The Dr Louise Newson Podcast - 73 – Hormone treatments after 70: why you don’t need to stop

Episode Date: June 9, 2026

So many women are wrongly told they need to stop taking hormone treatments when they reach a certain age, yet there is no evidence-based age limit for natural hormone treatments.In this episode, Dr Louise Newson is joined by Paula Keats, who has been taking hormone treatments for 33 years and is still benefiting from them at the age of 77. Paula shares why she chose to continue hormone treatments through the fallout of the Women’s Health Initiative (WHI) study, the difference hormones have made to her life, and why she has no intention of stopping.Together, Louise and Paula discuss the misconceptionssurrounding hormone treatments in later life, why so many women are still being denied hormone treatments because of their age, and the importance of individualised care and treatments rather than arbitrary cut-offs.Whether you’re already taking hormone treatments, wondering if you should continue, or have been told you’re “too old” to start, this episode will give you the information and confidence to have informed conversations and make the choices that are right for you.We hope you love the podcast. If you enjoyed this episode, please make sure to follow us, leave a 5-star rating and share it with someone who might find it helpful.LET'S CONNECTSubscribe here 👉 https://www.youtube.com/@menopause_doctorWebsite 👉 https://www.drlouisenewson.co.uk/Instagram 👉   / @drlouisenewsonpodcastLinkedIn 👉     /https://www.linkedin.com/in/drlouisenewson/TikTok 👉   / https://www.tiktok.com/@drlouisenewsonSpotify 👉 https://open.spotify.com/show/7dCctfyI9bODGDaFnjfKhgLEARN MOREDownload my balance app 👉https://www.balance-menopause.com/balance-app/Get tickets for my new theatre tour, Breaking the Cycle 👉https://www.nlp-ltd.com/dr-louise-newson-breaking-the-cycle/Order my new book 👉https://bio.to/ThePowerofHormones

Paula's on my podcast today. She's taken HRT, uninterrupted for 33 years. She's in her 70s. She does Zumba. She does singing classes. She's really fit and very active. So she just talks about her experience of taking hormones. So, Paula, you're in the studio. Last time, it was a while ago, we did a couple of years. Yeah, it was a couple of years ago we did a podcast. And I just wanted to talk to you about someone who's taken, HRT for decades? Yes, 33 years. 33 years you've been taking HRT and am I allowed to, you're allowed to tell people how old you are? Yes, you can. Go on then, you can tell. Okay, but I'm 77, I'll be 78 this year. Amazing. So you, and I'm not just paying you a compliment, you do not look your age. Oh, thank you. And you're super busy, mentally and physically. And you've taken hormones for your own choice for many years. Yes. And it's impossible to know what you would have been like if you hadn't have taken hormones.

But when you started taking them, you were having a very difficult time at work. And you wouldn't have continued as well as you had done when you were younger if you hadn't taken hormones, would you? No, I don't think so. I think life would have been much more difficult had I not been put on them. Fortunately, I was, as soon as I had a hysterectomy, which I know is very, very fortunate for me. But I didn't go through a lot of the things that a lot of women have been through.

you know, the anxiety and the problems and, you know, the general feeling of not being well, it sort of passed me by completely. So you were started at HRT before the WHO, the Women's Health Initiative study. And that was a study that scared so many people away from hormones. And it was the wrong type of hormone to the wrong type of women. Yet still now people are scared of hormones because they think about the risk of breast cancer, clot, stroke, heart attack, doctors are scared. But actually, HRT we prescribe is not associated with those risks.

So you were lucky. I was very lucky, yes, and very appreciative of it. Yeah. But I did stay on it even during that scare because the doctor that was treating me told me at the time that it was a flawed study. And for all the reasons that you said, the wrong age, the different type of hormone, the rest of it. And he asked me how I felt,

what did I want to do? And I said, well, I'd already been on it for quite a while, and I felt fine on it. And I thought, I don't want to go back to feeling the way I felt before I had my hysterectomy. So I said, no, I'm going to stay on it. And he was, he'd been told, apparently, that, you know, you prescribe this at your own risk.

Yeah. But he said, he generally felt that was the right decision. Yeah. And I never looked back. I've never had a break from it. Yeah. And that's, and which is important, because, You know, we've known for decades, many, many decades, well before the WHOHI, that there are benefits from hormones for your bones, for your brain, for your cardiovascular system, for your mental health as well. And HRT used to be prescribed so much more often.

