Latest / The Dr Louise Newson Podcast / 39 - Looking back at 2025: progress, pushback and what still needs to change

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39 - Looking back at 2025: progress, pushback and what still needs to change · The Dr Louise Newson Podcast

0:00
So I wanted to use this time to reflect on the year.
0:02
It's the end of 2025 and I'm always reflecting, thinking
0:07
about are we making progress or are we going back in time,
0:11
What's happening for women? And obviously I'm very close to
0:14
a lot of women. I see a huge amount of women in
0:17
my clinic, on the street, through my social media, just
0:22
listening to stories and sometimes I feel really
0:25
encouraged. I think how wonderful women are
0:28
being listened to, they're being believed, they're being
0:30
prescribed hormones when they want them, their future health
0:34
is improved, their symptoms are improving, there's so much
0:37
positivity going on. And then other days I don't feel
0:41
quite as happy. I feel very frustrated, I feel
0:43
very angry and I often feel very sad for the injustice of those
0:47
women who who are unable to be listened to, who are not being
0:51
believed, who are being dismissed by the medical
0:54
community and are unable to access hormones.
0:58
So I thought I would just think a bit about what's been going on
1:01
over the last year and whether anything is really helping.
1:08
Now I'm going to talk positively first because I'm quite a
1:11
negative person and I think that's not very good to just
1:14
focus on negative aspects of life.
1:17
So let's think in a positive way.
1:20
I feel that a lot of my work is about empowering people, giving
1:25
people information in ways that they understand so they can make
1:29
choices that are right for them about their health and their
1:33
future health. So I've been working very hard
1:37
with a huge team of people to try and help improve this
1:41
knowledge sharing. So some of you hopefully will
1:44
have noticed I've rebranded the podcast, The Doctor Louise
1:48
Newsome podcast. I've got these wonderful studios
1:51
that I rent and it's just so comforting coming here and every
1:56
single guest who's come into these studios has really enjoyed
2:00
the atmosphere. Jack, who runs the studios, is
2:03
fantastic. He helps us, he reassures us, he
2:07
encourages us. We have a few tears, but we also
2:11
have some laughs as well. And that's been really actually
2:14
great for me. But also we I've got a new
2:17
website which the branding links in with the podcast rather
2:21
conveniently. My website really is a
2:23
springboard for you to find out more about the work I do.
2:27
So you can read articles, you can find out about the Hormones
2:32
Unlocked, which is a course that we've developed for anybody,
2:37
especially people who are having symptoms or people that want to
2:40
know more about hormonal changes.
2:43
Also for people in corporates, in companies to understand as
2:46
well. So this is a course where people
2:49
can listen to different classes, if you like, about different
2:52
topics related to hormonal changes.
2:55
And I've got experts that I interview and also people
2:58
sharing their own experiences. So you can find out more about
3:02
Hormones Unlocked on my website. You can also find out about the
3:07
large amount of education that I do for healthcare professionals.
3:11
And we've now got a new website directing people to education,
3:15
which you can go to from my website.
3:18
So our education is really important because I feel very
3:22
strongly that for the health of women to improve, two things
3:26
have got to happen. We've got to be more empowered
3:29
as women. I'm a menopausal woman, and I
3:32
want as much information as possible that's right for me.
3:35
But the other thing is we have to educate more healthcare
3:38
professionals. I'm a healthcare professional
3:41
and every day I learn more about hormones, I learn more about
3:45
diseases, I learn more about how I can help my patients.
3:50
And we need to move this conversation forward for other
3:53
healthcare professionals. So I've been working very hard
3:56
with some amazing doctors, nurses and pharmacists to
4:00
improve our education. Some of you might know that I
4:04
launched the Confidence in Menopause course several years
4:07
ago now and it's had over 33,000 downloads with really positive
4:13
feedback from people from not just the UK but globally as
4:17
well. But we're rebranding, we're
4:20
relaunching that education program and it's called
4:24
Confidence in Hormones because my work is far more than
4:28
perimenopause and menopause is thinking about hormones in women
4:32
of all ages. So women who have hormonal
4:35
changes, as you know, can develop symptoms due to PMS,
4:39
premenstrual syndrome or PMDD, premenstrual dysphoric disorder,
4:44
or post Natal depression, or women with PCOS come in with
4:48
endometriosis that can be related to hormonal changes.
