.

So you've carried on, which is great. And we'll talk about that in a bit. But actually, you were really lucky to. to have been prescribed HRT, like almost from the beginning? Well, when I initially went to the doctor, my doctor, he's in my day, of course, as you know, it was called The Change. Yes. The doctor said, oh, don't worry, you're just on the change.

And I was teaching drama to students in London, and I just felt so exhausted and on reflection, probably depressed as well, and having to juggle all sorts of things in my life. So I went to another doctor. And this doctor, she was a she, the first one was a he. I shouldn't say that, but it's true. She said, well, try HRT.

So I tried it. And I just came back to life and I could cope. Well, you must remember that. I think I was about 15. Yeah, something like that, you know, sort of the exam term and everything. Yeah, because, I mean, some people listening, no. But, you know, Daddy died when I was nine. you single month three children

John was my brother was only two you were working as a teacher there's lots of reasons why you could be low in your mood and struggling oh absolutely so when he said the change did you know what that meant well yes because you know one didn't talk about health issues

when I was young I didn't you know talk about periods it was a sort of secret word the curse she's got the curse but then and you know some of my mother's friends, especially one in particular, I can remember her sitting in her living room pouring with sweat and really low and depressed. And my mother said, well, she's on the change, you know. So that's what I knew about it.

But I knew, you know, after daddy, I had to pick up life and carry on and was teaching. So I knew I could do it. But suddenly it hit me, this energy loss. this, as I say on reflection, depression. I didn't have the hot sweats or anything. I can't remember whether my periods had stopped or not, but that to me is irrelevant. The fact I was having to cope with life.

And it was so incredibly hard, I can remember, you know, having to catch the train up to London. And it was just one foot in front of the other. It was just so much. And then, you know, being given HR, as it was my choice. I could try it and I did. And as I say, it was a great thing.

And on reflection, they say, you know, you react to the menopause as your parent, your mother has sometimes. And on reflection, again, my mother was probably very depressed but she didn't get the hot sweats. We, as I say, we just didn't talk about things like that. And it's funny, I don't know. You know this, but I was reading one of my diaries recently because I was showing my children

how argumentative I was and how irritable I was as a 15-year-olds. I'll zip up, shall I. And I was writing. There were things I was saying, like, no one understands me. I'm just on my own. I try and explain to them about work I'm doing or interested and mommy's not interested and she slammed the door or something. Honestly, I was reading it to the girls.

It was a while ago because I was saying, look, it's not just you that feels like this. It's part of, and I would have been having a hormonal changes, of course. But I also then at the time didn't know anything about the change, menopause or anything. But I wonder how much of you and me not getting on so well was because your hormones were fluctuating as well. Because we wouldn't have thought about it, would we? No. I wouldn't be aware. I'm sure that on thinking about it, you know, it probably was part of it.

I mean, I think we have similar personalities. No, we can't blame everything on our hormones. Clash, then. Yeah, so I'm not blaming everything on my hormones. But it does make me think because, you know, and it is actually, like you say, when people still have periods, so perimenopause, often is the more turbulent time. Yes. And, you know, households can really break down.

It's not just relationships. with children as well. And that really worries me because it can be very difficult bringing up children, as we both know, but even harder if you've got anything else that's going on and not being recognised. So I just think it was very forward thinking

of that female doctor to actually prescribe you. But she prescribed you a tablet, didn't she, of HRT? Yes, yes. And only watching your theatre tour and realise that they were made from horses urine or something, that made me feel quite ill. Because you didn't know, did you? Well, no, no.

But, and I didn't talk about, I didn't know the word menopause, I don't think, till you started specialising in menopause. And certainly, I had never heard of perimenopause. What on earth's that? Oh, I know all about it now. But, you know, I just feel sorry that we're talking about how many years ago? Long time, 40 years ago. 40 years ago.

But things haven't moved on. I've got friends. who've actually gone to their doctors now and, you know, because I've persuaded them or they, you know, they might be a little bit older or they've got some young friends as well and they're not getting the help from the doctors that they deserve.

And I think it's not just the help they deserve, it's also given the choice. And you mentioned earlier on about this scare of breast cancer. And I can remember then, I think you would just, sort of, you qualified, but anyway, we were talking about it and I said, oh, should I come off? And you said, Mom, you know, if you think about it, you've been on HRT for several, if you get breast scants tomorrow,

you've had a good quality of life for those last few years. And I agreed with you totally. And I just think it's just fate if you get it or not because I have four friends that I can name who had breast cancer, they've all survived, thank God. But none of them have been on HRT. So I think things like that are the luck of the draw, and life is for today.