In the UK, it was about 30% of menopals or women and increasingly prescribed. And now it's about 14%. So it's less than half of what it was. And we did an audit, about a year or so ago, of three big teaching hospitals in London looking to see how many women after hysterectomy were prescribed hormones, and only 5% were prescribed them. Which is nothing. It's almost unbelievable. It is unbelievable because if I was a surgeon and took out someone's thyroid gland, I would automatically give them thyroxin. Yes.

People have ovaries removed and they're not given their replacement hormones without any reason for it. And so it's completely wrong. But even now, people are still talk a lot about once you reach a certain age, you have to come off hormones, which again isn't right. No, your hormones haven't, they're not going to come back again, aren't they? That's exactly right. Absolutely. You know, my mother and my mother and I've been on HRT for decades as well.

And my mother keeps getting called in to talk about her hormones. And the other day, she actually confronted them. So, well, show me the evidence then. Show me the evidence of harm. And obviously, they can't. And I feel sorry for the doctors because they're not trained in the right way often. They're given misinformation. The guidelines sometimes are out of date.

But actually, a lot of what I do is about educating people so they can make choices that are right for them. And you've made choices about the exercise you do, the activities you do, about taking hormones. And I feel very strongly as a doctor I shouldn't be dictating to my patients what they should and shouldn't be doing. and it's great that you have been able to have that choice to continue taking hormones. It's amazing and I've realised I'm very, very fortunate. Nobody has asked me recently if I want to stop it and the answer will always be, no, I don't. As you said, I don't understand why these hormone-related losses aren't routinely treated. All the others are, this one isn't.

And it's puzzling and I really don't understand it because I'm sure more and more women would have to go to the doctors less and less. Oh, yeah, absolutely right. A lady I met on the train coming in said to me that she was now 72. She's actually quite young. She's quite active. But she said, I eke all over and it's getting worse and worse and worse. And she's had all sorts of consultations.

She said, I know it's a lack of estrogen. But she was told by her GP that they wouldn't even consider her going on it if she's over 59. So does that mean, you know, if you have a 59, then frankly, go to the dogs, no use to anyone. See, it's awful, isn't it? It's dreadful. And again, I wouldn't start the HRT that was given in the WHI study to older women. No, no. But then I don't give it to younger women either.

No, either. That's right. We had someone in our clinic recently who came to see one of our other doctors three months ago, and she was in her 70s, and she could barely walk up the stairs in the clinic. She was in a loss of pain, a lot of discomfort. and she wanted to try hormones in case it helped her pain, her sleep, her urinary symptoms and so forth, and also to help her bones to reduce the incidence of osteoporosis. Three months later, she came back and she walked up the stairs so much easier. You know, the proof is in the pudding often.

It's in, and also, you know, you know fairly quickly, most people will know fairly quickly if it's working for them. Yeah. Within a couple of weeks normally. Yeah. You know, they feel better and they perk up a bit. I mean, yes, you may have to go back if the dosage is not quite right. And I do honestly believe what you've said about dosages, you know, people absorb at different rates and different times of their life.

We're all different, you see, and that's why having an annual review is often really important because the way that we absorb, the way we metabolise, our requirements for the hormones can really vary. And some people's skin type changes. So if you're putting it on the skin and the skin has become thinner or thicker or drier, then it's going to affect the absorption of the hormone anyway. Yes. Yeah, I'm sure you're right. So I don't think it's something that you can't just say, well, one size fits all. No, absolutely not.

Even as a medical doctor, I still don't know how many symptoms are related to hormones or not. And recently I was getting more migraines and I then realized actually what I could hear. my patches were crinkling as I was walking. Oh, I had. Normally they just stick on and literally, they were just flapping in the wind. And I actually put a video on my Instagram to show people. And I wear more than one patch because I don't absorb very well. But you could see it lifting off my skin.

It's not rocket science that I'm not going to be absorbing properly. And I'm sure that was why I was getting migraine because I was not having the right amount of hormone that I needed. Yes. And it's important, you know, we. we don't work with the same amount of hormone every single day. Like our hormones interfere and interact with each other. And so it makes sense that requirements might change as well. And some people as they age need less.

Some people need more. Some people need the same. It really varies. Well, I've had the same for quite a long time now. I feel well. I think your body tells you if you feel okay. I think that's the thing. Women are quite intuitive.