4:52
So we're doing a lot of that. We've been refilming, we've been
4:56
using some new content and this is really exciting so we can
5:00
reach more healthcare professionals so they can be
5:02
more confident into what causes hormonal changes, what the
5:07
symptoms are, what the health risks are, and really
5:10
importantly for me, what the treatment is and how to safely
5:13
prescribe hormones in a very individualized way.
5:17
So we're doing a lot of work with healthcare professional
5:20
education. Earlier this year in March, I, I
5:24
had a, a conference at the Royal College of Surgeons in London.
5:29
And this was really exciting because it was a nuisance
5:32
education conference and people came from all over the world.
5:37
We had people from 16 different countries who came for this day,
5:41
mainly doctors, but we also had some nurses, some pharmacists
5:46
and some other allied professionals as well.
5:49
And it was a really wonderful day.
5:51
We had a lot of lectures from people that I know very well,
5:55
including people from the US and Singapore came over to educate.
6:00
We talked a lot about hormones and about how important they are
6:04
to get right. We talked also about lifestyle,
6:07
about longevity, about reducing inflammation, about
6:11
cardiovascular disease, and really importantly, about mental
6:16
health and hormones. We presented some of our
6:19
research there as well, which was really great to be able to
6:22
share it with other people. The night before the conference
6:26
we had a dinner, which was really great because the energy
6:29
in the room was so positive. And what I learnt from it is
6:33
that so many healthcare professionals across the world
6:37
are working as hard, if not harder than me to really help
6:41
educate others and also to help our patients.
6:45
Because all of us as healthcare professionals have gone into
6:48
medicine to help our patients. And so talking to others really
6:53
gives us all more confidence. There's some negativity that
6:56
goes on in our work, but actually if we know what we're
6:59
doing is right, if we share our clinical experiences and
7:03
knowledge and work together, it makes a big difference.
7:07
So having this conference was really important for me.
7:10
The feedback we had was absolutely brilliant.
7:14
So in 2026, we're doing another one on on the 13th of March,
7:19
again at the Royal College of Surgeons in London, a great
7:22
venue and you can learn more on the education website.
7:26
But people already are coming. I've got 2 colleagues who have
7:29
already booked their flights from Australia, so they're
7:32
coming over. We've got people from other
7:34
countries coming over, healthcare professionals and
7:37
we're just preparing the program for that.
7:39
So that's a very positive thing that has happened.
7:44
I just want to remind you that I'm the founder of the free
7:47
Balance app, which you should all be downloading.
7:50
So you can learn so much more about your hormones from and
7:54
also monitor symptoms if you're having them.
7:56
So just head to the App Store or Google Play and download Balance
8:00
app. We've also been working very
8:05
hard in the clinic to help our patients in lots of ways.
8:09
We've been improving some of the clinical pathways that we have
8:13
developed. We've been updating them, we've
8:15
been listening to feedback from patients and really improving
8:19
and optimised what we're doing. But as many of you know, my work
8:22
is far more than the clinic. One of the things that's been
8:26
really important for me is research, because I feel very
8:29
strongly that the only way we can really improve things is to
8:33
have published research because so often people say, oh Louise,
8:36
there's not enough research into hormones, we can't prescribe
8:40
them. Well that's absolute rubbish in
8:42
some ways because our hormones are physiological.
8:45
We've got basic physiological knowledge about how hormones
8:48
work in our body and we can use that knowledge to help when we
8:53
prescribe body identical hormones.
8:56
But I found a very small research team and we've
8:58
published quite prolifically. So we've had quite a few
9:02
publications in peer reviewed journal this year.
9:05
One of our publications was about dosing because some people
9:09
have been concerned about some of the higher dose prescribing
9:12
that we sometimes do for women, especially of estradiol.
9:16
So the estrogen through the skin is a patch or a gel.
9:20
So this paper was looking at how some women, about 1/4 of people
9:25
we see in the clinic do need a higher dose on a review
9:29
consultation when their levels of estradiol in their body are
9:33
low, they're still having symptoms and increasing the dose
9:37
improves their symptoms and also results in their estradiol
9:41
levels being normal. So this is really important
9:43
because it shows that some women that don't absorb adequately
9:47
through the skin. And the skin, of course, is a
9:50
barrier. We don't have many drugs or
9:53
medications that we apply onto the skin, but estradiol is one
9:57
that can penetrate through the skin.
