Meet the doctor taking on the menopause myths

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Many women have been gaslit for so long when it comes to their health, hormones and menopause, believes Dr Louise Newson. The doctor, who now focuses on empowering women to receive menopausal support and treatment, is hoping to bring her knowledge to a wider audience through her tour The Great Debate, which calls at Epsom Playhouse and Rose Theatre.

She says that for too long, menopause has been seen as a gynaecological issue rather than one that impacts all aspects of our health and wellbeing. Our hormones are often all over the place during perimenopause, with the eventual depletion of oestrogen, progesterone and testosterone. It impacts much more than just our periods, but there is often a poor understanding of the role of these hormones in our bodies.

Says Louise: “Hormone replacement is cheap and effective but there’s something more deep-rooted about it being a ‘female problem’ Also, it has been siloed into a gynaecological speciality. Gynaecologists are not generalists and they don’t think about the body in the same way.”

“We’ve had these amazing advances in science but not when it comes to menopause. We’re still debating who should be prescribed HRT. It is easier for women in menopause to get antidepressants.”

Louise has a popular podcast, a menopause centre and has written a number of books on the topic in a mission to enable women to make informed choices about possible treatments for their symptoms. She says part of the problem is that not enough people are trained in menopause.

In the meantime, women are struggling with a whole host of menopause-related issues. Louise recently carried out a questionnaire. Some 6,000 women took part and a report is to follow soon. The most common symptoms include brain fog; low mood; poor sleep; anxiety; palpitations; dry skin, mouth and eyes; inflammatory bowel type symptoms such as reflux and bloating; urinary symptoms, even pins and needles. Joint pain and seemingly unrelated problems such as a frozen shoulder can occur.

Oestrogen, testosterone and progesterone play an anti-inflammatory role in our bodies. “If you know how these hormones work physiologically then it is no surprise that when you don’t have them you can have these problems.”

But it is the impact menopause can have on mental health that is a huge concern. “A lot of people say they don’t feel like themselves. They say that their zest for life has gone and are plodding through without that same spark.”

“We also see a lot of women who have really dark thoughts. We know that suicide rates increase in the late 40s and I’m sure it is related to hormones.”

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Louise hopes to help dispel many of the myths around menopause. One of the biggest is what menopause actually is. “The definition of menopause is not having had a period for a year. Who even decided this? It doesn’t make sense and it’s a problem, as people become fixated on this. As women we don’t really care about periods, we care about how we are feeling.”

It also gives rise to another myth in that menopause is some kind of transition that you pass through. “People talk about this transition, and while symptoms are often worse when hormones fluctuate during perimenopause, once your hormones stay low, they will stay low forever. Whether you have symptoms or not, it means there is an increased risk of diseases such as diabetes, heart disease, dementia, and depression.”

But perhaps the biggest myth is around HRT and an increased risk of breast cancer, which came about because of the Women’s Health Initiative Study in 2002. It grabbed headlines but the data was misunderstood and misreported. When the study was followed up, it was even discovered that for women who’d had a hysterectomy and took only oestrogen, there was a lower incidence of breast cancer.

“We know oestrogen is safe. This risk, which isn’t even statistically significant, is with this older type of synthetic progesterone. We normally prescribe natural progesterone which is the same as the progesterone we produce when we are younger. We don’t have randomised controlled studies but the studies we have don’t show an increased incidence. Why would natural hormones cause breast cancer? It doesn’t make sense. They are very anti-inflammatory.”

Despite this, it is still causing concern: “It is why many women don’t take HRT or aren’t prescribed it. There is this unfounded risk that people still worry about now. That’s awful when it comes to thinking about women’s health for the future.”

Louise’s message for managing menopause is to make sure that you find a healthcare professional that is right for you. “Menopause lasts forever. It’s not a headache that might go away in a few days. We’ve got to make treatment choices that are right for us so it is a positive time of our lives.”

We can also take measures to help our wellbeing. “Sleep is crucial, as is eating well, such as reducing sugar and processed food, and incorporating movement into our daily lives. You also need to look after your mental health and connect with things you enjoy. But you have to tackle all this in the right order: if you have hormones, you can sleep better and have more energy to do everything else.”

Louise is looking forward to the tour. She will be sharing a stage with comedian Anne Gildea, with her brilliantly funny take on the menopause. “The people who will be coming are likeminded and hopefully will get a lot of positive energy from each other,” says Louise.

“I also want this to create a longer-lasting movement and not just a good night out, so that people go away feeling empowered. I hope they will reflect on their autonomy over their bodies and the history that has weaved in over the centuries that has stacked up against women being well. I don’t mind what they decide to do but to do what is right for them and also for future generations.”

Dr Louise will be at the Epsom Playhouse on 30 September and at the Rose Theatre on 10 November.

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