Women do know their bodies. and often the saddest thing of my work really is listening to the stories where they haven't been believed. Women haven't been listened to, they haven't been believed. A lot of women know if it's a hormonal problem and it might be because their symptoms are similar to how they are just a few days before their periods when they were younger and they say, well, I'm sure it's my hormones. So then why give them an antidepressant, why give them a painkiller, why give them other drugs? It doesn't really make sense, isn't it?

Well, I think my view is, I mean, as a complete amateur, but my view is that when people get to perimenopause stage and they're talking of symptoms that are clearly perimenopause or, you know, anxiety, when they've never had it before or feeling, you know, so just terribly unwell and just not right. That should be the first port to call, not the last. You know, so, well, try this for a couple of weeks and see if it makes a difference. then if it doesn't, you know, then's the time to think, well, maybe this is something else,

not the other way around. I know. It's almost like the last resort really. Yes, it is. With a big sucking in of teeth. Yes, and you made to feel guilty for having it. Yeah. I was talking to some physiotherapists and they said in the 1980s, when people had joint pains,

the first thing they would do was talk to them about hormones and they would easily get them to really improve their musculoskeletal symptoms, which makes a lot of sense because they reduce information in the body. But you were saying that recently you had a fall and you didn't fracture anything. No, I had two actually, well, three in the end. Or two falls now. The year before last, I tripped over a paving stone. It was just one that was up, didn't see it in the summer.

Sprawling and really crashed both my knees, which I've crashed before years ago, so they're not great. Lots of bruising. I found it difficult to get upstairs. I have a lot of stairs in my house. I did it, but it was really painful, really awkward. And for several months, I was sort of black and blue and very swollen and all the rest of it. But I didn't break anything.

And I'm sure that had I not been on HRT, I would have probably been in hospital with something, a fractured kneecaps or whatever. So, and then this year, I had sciatica quite badly because I had something else that stopped me doing excesses. exercise, which will knock on effect. And then, just as it started to recover, I managed to fall down the bottom step indoors and spray my ankle really badly. And again, a really nasty spraying, but it didn't break. It was very swollen, but it didn't break.

And you think, you know, just thank goodness. And the other thing that I think of, I have another reference now because we're all at the end, you know, it's the last dog end of this 70s. and some of them have had knee replacements, hip replacements, and goodness knows what else. Nobody ever says to those people, or has ever said to them if they have osteoporosate, anything like that, they'd say to them, take calcium. They never say to them, are you taking HRT?

It's almost as if all nothing to do with us. I know it doesn't make sense, does it? Because HRT, we know, will prevent osteophrosis. It's licensed as a treatment to prevent osteophrosis. Osteoporosis affects one in two menopausal women. One in three menopausal women will have an osteoporic hip fracture. And lots of other women will have fractures of their wrists and other bones, especially their spine as well actually.

And it really is not just a fracture that you can repair quickly often. A lot of people have reduced mobility, have increased dependency on other people. A lot of women, once they have their first osteoprotic fracture, they end up not being able to live independently. And it's that slippery slope really. And it's so important that we can be as strong and active as well. And it's really great because you do Zumba, you're really active.

But would you be that active if you weren't taking hormones? I don't think so. I really don't think so. You know, I see a lot of my friends who are not on it and you can see there's a different. I'm not saying I'm fitter than everyone else or I'm more energetic. everyone. Some of them are quite adigeti, but for some, you think, I do wonder, you know. And I say, I just think if you can do something to make you feel better, again, when you get to this stage, it's not a question of saying, oh, I don't want to get this, I don't want to get

that. We're all going to get something in the end that's going to finish us off. But I'd like to live as many years as I can feeling well, not sort of just being on this earth, suffering. You know, That's not what I was putting here for. Too many women are still being dismissed or told wrong information by their healthcare professionals. My free balance app is designed to change that. It's a space where you can learn how your hormones actually work, track your symptoms and connect with other women

who understand what you're going through. There's no judgment and no misinformation, just clear evidence-based education, designed to help you understand your body and advocate for your hormone health. I believe knowledge is one of the most powerful tools we have. If you want information that's grounded in science and built with care, download my balance app today. I'm very interested in health span rather than life span.