9:59
But we've known for decades that the thickness of the skin, the
10:03
temperature of the skin, the type of skin really varies
10:07
between women. And all of these factors can
10:10
affect the absorption of estradiol through the skin.
10:13
So this paper confirms something we've known for many years, but
10:17
it's very reassuring. We also, which was sort of Part
10:21
2 if you like, we looked at people who have had bleeding
10:26
because there are some doctors who get very concerned about
10:29
bleeding as a which is a very common side effect of HRT.
10:35
So we looked at people who had been referred for a scan and had
10:38
a scan of the lining of the womb to see whether the dose of
10:41
hormones we prescribed correlated with the increased
10:45
thickness of the womb. And we showed that there is no
10:48
correlation, which is what we see in our clinical practice.
10:51
So we have some women who have low levels of estradiol and low
10:56
doses, and their thickness of their lining of their womb,
10:59
their endometrial thickness is greater than other women who are
11:03
prescribed a higher dose. And that's again because of the
11:06
absorption, but also the way that the lining of the womb
11:09
responds to different concentrations of estradiol.
11:13
So there was no correlation between dose of estradiol and
11:17
the thickness of the lining of the womb.
11:19
But also the dose of progesterone that was given
11:22
didn't correlate with the thickness of the womb also.
11:25
And some guidelines over this year have changed to say that if
11:29
women are on a higher dose of estradiol, they automatically
11:33
need a higher dose of progesterone.
11:35
There's no evidence for this. And in fact, our paper showed
11:40
that not everyone needs a higher dose of progesterone.
11:43
Some people will need a higher dose if they're on a lower dose
11:46
of estradiol or vice versa. So The upshot of those articles
11:51
really is that dose of hormones is individualized, which we've
11:56
known for many years. It just seems to spark a delay,
11:59
a debate sometimes in medical communities.
12:02
So those papers are really reassuring.
12:05
We also looked at women who've had breast cancer to see what's
12:09
it like for them if they've become menopausal.
12:13
Are they listened to? Do they have people they can
12:15
speak to? Do they understand about the
12:17
symptoms of menopause? And a lot of women who've had
12:20
breast, breast cancer are given treatments to block hormones, so
12:24
they become menopausal and sometimes at a younger age than
12:27
they would do otherwise. And so we asked women, it's
12:31
always good isn't it, to involve women in research.
12:34
So we asked women what was their experience like and when they've
12:37
had breast cancer, learning about menopause, talking about
12:41
menopause, getting help, advice, support and treatment for their
12:44
menopausal symptoms. And so we published 2 papers, 1
12:48
was quantitative and 1 was qualitative.
12:51
But the results were actually really harrowing and sad to read
12:55
because what they showed was that many, many women who've had
12:58
breast cancer are not being listened to.
13:01
They are not being explained. They are not being told about
13:05
the myriad of symptoms and also, rather concerningly, they're not
13:09
being told about the health risks of having low hormones as
13:12
a consequence of their menopause.
13:15
They're not prepared for it. They're being often dismissed
13:18
and being told they're lucky that they've got through their
13:21
breast cancer. But breast cancer generally has
13:24
a really good prognosis. So we should be thinking beyond
13:28
the initial diagnosis for many women, and we should be thinking
13:31
about ways of making their menopause as happy and healthy
13:35
as possible. Many doctors didn't even want to
13:38
talk about treatment options, especially when thinking about
13:41
hormones. And many doctors are saying to
13:44
patients they absolutely could never have hormones, despite
13:48
there being no good quality evidence that hormones are
13:50
dangerous for women. And there's always choices, of
13:53
course. So it's very sad reading this.
13:57
We also had another publication where it's taken us three years
14:01
actually to get it published, where we it was a consensus
14:04
document. So we've involved other doctors,
14:08
so people who are breast oncologists, people who are
14:11
breast surgeons, people who are menopause hormone specialists as
14:16
well, to ask their opinions on different statements about
14:20
hormones and breast cancer. And it was very interesting
14:24
because this isn't really been done before.
14:26
And it's very hard, isn't it, for people to agree, especially
14:29
when we don't have good solid evidence.
