The Dr Louise Newson Podcast - 88 – Endometriosis, surgical menopause and getting the right hormone treatments

Episode Date: July 30, 2026

Having your ovaries removed causes an immediate menopause, yet many women are still told to simply ‘see how they get on’ afterwards.This week, Dr Louise Newson is joined by Laura Daly, who shares her experience of surgical menopause at the age of 37 following treatment for severe endometriosis. Having seen first-hand how hormonetreatment transformed her mother’s life after PMDD, Laura knew she wanted to understand her options before surgery and advocate for the care she needed.Together they discuss why replacing hormones after surgical menopause is about far more than relieving symptoms. Laura shares how she experienced brain fog, anxiety, joint pain, palpitations, poor sleep and a loss of confidence despite being prescribed a standard dose of HRT, and explains the remarkable improvements she noticed once her hormone treatment was personalised.Louise and Laura also explore why hormone treatments should be individualised, why women who have their ovaries removed lose more than just estrogen and why treating the underlying hormone deficiency is so important for both current symptoms and future health.Louise and Laura discuss:Why women need a plan for hormone replacement before surgical menopauseWhy replacing oestrogen, progesterone and testosterone can all be importantWhy hormone treatment should be tailored to the individual, not standardisedThe long-term health benefits of optimising hormones after early menopauseWhy women deserve informed choices about their treatment after ovary removalThis episode is an empowering conversation about advocatingfor better care, understanding your hormones and ensuring women receive the treatment they need to protect both their quality of life and their future health.LET'S CONNECT👉 Subscribe on YouTubehttps://www.youtube.com/@menopause_doctor?utm_source=DLNpodcast+&utm_medium=shownotes&utm_campaign=BAU+👉   Instagramhttps://www.instagram.com/menopause_doctor/?hl=en&utm_source=DLNpodcast+&utm_medium=shownotes&utm_campaign=BAU+👉 LinkedInhttps://www.linkedin.com/in/drlouisenewson/?utm_source=DLNpodcast+&utm_medium=shownotes&utm_campaign=BAU+👉   TikTokhttps://www.tiktok.com/@drlouisenewson?utm_source=DLNpodcast+&utm_medium=shownotes&utm_campaign=BAU+👉 Spotifyhttps://open.spotify.com/show/7dCctfyI9bODGDaFnjfKhg?utm_source=DLNpodcast+&utm_medium=shownotes&utm_campaign=BAU+LEARN MORE👉 Download mybalance apphttps://balance-app.com/?utm_source=DLNpodcast+&utm_medium=shownotes&utm_campaign=BAU+👉 Order my new bookhttps://bio.to/ThePowerofHormones?utm_source=DLNpodcast+&utm_medium=shownotes&utm_campaign=BAU+👉  Speak to NewsonClinichttps://www.newsonhealth.co.uk/?utm_source=louise_podcast&utm_medium=show_notes&utm_campaign=clinic_cross_promotion👉  Visit my websitehttps://www.drlouisenewson.co.uk/?utm_source=DLNpodcast+&utm_medium=shownotes&utm_campaign=BAU+

is on my podcast today, who's a very inspirational person for lots of reasons. She's experienced firsthand hormonal changes in her mother that we're going to talk about. And she's had her own challenges, including having menopause at an earlier age as well. So welcome, Laura. Happy, thank you. It's great. I've known your mum for quite a while and now recently got to know you. And you have got a story which we'll talk about. But what's been great, actually is you are such an advocate for your own hormonal health. You are like the picture of how I wish all women could be because you're very calm, you're very knowledgeable and you've got a huge wealth of knowledge. Would that be fair to say? Yes. With mum going the way she has, I felt like

I had to. Well, your mum's had to advocate for herself in many ways. You know, many years ago, she reached out to people in London and she's, you know, she's not, doesn't live in London, but she's had, she's been on my podcast before and talking about her own PMDD. But just talk to me from your experience of living with a mother with PMDD. So, firstly, me and my mum are like best friends. And when I was growing up,

I remember her regularly just being in tears. she would snap at us like we were kids she'd snap at us for something that you know we'd probably were being naughty but she'd snap and then I'd go in 10 minutes later and see her in tears because she felt so bad that she'd overreacted and I just like it was horrible seeing her so upset and she just was always so sad and I remember when she got her treatment it was like like a light switch. All of a sudden, she was just, she was happy and she was calm and just, yeah, it was lovely to have my mum. And even like when she was on, she was on the implant for a long time, by this point, me and my brother were more grown up and we'd moved out and when the implant was

running out, you'd start seeing some of my symptoms come back. And I mean, it got to the point we could joke about it. We'd go around, we'd get snapped out and we'd be like, when's your implant you? My brother would just refuse to come around. He's like, oh, with that next month once you've had your implant. Not like, just because we used to joke about it because we knew how bad it got. But since then she's been fine. But she's had to fight for that.

