Why Prescribing HRT Made Her a Target with Dr Louise Newson #193

Dr Louise Newson, GP, menopause specialist and founder of Newson Health and the Balance app, joins Laura Dowling for a frank conversation about hormone replacement therapy (HRT), the barriers women face in accessing treatment and the criticism she has faced for challenging established approaches to menopause care.

Louise traces her advocacy back to the 2002 Women's Health Initiative (WHI) study and the publication of NICE's first menopause guidance in 2015. She explains why she believes the risks of HRT have been misunderstood, why prescribing remains low, and why the distinction between different types of hormones matters.

Laura and Louise discuss testosterone for women, starting HRT later in life, individual responses to estradiol, and difficult questions around hormone treatment following breast cancer. Louise also explores progesterone, PMS, premenstrual dysphoric disorder (PMDD) and postnatal depression, including the influence of Dr Katharina Dalton's work. These are complex areas where treatment decisions require individual medical advice.

Louise speaks openly about professional opposition, BBC Panorama, correspondence involving the British Menopause Society and the scrutiny of her clinic. She reflects on the personal cost of speaking out, why she continues to campaign for better menopause education and what she hopes will change for women's healthcare.

🔑 Key Points

HRT prescribing fell off a cliff after 2002

Louise kept prescribing HRT as a GP for decades and only realised after NICE's 2015 guidance that many colleagues had stopped, while her friends were being given antidepressants instead.

Guidelines are only a guide

She says the NICE guidance mentions risk 22 times more than benefit and groups synthetic and bioidentical hormones together, which leaves busy clinicians confused.

The over-60 risk came from synthetic hormones

The heart attack signal in the Women's Health Initiative study was in women given horse-derived oestrogen and a synthetic progestogen, not the estradiol and progesterone she prescribes.

Testosterone has a long history in women

It was prescribed in the 1940s and '50s for period problems and menopausal symptoms, and she says its reputation comes from the synthetic anabolic steroids of the '60s and '70s.

Some women need more than the licensed dose

Skin varies in how much estradiol it absorbs, and her clinic's published data shows about a fifth of patients need a higher than licensed dose.

Progesterone changed her thinking on PMDD

A colleague's own postnatal illness led Louise to Katharina Dalton's work, and her clinic now prescribes progesterone for PMS, PMDD and postnatal depression.

Ten years of being targeted

Louise says the emails she obtained show people trying to silence her, and the pressure on her and her family brought her close to giving up.

Only 5% of menopausal women get HRT

Every menopause guideline calls HRT first-line treatment for most women, yet she says only 14% of menopausal women in the UK and 5% globally are prescribed it.

📚 Resources

Newson Clinic

The hormone clinic Louise co-founded with Dr Rebecca Lewis

Balance

Louise's free app for tracking symptoms and learning about hormone health

Confidence in Hormones

The hormone health education programme for doctors and healthcare professionals

⏱️ Timestamps

00:00 — Welcome to The Laura Dowling Experience

03:47 — Rereading the WHI study after NICE's 2015 guidance

11:18 — Why HRT is scrutinised like no other medicine

15:43 — Testosterone's forgotten history in women

20:43 — Starting HRT after 60

24:43 — "A body of people trying to take me down"

29:33 — If she were a male gynaecologist

32:07 — Are her doses too high?

35:45 — HRT after breast cancer

39:43 — Progesterone, PMDD and postnatal depression

42:16 — The Care Quality Commission inspection

45:47 — Running a private clinic

48:27 — Has the pendulum swung too far?

53:02 — Advice for young people and the meaning of life

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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Why Prescribing HRT Made Her a Target with Dr Louise Newson #193

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