14:32
What we all agreed was, is that people should be listened to,
14:35
People should have a choice. And we agreed that vaginal
14:38
hormones are safe for women who have breast cancer.
14:41
But also, we don't have the evidence.
14:44
We don't know whether HRT is safe or harmful in people with
14:49
breast cancer, But we know there are different types of breast
14:52
cancer, there are different grades, different stages,
14:55
different receptor status as well.
14:57
And all of this needs to be taken into account.
15:01
Often when I see people who've had breast cancer, we have very
15:04
open conversations led by the patient, of course.
15:08
And some women decide to take hormones because they want to
15:10
feel better. They want to improve their
15:13
future health, for example, their bone, their heart, their
15:16
brain health. And increasingly, I might
15:18
prescribe testosterone first line without having to think
15:22
about the estrogen side of hormones.
15:25
We all agreed at the end of the consensus document that choice
15:30
is really important. And actually what this paper has
15:33
done has almost allowed clinicians to think beyond the
15:37
box. And quite a few clinicians I've
15:39
spoken to have thanked me for the paper because they say we've
15:43
been prescribing hormones to women who've had breast cancer,
15:46
but we've been too scared to talk about it.
15:48
And now you're talking about it, it means that we can all talk a
15:51
lot more and understand for some women, hormones are really
15:56
important and we can't just dismiss them because of
15:59
unfounded. The other side of research that
16:02
I've been working very hard on is looking at mental health and
16:05
hormones. We've had quite a few
16:07
publications in peer reviewed journals about this and I've
16:11
been funding APHD student in suicide prevention with
16:16
Liverpool John Moores University and this has been really great
16:20
research. It's just come to the end.
16:22
So Olivia has just passed her PhD, which is wonderful and
16:26
she's learned so much. And so we've been looking at
16:29
women who have had suicidal thoughts as a consequence of
16:33
their hormonal changes. Some of these stories have been
16:36
very harrowing. A lot of these women haven't
16:39
been receiving help at support and treatment.
16:42
But what we've also learned is that when women are given
16:45
hormones, especially with testosterone, their mental
16:48
health improves. Their intrusive negative
16:50
thoughts improve as well. So really important because
16:54
we've known for many years the association of mental health and
16:57
hormones, but this is often being dismissed.
17:00
So actually having research in this area is really crucial.
17:04
And Professor Pooja Sanai, who was the lead for this research,
17:09
she was on Women's Hour talking about this research which is so
17:14
crucial. And we're doing a lot more in
17:16
this area. We've got loads more projects
17:19
lined up looking especially at mental health, but not just in
17:23
perimenopause and menopause, also in women with PMSPMDD and
17:29
post Natal depression. So we've got a lot more going
17:32
on. We've done a lot of
17:33
collaborative research actually with other people, especially
17:36
Professor Mokira in the US and we've been presenting some of
17:40
our data at different conferences.
17:43
We've also been looking at our D prescribing data, so looking at
17:47
how women who are balanced on the right dose and type of
17:50
hormones can reduce their antidepressants, their anti
17:54
anxiety medication, their sleeping tablets, their
17:58
antipsychotic medication as well.
18:00
And this is really powerful data because we know how addictive
18:03
these drugs are and they also are associated with risks and
18:07
side effects. So reducing those medications
18:11
when women are given the right dose of hormones is really
18:13
important. So there's lots of research
18:16
going on which is really stimulating.
18:19
It's really exciting to be able to bring everything together.
18:24
We're doing some research on addictions.
18:26
We're doing some research on ADHD as well.
18:30
We're doing some research on on different types of contraception
18:33
too. And lots more that I'm not going
18:37
to talk about, but I will share with you next year.
18:41
So there's lots of really positive things.
18:43
The other thing that happened was that I went to Australia
18:46
earlier this year, which was a real highlight, talking at
18:49
Sydney Opera House to an audience of 3000 women.
18:52
I went with some other doctors from us.
18:55
It was wonderful to be able to share the stage with them and
18:58
also to listen to the stories that we all have in our heads
19:03
from our clinical practice, but to share and realise that
19:06
inadequate and poor menopause care is harming so many people.
