The OTHER facet of the story within the Dr Louise Newson HRT scandal

A BBC Panorama investigation called The Menopause Industry Uncovered, which aired last week, has stirred a hornet’s nest of controversy in the menopause world.

The show began by revealing the untested and spurious benefits of products marketed at women in menopause, but rapidly switched to an expose of one particular high-profile GP called Dr Louise Newson.

Dr Newson is the medic credited for kick-starting the menopause revolution, running private clinics around the UK and building a prominent public profile through podcasts, TV appearances and friendships with celebrity menopause campaigners including Davina McCall and Mariella Frostrup.

In the Panorama programme, presenter Kirsty Wark interviewed Dr Newson’s former patients at Newson Health, her privately run clinics, who felt they had received poor treatment.

The documentary also revealed that last year the British Menopause Society (BMS) removed her from its online register of specialists because of concerns that ‘aspects of her practice’ did not fit with ‘established guidance’ and accused her of dangerously overprescribing hormone replacement therapy (HRT).

The BBC received a flurry of complaints from viewers who felt the show was biased against Newson Health and scaremongering about HRT, and the corporation were forced to release a statement saying ‘the recent rise in the use and popularity of menopause services and products has highlighted the need for more regulation and clear guidance to protect women’.

It also sparked a florid social media frenzy with Dr Newson’s celebrity friends calling the programme part of an establishment ‘witch-hunt’ as they spoke out in defence of a woman who they say has helped to bring menopause care out of the dark ages in the UK. The Mail’s Bryony Gordon wrote that the programme painted Dr Newson as ‘predatory and exploitative’.

‘But I have met Louise on several occasions, and was briefly treated by her, and have always found her to be motivated by a desire to help women rather than harm them.’

So, what’s really going on?

Who is Dr Louise Newson?

She is a former NHS GP who decided to specialise in menopause when her own hot flushes started, founding her Newson Health empire of eight private menopause clinics with more than 70 clinicians who have seen over 40,000 patients since 2018. She is now probably the most famous face of menopause medicine and a fierce advocate for giving HRT to all women who want it.

Why is she under the spotlight?

Dr Newson’s massive media presence makes her the unofficial but most recognisable representative of the fast-growing private menopause sector, which sometimes goes against established (and historically cautious) NHS guidelines to prescribe HRT to women with complex medical histories.

She loudly and publicly advocates for HRT for all women whether suffering menopause symptoms or not; higher than recommended doses of HRT in individual cases as required; HRT for women with complex medical health histories and testosterone as part of the HRT mix.

Why are her methods so controversial?

The Panorama programme appeared to portray Dr Newson as someone who is making a lot of money by charging £300 for online consultations and dispensing prescription drugs with impunity and flagrant disregard for guidelines.

But the whispers among her supporters say the NHS menopause machine doesn’t like personalities like Dr Newson wielding too much influence and weight. While the medical establishment shuffles slowly forwards, hamstrung by cautionary regulations and swathes of red tape, she seems to be operating as a lone wolf, ignoring the regulatory bodies and irritating her GP peers by dispensing HRT like Smarties – with (her critics say) little concern for the consequences.

Journalist and author Lorraine Candy told the Mail the reason for the witch-hunt is that Dr Newson isn’t afraid to tell the NHS where it is failing women.

‘She is relentless,’ says Lorraine. ‘She has dedicated her life to making women’s lives better. I think she is ground-breaking and extraordinary, but this attack is her punishment for poking the bear.’

It is clear her prominent public profile ruffles feathers.

This week the International Menopause Society (IMS) stepped into the fray, releasing a white paper which aims to address the current debates and controversies surrounding menopause management. It states that the ‘empowerment of women to seek assistance for menopause’ which has been driven by ‘media celebrities rather than government departments of health’ have been ‘largely a positive development’, but warns that this has driven ‘unrealistic expectations’, ‘disappointment’ and HRT supply shortages.

Although NHS menopause care has improved significantly over the last decade, the response any woman might receive when she goes to her GP to discuss symptoms will still depend on location and whether her GP practice has a menopause-trained specialist GP or nurse.

