Theatre Review: Louise Newson and the Hormones and Menopause Great Debate

I have many friends who are approaching or going through the menopause, and it sometimes feels as if we are part of an underground resistance movement with discussions of symptoms, diagnoses and treatments being shared via WhatsApp messages and street corner discussions. Snippets of information that are passed amongst us as if they are illicit secrets on which our lives depend. It was with this in mind that I skipped the joys of Goose Fair on a wet Tuesday evening and went, accompanied by one of these friends, to hear Dr Louise Newson, the self-named ‘Menopause Doctor’ at the Nottingham Playhouse, on the fourth night of her 34-venue tour. 

It was timely, in light of the BBC Panorama programme The Menopause Industry, which aired the night before (now on iPlayer), and in part, questioned the practice of her private clinics in their prescribing of high dose HRT. 

Dr Louise Newson is a known champion for women’s access to menopause care. She is the source of online information which many women turn to and having appeared on a plethora of TV programmes, she is in the company of other high-profile women, like Davina McCall, who have raised the clarion call for more awareness on this issue.

The publicity for her tour states that she ‘aims to educate and challenge misconceptions about menopause and advocate for better healthcare for women’ and Dr Newson was clearly amongst friends. The Playhouse lobby was filled with women of a certain age and packed with an energy of powerful collective determination. In a different era, with cheaper ticket prices and fewer large glasses of white wine, I would have expected an unfurling of placards and a march on the castle.

Instead, we settled in our seats as Dr Newson talked us through the multitude of symptoms that women may face when their hormone levels change during the perimenopause and menopause. It was this that my friend found most useful. Hearing her experiences, past and current being named and recognised as worthy of concern with a potential for improvement through treatment. She felt empowered and better armed for her next appointment with her GP.  

Dr Newson delivered a wealth of information in a way that was easily understood, taking us from the symptoms through to potential long-term risks of hormone reduction and back to the inglorious history of treatment for women. Her advocacy for hormone replacement therapy was her overriding message as was her belief in the superiority of bioidentical HRT over synthetic HRT. Dr Newson was occasionally joined on stage by Dublin based comic Anna Gildea, which felt like an unnecessary distraction. None of us were there for the laughs. 

Using personal testimonies to back up her assertions, Dr Newson told us that medicine was not only about learning from the science but also from people’s experience and in the context of women’s poor menopause treatment, this is undoubtedly true. Yet the conflating of scientific evidence with experience felt problematic, when many of us are trying to wade through a quagmire of confusing information. What may have been more useful was to admit that there is a lack of evidence-based research in this area, especially when considering more complex scenarios. 

Dr Newson didn’t overtly mention the BBC Panorama programme and the concerns they raised about her private clinics prescribing doses of HRT higher than the licenced limit recommended by the UK medicines regulator’s. Concerns which have led to the British Menopause Society withholding her Advanced Menopause Specialist Certificate. She did say that she is waiting on two peer reviewed studies on her work to be published, and her response to the questions and answers at the end of the evening offered a more nuanced approach to some the issues she had discussed earlier, like mental health treatment for women. 

Over the last seven years the landscape of menopause treatment has changed dramatically. It has moved from blanket and ill-informed resistance to HRT prescribing to a stated recognition that ‘The benefits of hormone replacement therapy (HRT) usually outweigh the risks, and that recent evidence says that the risks of serious side effects from HRT are very low.’ https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/benefits-and-risks-of-hormone-replacement-therapy-hrt/ . Yet women still struggle to get treatment or understanding from their GP’s. Too many of my female friends have significant difficulties in accessing advice or treatment for what are often varied, and complex symptoms and a significant number have been told by trained health professionals to go away and do their own research.

The question I left with wasn’t whether Dr Newson was prescribing overly large doses of HRT in her private clinic. Access to treatment we can trust is one of the reasons we have an NHS and anyway none of the women I know can afford private care, or her book for that matter. The questions that remained were; Why did so many women feel the need to go out on a wet Tuesday night to get information about a health condition that currently affects approximately 13 million women in the UK. And followed by; Why aren’t we able to access evidence-based treatment at our GP Surgeries and when needed from NHS hospital specialists. Time to unfurl those banners, I reckon. 

Dr Louise Newson and Hormones and Menopause - The Great Debate appeared at the Nottingham Playhouse on Tuesday October1st 2024.