Yeah. And I remember one story she told me, I hope she doesn't mind me sharing, but where she, I think she'd forgotten her front door keys or couldn't find them. And the only way to get in was through the garage door. but she had to, is this, because this is this bringing any males? She had to damage the garage door to open it. So she did that, but there wasn't enough gaps. So she put, I don't know whether it's you or your brother,

one of you, to under the gap to open the front door. Yeah, so I don't remember it happening. I've been told the stories. I was four. And yeah, she just drove into the garage to dent it. And then I was small enough that I could crawl underneath and open the door from the inside. I remember the dent in the garage.

I do remember always having a dent in the garage, but it was it's mum that told me the story about what had happened. I remember telling me this years ago, and it's funny, but actually I worry about children a lot. I worry about domestic violence in women. I worry about women's vulnerability, especially when they've got PMDD. And this uncontrollable anger,

your mom is the calmest person, I know. She's really not that sort of person if you met her when she's balanced on hormones. But she, you know, if someone had got in her way then, she would have done anything to them and probably run them over. And so we know people commit crimes more and they have hormonal changes, but the children aren't looked after this. I mean, she was never violent to you. But there are people that really have this uncontrollable anger.

And it's really quite scary, actually. But just to grow up with someone who's got this volatile, temper that was needless actually because you saw how much better she was with hormones. Yeah. Yeah. And it meant that I was very aware of hormone issues and what it could cause. Yeah. So what about your own hormones? So I have had endometriosis. I probably since I started my periods and I got put on the pill when I was like 13 because I had horrendous periods. but it last year resulted in I needed to have a full hysterectomy and kidney removed. It caused my kidney to fail.

The surgery was obviously really scary. We thought it may have been cancerous. My biggest fear was surgical menopause. Yes. After all that, like, and I said that to my doctor. Like, I know he'll get me through the surgery. I'm so scared of what's coming afterwards. having some what mum went through.

Because they removed your ovaries as well. Yes, yes. So both ovaries are gone. So, and how old are you when you had the operation? I was 37. Yeah. So your hormones, you were having hormones from your ovaries and then you knew overnight that your hormones would plummet.

Yeah. And obviously, mum is on higher than standard dose estrogen. I knew that, you know, very similar. There's a very good chance I might not absorb estrogen as well. And I was, I booked an appointment with you before I even had my surgery. This is why it's perfect, though, because, you know, if I was having my thyroid gland removed, I would want to preoperatively talk about when am I going to start thymoxin? How is it going to work?

And somehow, so many women have their ovaries removed and they're told, just see how you're get on. But actually you're young. The guidelines, the evidence are very clear that you have to have the right dose of hormones to improve your future health, even if you didn't have any symptoms because women, especially under the age of 40, you have an increased risk of diseases without those hormones. So you, but you did the right thing because we, you came in and we spoke, because your knowledge of hormones is so much better than a lot of people, it was a very educated conversation, very shared decision making, because also we spoke about not just East Jordan, didn't we? Yeah. I knew I wanted all three from day one. So I've got three

hormones there now. Yeah, which again makes sense. And it's interesting because I'm not really wanting to be rude about other doctors, but if you'd come to see me maybe 20 years ago when I was a GP, I would have not been able to have that conversation with you. And I would have said, I don't think you need the other hormones. I think it's just estrogen. I would honestly, I wouldn't have known because no one taught me. But I did learn, probably as a teenager, actually, that our ovaries make estrogen and progesterone.

And then someone at medical school told me that we don't need progesterone unless we've got a womb. And I don't know why I didn't challenge it then because it works all over the body and the brain, as you know. And then about 15 years ago, I learned for the first time that women had testosterone in their body, because no one taught me that before. And then I'm like, hang on, if we've got it in our bodies, it must have a function.

So I learned about the physiology and how testosterone works in our brain and body. And about half of our testosterone is made in our ovaries. And I remember saying to a menopause specialist a few years ago, so do women routinely just have testosterone when they have their ovaries removed at a young age? And she looked at me and said, no, Louise, only if their libido is really bad after the operation. And I still, that's still like stuck with me because at the time I thought, Maybe I've asked stupid questions. So I said, okay, okay, thank you for telling me.