19:12
I've given lots of lectures over this year to healthcare
19:14
professionals, to women. I've been to face to face
19:18
events, I've been in the media, in articles, in magazines and
19:23
newspapers, on radio interviews. There's been a lot that's been
19:26
happening and every time we have these conversations, more and
19:30
more people learn. The podcast is doing really
19:33
well. Since being in the studio, we've
19:35
had more and more people subscribing to the podcast,
19:39
sharing the podcast with their friends and family and
19:42
colleagues. And keep doing this because the
19:45
more that you subscribe, the more that you share, the more
19:48
that we can put out really good content.
19:50
I've got some really great guests lined up.
19:54
I'm not going to talk much about the negative things that have
19:57
happened this year because I feel very strongly that when
20:00
something negative happens, it just makes you grow stronger.
20:03
There's no time in life to to focus too much on negative
20:08
things because it can really draw you down.
20:11
And I know this from having negative things that have
20:13
happened to me in the past. If you dwell on them and focus
20:16
on them, you end up looking backwards rather than going
20:19
forwards. And I feel there's so much we
20:22
need to do that I need to keep propelling myself forward.
20:25
So there are negative things that have happened in the media,
20:29
on social media, various platforms, various people,
20:32
various healthcare professionals.
20:35
But you know, I was bullied a lot at school for being clever
20:38
and I felt quite ostracized at school and quite lonely at
20:41
times. But I took comfort in learning
20:44
and and moving myself forwards academically.
20:49
And the same is happening here. I think there are quite a few
20:51
healthcare professionals that are scared of what's happening.
20:54
They're scared of all this knowledge that's been shared.
20:57
They're scared of choices for women and they're scared of a
21:01
new generation of healthcare professionals that are happy to
21:04
share their information in ways that we never did before.
21:08
So through social media, through each other, just connecting in
21:12
different ways. And I realise there's a huge
21:15
community of healthcare professionals that are working
21:18
together to educate women, to help women, and we need to move
21:23
faster. The reason I want to move faster
21:26
is that I can't bear the suffering.
21:28
I can't bear the stories. Every day I'm hearing stories of
21:32
women who are being turned away from healthcare professionals
21:35
for the wrong reason. Women who are suffering often by
21:38
themselves with quite harrowing symptoms that I know would
21:42
improve with the right dose and type of hormones and having
21:45
supportive treatment as well. So we need to be changing
21:48
conversations, we need to be bolder, we need to be thinking
21:52
differently. So next year I've got some
21:54
really exciting things planned. Hopefully some of you already
21:58
will have booked your tickets for my tour, which is starting
22:01
in April. I think it's going to be rather
22:03
exhausting. I'm going to 45 different
22:05
theaters throughout the UK, hopefully meeting many of you,
22:09
but there'll be a lot of time for questions and answers which
22:13
I will be answering live to the audience.
22:16
Before I end, I just wanted to say the other thing I've been
22:19
doing a lot on is my balance app.
22:21
So this is a free app. There's a small paid for
22:23
section, but the free app is giving people lots of
22:27
information and choice and knowledge.
22:30
And also you can you can monitor your symptoms if you want to.
22:33
We've been working with some other people collaboratively to
22:36
share some content and through Balance plus I do a weekly
22:40
event, it's a live event talking about different topics and
22:45
people can put in their questions on that as well.
22:48
So those have been going really well and we're going to continue
22:51
that. The most important thing I want
22:53
to share with you is that the only way we can move forward is
22:57
by you. You're listening, you being a
23:00
community and you shaping the future.
23:02
So if there are things that you want more of or less of or done
23:06
differently on new topics or ideas for for podcast guests,
23:11
please get in touch because I can shape and change things very
23:14
quickly if I know what's needed. I want to make the biggest
23:18
impact to the most people in the shortest time possible.
23:22
So with your help, we can do this.
23:24
So get in touch either through my website, through my social
23:27
media, through my podcast and give us ideas, Shape up.
23:32
Let's work together to think about the future, how we're
23:36
going to share the knowledge, how we're going to help others.
23:40
Because it's not just us who are suffering, it's people around us
23:44
too, and we need to be looking out for them.
23:46
So I just wanted to thank you also for all your kindness, all
23:51
your support, because it means a lot.
23:53
Having your support will really help to encourage me to keep
23:57
going because there's some really exciting things we can do
24:00
in the future. So thank you very much.