The menopause module remains optional for trainee GPs (though it is ‘recommended’) and there are still many GPs in the UK who remain untrained in the menopause and developments in HRT research.

This means that some women might still be prescribed anti-depressants rather than the HRT they need or sent home empty handed with advice to eat healthily and exercise more. If you have a more complex case, you might be referred to an NHS menopause clinic (often the gynaecology department of a big city hospital) and join the end of a long waiting list to see a specialist.

For some women it can be tempting to jump the queue by paying for an online consultation with a private clinic.

One example is the MP Carolyn Harris, who is an advocate for greater menopause awareness and revealed on Woman’s Hour last week that when she went through the perimenopause her GP prescribed anti-depressants, which she took for eight years. After visiting Dr Louise Newson she was put on HRT and says she ‘instantly felt better – it dramatically and completely changed my life’.

In response to the Panorama programme, Mariella Frostrup told her 60,000 followers on Instagram: ‘Millions of women are not being given support and are driven to spending money they haven’t got on private clinics.

‘The biggest scandal here is not the practices of one private clinic but why 45,000 women in the UK felt they needed to attend Newson Clinics instead of getting advice and support from their GP.’

If a GP decides HRT is not appropriate for a patient and that patient is unwilling or unable to wait to see an NHS specialist, they might pay for a private consultation and be given a private prescription. Many then go back to their NHS GP to ask for the HRT prescription to be honoured. An NHS pre-payment certificate allows you to have unlimited HRT for a year for a one-off payment of £19.80. This leaves NHS GPs unwittingly endorsing an HRT prescription which they might not have advised, with a real fear for the consequences. They also then find themselves expected to provide follow-up care if any complications do arise.

Many GPs see this ‘Newson factor’ as a potentially dangerous, middle-class privilege. In return, Dr Newson’s team argue that Newson Health provides a wealth of free advice (via the Newson Health website and a free app called Balance), a training programme for healthcare professionals, and funds research which uses ‘large sets of patient data to better understand disease mechanisms and tailor personal treatment plans’.

What’s the issue with HRT dosages?

Some women don’t absorb oestrogen as easily through the skin and doctors, including Dr Newson, have found a higher dose of oestrogen – two or three times the guidance limit – lifts blood levels high enough to mitigate symptoms.

Studies have shown that high levels of oestrogen can cause a thickening of the lining of the womb, which can increase risk of endometrial cancer, so progesterone is routinely prescribed alongside oestrogen (normally as a daily capsule) to mitigate that risk.

There has been no research to indicate how much progesterone a woman needs to offset these elevated oestrogen doses and some doctors are concerned that high-dose prescribing puts women at risk of cancer. The new IMS paper recommends the progesterone dose is increased proportionally in line with oestrogen ‘to provide sufficient endometrial protection’ but acknowledges that more research is needed.

The General Medical Council (GMC) guidelines do allow UK specialists to prescribe above the licensed HRT dose if they think it will help the patient, and clinicians are expected to explain the risks so patients can make an informed decision.

In April last year, the BMS joined with four other professional bodies and the Royal College of General Practitioners to issue a joint safety alert about high-dose HRT prescribing, urging practitioners to stick to NICE guidance to aim for the lowest effective dose to control symptoms.

Dr Newson argues that NICE guidance don’t specify a maximum dose, arguing that the 100mcg limit is based on tolerance trials conducted by the drugs companies themselves. Her team told Femail that ‘prescribing outside guidelines is relatively common practice and Dr Newson and her clinicians are not outliers in this respect.’

Certainly, the new IMS white paper states: ‘It is not unusual to see three or four times the maximum recommended dose used.’

Dr Newson has revealed that she takes three times the licensed maximum dose of oestrogen-only HRT (she has had a hysterectomy so does not need to take progesterone to protect her womb lining) and argues that as many as one in five women don’t absorb oestrogen well through their skin, thereby requiring a higher dose to achieve adequate levels in the blood to ease symptoms.