And I really don't agree with that statement at all because it doesn't make sense. No, I mean, I am tempted testosterone as soon as literally the day after my surgery because I got an email from you while I was in recovery saying, yes, your testosterone levels were low before the surgery. Yeah. And I took it for six months before I even went to the GP to. asked her to replace it because I thought there's no point you even having this conversation. Yeah. And she did give me it.

I'm quite fortunate, I've got quite a good GP actually. But she said, we tend to avoid doing this until you're on the top level of estrogen because of the side effects because it's a male hormone. And I was like, but men don't have ovaries. And that's where I'm producing it. So what did she say to that? she was quite happy to give me it and she just went, oh, I'd be interested to hear.

I've since been back to her and she said, do you have any side effects? I was like, other than feeling like fantastic. So I feel like I'm in my 20s again. It's amazing. Well, the thing is, so there's a couple of things there. One of the things is people with endometriosis often have low testosterone. And there's been some studies to show that women,

even from a young age, have low testosterone and more likely to get endometriosis. and more likely to get endometriosis. So the chances are you've never had the full amount of hormones that you've needed because no one thought or looking. So you probably do feel better than you felt for quite a while with your own hormones balance. But the other thing is lots of people think you have to have estrogen first and then testosterone.

Some people, some women have recently contacted me and said that they've been told they have to have 100 microgram patches or they can't have testosterone. Now, this is like saying you have to have 100 micrograms of levothyroxin, if you've got an underactive thyroid, before I can start you on insulin because you've also got type 1 diabetes.

Like, it doesn't make sense. You know, if you'd broken your arm and your leg, I wouldn't say, well, let's repair your arm first and then I'll come to your leg in a bit, Laura. Like, there's just two different hormones. We know that testosterone gets aromatase to estrogen, but that still doesn't make sense. It absolutely makes no sense at all.

And some women, as you know, who have regular periods, they might have enough estrogen and they might have enough progesterone, and they might be very deficient in testosterone. So why would I start them a hormone they don't need? So anyway, so you're on it, but you don't have any side effects. No. Well, other than feeling great. Yeah.

Like, even like confidence, it's amazing. Like, my friends laugh. They're like, is you becoming more manly. like getting a job interviewing. Well, it's interesting. And a lot of women say this to me, actually, that they can stand up for themselves more. They're more assertive.

And some people have told me that their partners don't like the way they've become because they're like, no, you can unload a dishwasher. You can take a bit of responsibility. And, you know, it's quite an interesting thing, isn't it? Because, you know, there is some evidence. that you choose your partner differently if you're on the contraceptive pill to when you're not on it because your own hormones are suppressed on the contraceptive pill and I think some men don't like women being well.

But you talked about the doses as well. Now this is really important because dosing of hormones, all three of them, is individualised. We're all different. But when we use the estrogen and testosterone through the skin, the skin is a barrier. There's not many hormones or drugs we can put through the skin, but eustodil is one. But there's two things really. One is that you're young, and we know from studies and guidelines that young women do often even need a higher amount of estrogen in the body just to replace what's missing. But then secondly, some women don't absorb the same amount through the skin.

And so you've got two things really. One of them is you're young that we've said already. or under 40 so the chances are you probably need a higher amount in your body to get full optimization of symptoms and the future health benefits but the second thing is that you don't absorb it particularly well through the skin do you? No.

So I had blood tests done and over the sort of course of a patch at some points it was just above 300 and sometimes it was below that it wasn't even at 250. Yeah, I spoke to the menopause clinic about that and they said it doesn't matter, which I now isn't true. They said what, the blood test doesn't matter? Yeah, they said that and the fact that it drops below 250 probably every three days doesn't matter. As long as it goes above 250 at some point in a patch cycle.

which as a mathematician I find that incredibly difficult to believe because the average will be lower. Well this is exactly right. And levels are only a guide, as you know, like a blood test for anything we do in medicine is a guide and it's in clinical context, of course. But one of the reasons that you're taking hormones is to try and improve your future health. You don't want to get osteoporosis and heart disease and other inflammatory conditions. and we know that if you have a normal physiological level, which normally is between 250 and 1,000, then you're less likely to have increased bone turnover and osteoporosis, for example. So the blood tests are a guide, but yours were consistently low.

So we increased the dose, and the most important thing in my mind as the clinician happened is that you started to feel better. Yeah, yeah, like within, a week some of the symptoms had started going away and within three weeks I felt fantastic. I felt so much better. Virtually every single symptom that I had had gone. So what symptoms were you getting?