I'm very interested in being well, as you say, for as long as possible. It's not the age we die. It's the journey to that age. And in medicine we often fail people because we're waiting for them to have diseases and then we treat. We don't look at preventing diseases. But we know it's great that women are living longer than they did many years ago. But what's not great is the last 10 years of a woman's life is often in poor health. And, you know, as a doctor for many years, I used to visit mainly women in nursing homes, in residential homes, in ward and control flats.

And they really would be existing, not living. They would be very reduced in their mobility. Their mental health would obviously not be very good. Their cognition wouldn't be great. They'd have recurrent urinary tract infections. They'd have a lot of loss of muscle mass. You know, they'd be rocking in the chair and I dribbling, you know, and I just thought, gosh, they're younger than my mother.

I do not want to be like that. And no one knows what's around the corner. but it was quite revealing when I left my general practice, when I looked to see how many of these women were on hormones, and none of them were at all, none of them. It's very sad, actually. The other thing I was thinking the other day, there are more and more people now living on their own than men and women.

Yes. But if you're living on your own and you're elderly, all the more reason to be as fit as you possibly can because you haven't got anyone to help you. Yeah. So it's in everyone's interests, I think. It's not just the person, but the doctors, the social workers, everyone, to keep yourself as well as possible.

Your family, you know. Absolutely. And I think this whole thing of trying to resist people to have hormones is very short-sighted because it's not looking at their future health. And, you know, personally, and I've said this before, I'm very scared of osteoporosis, especially of my spine. But we know we have a loss of muscle mass. bone mass and this osteosarcopenia that occurs means that women are less likely to be

independent because they're less likely to be able to reach into the cupboard to get something, to be able to get out of the bath. You know, just little things. It's not all about weight bearing exercises. It's about day-to-day living. And like you say, keeping independent because you've always been really independent. Yes, I have, yeah, most of my life, I would say, yeah. And you want to carry on?

Yes, I do. And I feel sad that women aren't given that as a choice. And there's lots of women who have missed out on hormones who are slightly younger than you who would have had hormones around the time of that WHOHI study. And now they're just a few years younger than you and they're still not having hormones. And they are frustrated about it as well.

And also some of them, as you said, are still anxious because that study did so much damage. I think it put the whole thing back by 20 years before anyone was prepared to even admit that it was wrong publicly. And it's a real disservice. So one of the reasons I wanted to be involved in this and to tell a bit of my story

was purely because there probably aren't so many women around who have been in my position where they've been able to take advantage of something, which I think has been really beneficial. No, I think less and less, very sadly, I don't know the figures for women in their 70s taking hormones, but it's considerably less than it was. And lots of people say, oh, well,

it's because healthier women take hormones. That's why they're healthier. And a lot of doctors have taught me that as well over the years. And I've often reflected and thought, well, firstly, is it a bad thing that healthy people to stay healthy? I don't think it is. But secondly, why is that happening that there's a two-tier system

that people can access what they want if they've more educated? We know in lower socioeconomic classes and certain ethnic groups, it's harder to get HR2 prescribed and HR2 prescribing is a lot lower. In some areas of deprivation, it's as low as 2% of menopoles or women.

And that's completely wrong. There's this postcode lottery. It doesn't feel, that it could only be people who are more educated who've got a louder voice to be able to receive the treatment that they want? No, it isn't fair. It really isn't fair.

The longer I live, the worse, the number of unfairnesses become, you know. But, yeah, I think it isn't fair that people can't try this out. And I don't see the big risk of doing this for a few months and say, does it make a difference? No.

You see, I find it really, it just doesn't make sense, really. Exactly not with all the information we now have on it. Exactly right. A doctor I spoke to a few years ago now who works in areas of deprivation and I said, oh, do you ever prescribe hormones? And he said, Louise, I'm far too busy. I wouldn't consider prescribing a lifestyle drug to people. Yet he's prescribing antidepressants with their risks,

painkillers, sleeping tablets, all sorts of other treatments. And you do wonder if people take hormones, how many other drugs that they're taking. Yes. Because I don't know how many drugs you take, but you probably don't take many, no. You don't take any. I just take vitamin D. Yeah, perfect. That's all.

Don't take any other drugs. And in fact, funnily enough, when I had this sciatica, I had to take some painkillers. My stomach does not like them. And it took quite several months for it to settle down. I didn't take a lot, just paracetamol mainly. Not all the time, not more than probably twice a day. And they didn't do a bitter good, no good whatsoever for sciatica. But yet most women in their 70s are on at least seven medications.