Yes, and I remember at the time writing articles because, you know, I was writing that weekly column for GPs, and I actually found them recently because you very kindly have kept everything that I've written, unlike me. So in 2000, I'd written about HRT, saying that it's good for mood, it's good for mental health, it's good for bone protection, it's good for heart disease, probably good for dementia, type 2 diabetes, with the evidence associated with it.

Then in 2002, the Women's Health Initiative Study, so again I found another article that I'd written, saying there's a study that's come out, but actually it doesn't tell us anything we didn't know already. There might be this small increase risk, but it's associated with synthetic hormones, and there are still the benefits to the heart, the bone, the bones, and so forth. So in my own little world as a GP and also helping advise you a little bit, I just thought business as usual. I didn't realise the rest of the world were going into a mega panic because the data had been misinterpreted.

And that's been the hardest thing because going forward, you say those three letters, HART and everyone says breast cancer. People still remember. They still remember it. They're still scared. of it. But, you know, life is a risk. You know, crossing the road is a risk. But the irony is. We have a choice, don't we? We have a choice whether we want to cross that road or not and wait for the little green man. So we should all, as women, have a choice whether we want to take HRT or not. But we're not, women generally, are not given that choice.

No, but also the irony is, is that all those studies and all that this interpretation was based on older types of hormone, the one that you were taking. Yeah. The one that you're now taking, the one that I'm taking is what we call body identical. So it's exactly the same hormones. No horse's urine has been used to make this type of HRT. So it's sort of like comparing apples and bananas saying all fruit is yellow. Like, we just can't do it. So the conversation, the studies, the research has moved on,

but the people being scared still hasn't. But we also, from this study, there was a big misunderstanding because what they did, as you probably know, is that they were giving the wrong type of HRT to women. And the average age of women in this study was 64. So a lot older than we usually start women on HRT. And they found that some of those women had an increased risk of heart disease.

when they started HRT over the old of 60. So now lots of doctors think we can't start HRT and women over the age of 60 because there's this increased risk of heart disease. Actually, that's with the older types of hormones. So the natural type of hormones, we know reduce inflammation on the lining of the blood vessels. They help reduce blood pressure. They help the whole cardiovascular system to work well.

So in the clinic, we often do start women over the age of 60. with a lower dose of the natural body identical hormones. But also a lot of doctors now think anybody over the age of 60, red flag, you must stop your HRT. Now, do you know roughly how many doctors have tried to stop your HRT? I could count them on more than one hand. And I can remember, I wanted a repeat prescription. This is several years ago.

My doctor, oh, menopause. Well, it's not really possible. part of our remit and me being a bit arrogant, I suppose, as I left, I said, well, I want them, so please can I have them and also promised me to make it part of your remit in future. And she said, oh yes, we will have a meeting about it. And she was a woman, you know. But I think, you know, people who've, perhaps because you have brought it all to the fore, you have made people aware that they can get help out there.

women can get help out there. I think people from the age of, say, 50-odd, where they probably have become menopausal, then they've suffered all that time and something you've made aware, that there's help for us out there. But why are the doctors so stubborn or so old-fashioned or set in their ways

that they won't give it? And I went to one recently again. She gave me, and said, Oh, but why are you on HRG? That's so mere because I want to be. But it shouldn't be like that. No, I know. No, I know.

And because it should be my choice. And if you said to me, yes, okay, it might cause this, it might cause that, but then it will help you that way. It has to be my choice, surely, whether I want to take that risk or not or take that benefit. But we're not given that choice, are we? No, and I, I, yes, I mean, there are so many doctors I know, because you've told me, have tried to stop your HRT or questioned you or said you should reduce the dose. What are you doing? And, you know, that's even before talking about testosterone, you know, it's just quite incredible.

And I don't know, there's a lack of professional curiosity. I think if someone comes to me as a patient and they're asking me for treatment that maybe I've not heard of or maybe I don't understand, I might not necessarily. I might not prescribe it in the first consultation, but I would always say, let me find out about it. Let me go to the guidelines, let me read the evidence, and then we'll have a discussion. And if I don't feel confident prescribing it, I can, you know, arrange for you to see somebody else.

And I've always done that as a doctor. No patient expects you to know everything. But I think it's not just, I don't want to run the medical profession down, because I think you all do a fantastic job, knowing what you've been through to just get your qualifications, is amazing. But I think in any profession,

a lot of people are set in their ways and they've got their routine job and they do it and they go home and that and it's a way of life. And they don't want to explore other avenues. But you always have had that inquisitive curiosity and you've wanted to help people. So they haven't.

And also for a lot of people still, it used to be in my day that you had put on your Sunday best to go and see the doctor and it's yes sir no sir three bags full sir you know the doctor was on a pedestal but it it shouldn't be like that the doctor should be the friend and you could reach out and help and but with this HRT i remember when i had my first hip replacement uh then for operations you had to come off HRT and you know i was off for a while but i was so glad to get back on it again because again It was a type of...