Oh, there was a long list. I was getting palpitations, migraines, chest pain. I had a constacondritis. Very common. I ended up in A&E with chest pain. I had joint pains. Brain fog feels like it's underselling what I had. I couldn't remember people's names that I've worked with for 10 years.

Anxiety was quite bad. Just really low mood. I was really lethargic. I was finding it hard to get out on an exercise, which I've never struggled with. I was snapping at my husband. and my son, like for things that I wouldn't normally, that wouldn't normally bother me.

I couldn't sleep. I was finding it hard to get to sleep, and then I was waking up in the middle of the night. I think that's my sense. So you're not. So you're on a higher than licence dose, and you're feeling great. And obviously my clinic's private,

so understandably and very reasonably, you don't want to be getting HRT for me all the time, because hopefully you're going to be living for decades and decades. So any way that you can get something on the NHS is better. So you've gone to a menopause clinic to try and be prescribed the dose of hormones that make you feel well and are safe. And did you manage to get them? No. They agreed that the symptoms that I had were most likely low estrogen.

They acknowledged that on the higher dose that I'm on, all those symptoms had resolved. And then they suggested I go back to 100 and they would add in gabapentin or velifaxin. So let me just get this clear. Gabapentin is a highly addictive drug. I've written about it in my book, The Power of Hormones. It's a highly addictive drug that is associated with suicides and death and might help some blushes, but I don't wear that it's got any evidence for any other symptoms.

And vener vaccine is an antidepressant, but you don't seem depressed. I mean, you've never seen depressed to me. Do they think you were depressed? No. They said venal vaccine might help with my concentration and hot flushes again, which I don't have. So you don't, there's one symptom you don't have is hot flushes yet. Never had a hot flush. So, but they're giving you treatment, non-horminal treatment for hot flushes that you don't have.

So did you question that? I did, yeah. And I said, what about all these other symptoms that I get? And they just said it won't help with them. And that was the end of the appointment. Okay. And so did they, out of interest, warn you about the risks of taking something like Gaventen or Vendafaxin?

No. So with Gava Penton, I probably didn't give them a chance. As soon as she mentioned it, I said, I'm not taking that. Yeah. I know how bad that is. With Ben the vaccine, I expressed my own concerns. My mum reacted very badly to SSRIs and SNRIs.

And I explained to her at that point that they made my mum suicidal. But she still thought that was a sensible. approach for me when I'm not depressed. And actually depression isn't a symptom. I've had, I've had lethargy, but not depression. No. And it's interesting because, you know, SSRI is probably I've got a role in SSNRIs, probably have a role. But really when you look at the risks of these medications, one of the risks is an increased incidence of osteoporosis and probably dementia as well. Now, because I've already said you're young, if you don't have the right dose and type of hormones, you have an increased risk of osteoporosis and dementia. So you probably, I mean, I might not know you well enough to presume this, but you probably don't want to have a drug that increases your risk of conditions, you're increased risk of.

No, no, definitely not. I actually asked about where I'm growing densities. Oh, did you? Because my grandma had osteoporosis. So it's something I'm really scared about because obviously I know this is a long-term thing for me. And they said because I'm on 100 as far as they're concerned, estrogen, they wouldn't even consider letting me have a bone density scan. Because I said I'm concerned that I'm not getting enough protection.

So the doctor I saw said she would speak to her team, but they said no, because I'm on estrogen and I exercise so I don't need a bow density scan. So I can't even get the sort of comfort that I'm okay at the moment. But the guidelines actually for early menopause, as in or P.O. women under the age of 40 are saying that you should have a dexter scan. And it makes sense really to think about that. So what about testosterone and the progesterine?

Were they happy that you were taking those? Yes. The only reason I'm allowed progesterone is because I had endometriosis. So this is again interesting. Yeah. This is again very interesting because a lot of women, as you know, who have surgical menopause, have their ovaries and womb removed. People say if you haven't got a womb, you don't need progesterone.

And you're right in that you don't need progesterone to protect the womb that you don't have. But you actually benefit from. Magestrone for your brain, your body, everything else as well. So, and you're right with endometriosis. Often you don't want to flare up any endometriosis elsewhere. But even if you'd had a surgical menopause for a completely different reason, you'd probably still want to take progesterone. Well, and mum has just added it in because I said, why aren't you on progesterone?