Oh, that's true. Yes, I do realize that. So that's quite interesting that you're not on those medications. No, I'm not. I'm genuinely, I'm not. And that's what I see a lot with people who are on hormones. So it's not just about preventing future disease, but it's actually reducing your need for other medications.

And I do believe, now this, again, with no evidence whatsoever, this is just my life. For me, I'm better off not taking drugs. And I absolutely have to because they really upset my system. Really upset it. Well, this is the other thing I don't understand. I'm not inventing a new drug or something that we don't understand how it works in the body. It's just a natural replacement.

of a physiological hormone. It's not a drug. It's not a drug. And this is a big shame actually because when they first discovered hormones the only way of making them was actually from pregnant women. It's urine. But they did smell of urine,

but you could buy them over the counter. So women could then just buy them. But then they wanted to commercialise them and monetise them. So then they made them synthetic and then they made them just available to prescribe. And that's been the real problem actually because vitamin D is a type of hormone, but you can buy it over the counter.

Right. Estrogen is a hormone, but you can't buy it over the counter. So you're completely at the mercy of a doctor who's prescribing or not prescribing for you. I think the other thing that frustrates me a lot, people are saying, oh, you've got to take responsibility for your health and, you know, it's up to you to do this, that and the other. But when you want to do something that you believe will also be good for you, you can't. So really, you know, it's almost as if your body belongs to someone else, and I really bulk against that.

I totally agree. I was at a meeting a while ago and someone was telling me off for some of my work and saying that there's too much attention to hormones. And I said, but I feel that I'm not going to stop until 100% of women who want to take hormones can have them. I don't mind whether that's 2% or 92%. That's irrelevant. It's about women having what they want. Having a choice. and having the correct information to make that choice. Yeah, absolutely. Which is, I know you do this in abundance.

But we've still got a long way to go. Yes, but at least you're doing it. And it's really, I mean, hundreds and thousands of women, you know, are so grateful for those sorts of things. So you know there's an expert there and you can read about it. So when you go to the doctors, you're armed with some information rather than sort of being a bit, you know, sort of vague about it because you just don't know. And why is it they don't want to tell us about it? Why is it that this is all wrapped up in sort of big cloud of mustn't talk about it? Is it because nobody wants to talk about women, the problems they have when they get older?

I think there's an element of that. There's a bit of that. There's a bit of that. There's a bit of probably farmer involvement. There's a bit of this sort of willful blindness that people don't want to adopt a different approach. They don't want to admit maybe things were wrong in the past. For me, there's no problem with that because we're learning all the time. And like everything else, you know, people thought certain things were great in their day because there was nothing else.

And then they realised later on there's something much better. And actually, that was pretty bad, you know. But it was better than nothing. So I don't think it's a crime to admit that maybe what we were doing 20 years ago was not particularly good idea. But that was what was available at the time And that's what we did at the time I don't think anyone has to suffer for that No absolutely and it's sweet

So we need to change the conversation Yes We need to keep going with everything So before we end three tips So people will have listened to this And they'll be thinking about their mother Their friend themselves And they might be slightly older

Thinking should I have that conversation Either I'm on HRT Should I carry on Or maybe I should try it I'm a bit older. So what are the three tips that you would say to older women? Well, it's your body. And if you feel you want to try it,

then you should try and find somebody that will let you do that. And I know it's difficult if you don't have any money much to do. But then again, it's a question of priority. For me, my health is my priority. It has to be because everything else will not be any good without it. So I would say spend a bit of money, go and see an expert. And then they can always write to your GP. then they will do that and find out what's going on from expert people,

not from people that just want to make a fast buck because there are a few around, as we know. That will be the first thing. And certainly, try it out and you will notice a difference in most cases. And if you don't, don't give up, go back. Persevere because it sometimes takes a while to adjust. And the final thing is don't get hooked up on all sorts of negativities about it because I think there are many, many more positives than negatives. Personally, I can't think of any negatives at the moment,

but maybe I should be surprised in years to come, but I very much doubt it. No, very great. One of the best things I've ever done, so say try it, why not? Oh, thank you so much for coming today. It's been great. Thank you for inviting me back to Louise. It's been a pleasure. Thank you.

Thanks so much for listening. It would be amazing if you could follow me or subscribe because it will really make a difference to grow numbers enable this to reach even more people. Thanks so much.