Yeah, and that, just to let people know, you were not on the type of HLT you're on now. Now, the type of HLT you're on, body identical, there's no increased risk of clock. No, no, because when I had my second hip done, no, that's fine. You can carry on Mrs. News, you know. And just, actually, I do remember you were feeling quite warm and sweaty then after your first replacement. Yeah, yeah. And it probably made the recovery harder because you were not feeling so well with not being on hormones. No, no, I can remember the difference.

Yeah, yeah. And some people, like I was at a conference recently and they were talking about how to stop HRT and our patients and how to reduce the dose. But why? Well, precisely, I've got no idea. But if some people do want to stop, there's lots of the doctors are saying, well, symptoms will only last however many years. But as people know, it's not just about symptoms. It's about improving our future health. And so even if you had no symptoms stopping, as soon as you stopped, you have increased bone turnover.

increased risk of osteoporosis, increased risk of heart disease. And I hope you don't mind me saying. But when you had a problem and went to hospital last year, the nurse was really shocked that you're not on other medication. It wasn't she, do you remember? Yeah. She sort of was quite surprised with your date of birth, which I won't say because you do look younger than you. I'm glad you keep saying that, you know.

But she, when you said, oh, I'm on HRT and I'm on just a heart tablet. And she said, what else? And, you know, people usually are on about a dozen medications when they're your age. They're on a blood pressure treatment, a statin, a pain killer, you know, lots of, and you're not. I know. I feel very, very fortunate. I'm sure it's, well, thanks to my family, but a big thank you to HRT because, as you know, I only retired last year from work. And stop, it's not funny.

No, I think it's incredible. No, but I know if I hadn't been on HRT, I wouldn't have been able to keep going. Because I see friends who are my same age. I've got two particular close friends who were students with me, one I first met when I started teaching. And they'd both sadly got dementia. And it's really sad. And if there's any chance of stopping that or helping us. And, you know, if, as I said to my doctor, when she said, recently, you know, you come off.

And I go, why? Why do I have to? And again, it's probably because it's expensive for them to prescribe it to me, is it? I don't know. No, it's not. That's the irony of it. It is actually really cheap. And even if you look at the risks of the worst type of HRT, it's still less than most other medications.

But it's also about keeping people wow for as long as possible. Well, and then long term, that's cheaper. of the NHS. Of course it is. Absolutely is. But I also feel it does, it's so you mentioned bones and everything, but I think it's also your skin, your hair and all those. Because again, I have several friends who, you know, really look wizened and you might,

I might look in the mirror sometimes. Oh, my God, yes. But, you know, hopefully. Well, we've spoken about this to, with Saj Rajpah, the dermatologist that you know as well, because, you know, I've been told off in meetings before saying, Louise, people just take HRT because they want to have nice skin and that is terrible. Well, firstly, actually, if people want nice skin, that's not such a bad thing. But also, the skin is an organ.

It's living. We have blood vessels going through it and everything else. And the skin is a window to what else is going on in our body. Really important, actually. And if people lose collagen from their skin, from their faces, they're going to lose collagen in their bones and their muscles. So they're going to be more at risk of having osteoporosis. as well. So we have to be really clear about our skin is important. But the other thing is that

a lot of people who are older, especially women, have ulcers on their legs. And that is a real problem. And I know when I was a GP, I had so many patients where the nurses go in and out do all these. It's ongoing, is it? Yeah. And we know there's a study that Sajan I found from decades ago showing that women who take hormones have, guess what, a lower incident of ulcers. Now if you can imagine the cost of nurses going back and forth to somebody's home for the dressings and all that. But getting back to this sort of you said people, their skin, if I want to take it because it helps my skin, why shouldn't I? Why shouldn't I be allowed to? But can I ask you one question which I find really confusing? A lot of, several

of my friends have been to the doctors, they're not getting HRT help, but they're advised to take antidepressant. So as I took antidepressant after your father died, but it's really hard to come off them. But as far as in my naivety, antidepressants sort of dull the brain, don't they? And it's supposed to calm you down. But if you take HRT, it stimulates the brain,

so it brings you back to life. But if you come off, you don't, it doesn't have withdrawals. symptoms or anything like that. So why is our antidepressant more important than HRT as far as some medics are concerned? Well, a great question. I wish I could answer because it's easier actually for most women to get antidepressants than it is HRT. And you're absolutely right. A lot of women who take antidepressants when they're not clinically depressed will say, I just feel like I'm numb. I feel like I don't have emotions. I don't have sad.