Contention appears to lie in the fact that most specialists rarely prescribe high doses (Dr Paula Briggs, who is a consultant in sexual and reproductive health at Liverpool Women’s NHS Foundation Trust and chairman of the BMS said this happens ‘not routinely but for that tiny proportion of women who don’t respond to smaller doses’) and Newson Health does it more frequently. Dr Newson argues that specialist clinics like hers might see a higher number of tricky cases that hadn’t seen results on a minimal GP-prescribed dose.

Is there a problem with testosterone too?

In the UK testosterone isn’t licensed specifically for use in women, only men, though it can be prescribed ‘off licence’ and many private menopause clinics will add it into a woman’s HRT mix. Many women say it boosts libido, reduces brain fog and enhances mood.

One fellow journalist (who has asked to remain anonymous) saw Dr Newson ten years ago after her GP dismissed her perimenopause symptoms. ‘She put me on oestrogen, progesterone and testosterone and I felt amazing!’ she says, ‘there was no indication that I might suffer side effects but three months later my hair started to fall out. It was extremely distressing’.

She went to see a trichologist who diagnosed a sensitivity to testosterone, saying the hair loss would be permanent.

‘I emailed Dr Newson to ask her advice and we had a phone chat. She was very sympathetic but said she didn’t agree with the trichologist and refused to accept that her prescription was anything but fantastic.’

The journalist stopped taking the testosterone and now gets HRT from her GP at the lowest possible dose, but her hair remains very thin: ‘I’ve lost a third of the hair I once had – and it continues to shed,’ she says.

‘I blame myself for not researching potential side effects, but I’m angry with Louise Newson for not warning me that this might happen.’

The Newson Health website says NICE menopause guidelines DO recommend testosterone for women experiencing low libido and it states that adding testosterone to the HRT mix can boost mood, anxiety, irritability, physical fatigue and exercise tolerance. There’s no mention of it being ‘off licence’ but the website provides a link to balance-menopause.com which features an article published in August 2024 by a trichologist describing a possible link between testosterone and hair loss.

Daggers drawn: Louise Newson vs the BMS?

The British Menopause Society (BMS) calls itself ‘the specialist authority for the menopause and post reproductive health in the UK’, which exists to ‘inform and guide healthcare professionals’. It holds the most comprehensive list of menopause specialists (private or NHS) around the UK. Last year, the BMS removed Dr Newson from its online register of specialists because of concerns that ‘aspects of her practice’ did not fit with ‘established guidance’, and although many private clinics and GPs prescribe outside NHS guidelines, the BMS told Femail Dr Newson is the only specialist it has removed from the list.

In retaliation, Dr Newson commented that the BMS is merely a charity and not a governing body. Her spokesman said: ‘They issue guidelines, not rules.’

In her interview for the Mail, Newson said the BMS had phoned urging her to take down her menopause website eight years ago. But in a statement to Femail, the BMS said they did not ask Dr Newson to take down her website.

Dr Newson also told the Mail that the BMS has ‘repeatedly’ reported her to the General Medical Council (GMC) for calling herself a menopause expert. But in a statement to Femail the BMS said it had ‘never reported Louise Newson to the GMC’. The GMC told Femail it cannot disclose information about any concerns it receives but confirmed that Louise Newson is currently registered with a licence to practise with no restrictions – but as a GP. She is not on the specialist register.

Dr Newson told the Mail that she was hurt and confused by the fact her clinics have been reported to the healthcare watchdog, the Care Quality Commission. The CQC confirmed to the Mail that it had received ‘information of concern’ about Newson Health and although it was unable to share further details, a spokesman said: ‘We’re in contact with the provider about those concerns. We’re currently following up to understand if there are any risks to people using the service and if further action is warranted.’

How can I get good menopause care?

If you go to your GP with menopausal symptoms or to ask about HRT and find you are sent home frustrated, London-based GP Dr Murray Ellender recommends patients ask who at their surgery (whether a GP or specially-trained nurse) is best to see about menopause and HRT.

‘If you are not satisfied, move practice!’ he says. ‘We know that sometimes women feel they have little choice but to pay for private care, but we should – with better resources – be able to manage all women within the NHS.’