It's like, I'm taking it. So, unless you're feeling any better on it? Oh, much better. So yeah, our sleeps like is much, much better. It's very interesting. I challenged what I asked in a polite way somebody at a conference recently about what we're not advised to prescribe for gesturons, women,

had his director especially when they're young. And she said, well, Louise, it's not in the guidelines. And then she said, next question, please. And then moved me on. And the whole audience actually gasped because that is not a reason to do something. something or not do something because a guideline written by a committee of people who hardly ever see patients and don't think about science. You're like, how can we ever help our patients? Yeah,

it's just ridiculous. So there's no reason not to have natural hormones and not to have the right dose. So it's amazing that you are advocating for yourself. And in a sad way, you've had a difficult way of learning because you've, you know, experienced your mother. But if you hadn't, have had your mother and didn't have any knowledge, then what was you've done? Honestly, I don't, well, I don't know where I would be. I was, I did so much research before my surgery because I was, I need to make sure I know what I need because if I go to the doctors, they'll tell me, this is all you can have. And if I just, I, I feel for the ladies that go to their GP and believe what they're told that this is it.

I've got a friend who said just to manage my expectations to I might never get back to the way I was before. And it just makes me so sad that there's women that think once you've had this surgery at us basically, well, that's life. Get on with it. It's really sad. And one of the reasons I worked so hard is the injustice. really and the suffering that's needless for so many millions of women.

And we've been gas-led for so long, too long, being told things like that. Even PMS and PMDD being normalized that, oh, you will feel bad for a few days a month. But it's only a few days a month, so get over it really. And even quite a few PMDD charities, spend a lot of time and money talking about all the talking treatments, all the self-help measures. And of course, you know, having a cup of tea with a friend will help anybody, but it won't treat the underlying cause. And there's no mention about hormones at all. And doctors are so needlessly scared of natural hormones, but they're prescribed the contraceptive pill to anybody.

And meanwhile, it's the women that are suffering. And, you know, what's great about you is that you advocate for others as well. And I know you've helped some friends. And that's so important because when you understand, understand it. It's very simple medicine. It's just really, you're just replacing what's missing. It's not like, like giving venlo vaccine, you haven't got a deficiency of venlo vaccine in your body. So it's more complicated medicine, really. Yeah. No, I'm, it's, I feel I'm at work. If I ever hear any women mentioning brain foreground, have you got your testosterone yet?

Like, what? Yeah. Or someone's got a UTI. Have you got virginity estrogen? Yeah. My palace girl's. But it's great because I think that's where the landscape, and it seems to have changed even more over the last few months,

because women are working it out for themselves. And I strongly feel, especially with some of the negativity I've experienced, it's not about me and my messaging or me or whatever at my clinic. It's nothing about that. it's about women being empowered to make choices because if I was doing all this work and then women said you know what Louise I never want hormones I'm going to carry on with my vener vaccine

gabapence or whatever I would slow down because women in my mind just need to have a choice to do the thing that they want but what is happening is more women are understanding and like you saying no I don't want drugs I would like my natural hormones back first and and that's how we need to make changes I think going forward for your generation and younger generations because your future

health and life could have been very different if you were having all those symptoms and not able to receive hormones you know you've got a good job you've got a lovely future ahead of you but that could have been quite different if you were suffering those symptoms every day yeah yeah even on a hundred I did not feel myself I was I wasn't, I'm quite fortunate actually that I didn't feel dreadful, but I was gradually getting worse, probably because my body was just getting like more and more desperate for the hormones I needed. Yeah. And yeah, I'm just, I'm fortunate that I could come to see you and get the treatment I needed, but I worry for the ladies that don't know. Yeah.

So that's why this podcast is so important. so people can get knowledge. There's lots of information on Balance Up. There's more podcasts. And, you know, just listening today, be so helpful for people. So before we end, I always ask for three take-home tips. So if someone's listening and they're about to go and have an operation to remove their womb, their ovaries, their womb and ovaries, any of their reproductive organs, which are likely to relate to their hormones being low, before they have this operation

or those people that are listening that have had it and haven't got hormones what are the three things that you would recommend them to do? Do their research, learn about the three different hormones that they need find if they can find a private consultant so that they can

if they need to fight the NHS they can fight it feeling good rather than fight it feeling bad and warn your friends and family because it's a bit of a balancing act and I think friends and family need to know that it can take a while to get back to you. That's really important

because sometimes when you're with yourself the whole time you need someone else to validate that you're either improving or you're not improving or worsening. So I'm so grateful for your time today, Laura. It's been a wonderful conversation, so thank you. Thanks for having you. I have a minute.