emotions, but I don't have happy emotions. I feel like I'm going through processes in life without thinking about I'm just a robot. And that shouldn't be right. Yes, we don't want people to be sad, but we really want people to be happy as well. So having the right balance of the happy hormones, if you like, the good neurotransmitters is really, really important. And often when women are on the right dose and type of hormones, they'll say, my life is in color again. It's not. black and white, that zest for life is come back, that joy. And that's really important. But one of the problems is it's very hard to measure that in studies. And in studies, a lot of it has been looking at flushes and sweats because if I was analyzing you if you're better on HRT

and I had my little clipboard with my tick box, I could see you having a flash. I could actually monitor that. If you tell me one day, oh, Dr. News and I feel a bit happier, well, I might not believe, that that's due to your HRT and then it's very hard to quantify in a study. So it's easier to exclude that sort of data and just think objectively about the symptoms that I can see as a scientist. Yeah, but we're all different, aren't we? And I'm not a flat clipboard. I'm a person, a human being.

Absolutely. You know, I might be different to someone else. Yeah. And we're all individuals, so we should have that choice. But what's, what's, I find, as you know, I spend most of my time very, frustrated but I find it frustrating because we have known for many years that well-being can improve with hormones and even some of those quite awful adverts in the 60s did have women behind a steering wheel of a car saying you know her well-being she's happy she's joyful

and actually that's not a bad thing if that's all it did it's not bad because certainly in the 60s there were a lot of other drugs been given there were barbiturates being given there were benzodiazepines being given. There were lots of amphetamine-type drugs to try and boost people. And there was very much a, we want women to be happier because then they'll be better at home, there'll be better housewives and all that. But we've known that hormones can help because we're replacing what's missing. But I wonder sometimes whether it's just because people don't want women to be the best

version of themselves, they don't want them to be strong, independent women. Because we are still suppressed our human beings, aren't we, really? And of course, you know, in my day, not so many women had careers. You didn't sort of have female lawyers or not many doctors. I mean, you've, you know, come up against discrimination as far as being a female doctor. And that's still going on. And still, you know, my father was very much, my mother's parents. place was at home with a clean penny and, you know, cooking his meals and everything. She wasn't

allowed to have a career or anything. And, you know, when I was first married, I was doing the drama and everything. And I can remember my father saying, your place is at home looking after your husband. And, of course, your father, he was so supportive, you know, that that's what it should be all about. But I just feel that you're, you, I know you're my daughter and I'm very proud of you obviously, but I think you're doing a fantastic job to fly the flag for women. And I don't know anybody who's worked as hard as you and researched as much as you have on HRT and, you know, putting it out and giving us the opportunity to make a decision for ourselves. You're not telling us we have to take HRT.

You're giving the pros and cons and giving us a choice. and it should be freedom of choice. Yeah, I think, thank you. And I think that's so important because other things in life we can choose, obviously some things we can't choose as we know. But we can choose what we eat. We can choose whether we exercise. We can choose whether we drink sherry at 6 o'clock.

But that's fine. No one judge you. How many doctors have said to you, how much sherry do you drink? No. They're probably worse than. Well, it is, isn't it? It couldn't be addictive. Yeah.

Yeah. And so it does seem like just wrong that women, I can't think of any other medicine that's so hard for people to obtain as well. When we've got the guidelines showing the benefits in all ages. But I think the guidelines are a bit strange, aren't they? Well, it depends which guidelines. There's many different guidelines and it can be very confusing for people. but we know that the benefits outweigh the risk. I find it, you know, we've got lots of good evidence about how safe hormones are,

how different the body identical hormones are compared to the synthetic hormones, and we don't have evidence showing us that there are risks when we start HRT and older women or continue it. And we have to remember the health benefits too. So again, it goes back to choice. It goes back to allowing people to choose And also, knowing that there is some uncertainty. There's uncertainty in lots of things we do.

Life is uncertain. Yeah, women can usually make that decision. But in my mind, like you say, the most important thing is having that patient in the centre of their decision-making processes. And reviewing that decision. We review people every year. So if you change your mind, of course, you can change your decision about whether to continue. Or if you need the dose changing as well. So I'm very grateful for you being quite so open.

Thank you. And just to end on three tips, and this is really, I think that people would find it useful to know three things that have worked, actually, for you when you've seen your doctor and you've wanted to continue your HRT. What are the three things that you feel have worked

that you have been able to continue having HRT on your repeat prescription? I think, sadly, we still have to thump the desk. We still have to thump the table and if we're not given the choice we have to, you know, stick to our guns and if our doctors

won't give us, then we have to move on and find another doctor. We mustn't take no for an answer because life is for today and it's not a rehearsal and we as women must be given the choice. That's probably three things all in one, isn't it?

But, you know, I know we're going to end now but I would like to say please continue your work. I know you've had lots of people, Auntie, but please go for it. I will be there flying the flag for you and I know there are a lot of women who will be and want to be. Thank you. Thank you. Subscribe to my newsletter for exclusive insights and updates on new episodes.