BBC
Dr Louise Newson regularly appears on popular BBC and ITV shows
The UK health watchdog, the Care Quality Commission (CQC), is investigating “concerning information” at a clinic run by one of TV’s most famous menopause doctors.
Dr Louise Newson has also been stripped of her accreditation from the British Menopause Society over her prescription of high-dose hormone replacement therapy (HRT), BBC Panorama reported.
More than a dozen patients at her private clinic, Newson Health, told the BBC they had experienced complications. Some people develop a thickening of the endometrium, which can be a sign of cancer.
Newson Health said it leverages its “extensive clinical experience and data” to treat patients individually to “provide the best possible menopause care.”
It also said its approach was in line with national guidelines and that the British Menopause Society (BMS) was a charity and not a regulatory body.
The CQC told Panorama it was following up on the information it received “to understand whether there is any risk to people using the service and whether further action is needed”.
Newson Health said it had addressed all of the findings raised by the CQC and had not been advised of any resulting concerns. It also said it was confident in the quality of care it provided and maintained a good CQC rating.
One woman said her menopausal symptoms worsened even though the HRT dose she received from Newson Health was three times the maximum approved dose.
“I had constant flushing. It was unrelenting. Anxiety. I couldn’t sleep. I couldn’t sleep for days.”
Four former Newson Health doctors have also raised concerns about Panorama, with one warning that the woman could be “potentially in harm’s way”.
The British Menopause Society (BMS) told the BBC it removed Dr Newson from its register of menopause specialists last year over concerns that “aspects of her practice” did not meet “established guidance”.
As a result, BMS, along with five other organizations including the Royal College of General Practitioners, announced that it has issued a joint safety warning regarding high-dose prescribing.
Professor Janice Reimer, president of the British Menopause Society (BMS) and consultant gynaecologist, said high doses of estrogen were putting women at risk of unnecessary interventions.
Clarifying the menopause industry
Kirsty Wark speaks to women seeking menopause support from the NHS and investigates prescribing practices at Newson Health, an online clinic run by one of the world’s best-known menopause specialists.
Watch now on Monday 30th September at 20:00 (20:30 in Northern Ireland and Wales) on BBC iPlayer or BBC One.
For many years, Dr. Louise Newson has been seen as a positive force in the menopause discussion, supporting and empowering women to fight for proper care. Described by some as the doctor who started the menopause revolution in the UK, she regularly appears on hit shows on the BBC and ITV.
Newson Health said it has seen 45,000 women since 2020 and hired dozens of doctors, nurses and specialty pharmacists. An initial consultation fee with a doctor is £295 and a follow-up consultation fee is £230. Many appointments are made online.
In some NHS trusts, women may have to wait between six months and a year to receive specialist support at a menopause clinic. This means that some people end up seeking folk remedies.
When a woman is in perimenopause (the transition to menopause), her hormone levels fluctuate and decline when she reaches full menopause.
HRT is routinely used to reduce symptoms such as brain fog, hot flashes, and mood swings.
It contains estrogen, which reduces symptoms, but this can cause the endometrial lining to thicken, so another hormone, progesterone, is often prescribed to protect the uterus.
ITV
Dr Newson told the BBC that the damage was likely caused by the woman’s failure to give her the necessary HRT.
HRT can be administered as a gel, spray, tablet, or patch. The highest approved dose of estrogen is 100 micrograms (mcg) per day.
100mcg is the level at which manufacturers have established safety and efficacy through clinical trials, which are then approved by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA).
Dr. Newson said he sometimes prescribes higher doses than the approved dose of 100 micrograms, and that some women have difficulty absorbing estrogen, so he adjusts the dose to suit her needs.
General Medical Council (GMC) guidelines allow UK experts to prescribe more than the approved HRT dose if they think it will help a patient. Clinicians need to be informed about the risks so they can make informed decisions.
Fifteen women who spoke to Panorama said they experienced complications after becoming Newson Health patients.
Thirteen of them said they had taken doses higher than the approved dose, and some said they developed endometrial thickening. This can be a precursor to cancer, which can be caused by too much estrogen and not enough of the second hormone, progesterone.
One of these women is Rachel Osmond from south London, who first started experiencing menopausal symptoms during the pandemic. Because of the lockdown, she had difficulty getting to her local GP, so she started taking over-the-counter medication to ease her brain fog, anxiety and hot flashes.
But “nothing helped,” she says.
Rachel Osmond’s estrogen dose increased from 50μg to 300μg – three times the approved dose
After seeing an ad for a private menopause clinic, the 56-year-old decided to book a telemedicine appointment with Newson Health. She consulted a doctor and was prescribed 50 μg of estrogen, which she self-administered through a patch.
After a few months, doctors started increasing her dosage. Rachel says she entered a cycle of increasing doses and worsening symptoms.
“Some women need higher doses and we’ve been told, ‘It’s all about your body,'” she says.
Over eight months, Rachel’s estrogen dose increased from 50 micrograms to 300 micrograms. This is three times the approved dose.
Although HRT has been shown to be safe and effective, the safety of higher-dose regimens has not been established in clinical trials.
Dr Paula Briggs, sexual and reproductive health consultant and former chair of the BMS, says that while HRT can make a huge difference for women, “the concern for most experts is that things are not regulated. “When it becomes unsafe,” he said.
Dr Newson told the BBC there was no evidence linking high doses of estrogen to an increased risk of long-term harm. She says harm is likely to occur if women are not given the required doses.
HRT can be administered as a gel, spray, patch, or tablet.
Several women the BBC spoke to said doctors treating them at Newson Health continued to increase their estrogen doses even as their symptoms worsened. Some said they had not been informed that safety had not been established.
One former doctor at the clinic, who asked not to be named, told the BBC: “I am concerned that the current opinions and instructions provided by Dr Newson may continue to cause harm to women over time.” “There is,” he said.
As Rachel’s dosage continued to increase, her symptoms worsened and she began experiencing pregnancy-like symptoms such as nausea and morning sickness.
At the same time as the estrogen increase, Rachel’s dose of progesterone, the second hormone that protects her uterus, was cut in half.
Rachel began experiencing heavy bleeding and pelvic pain. She emailed Newson Health about her new symptoms, but felt she received little support. By that stage she had spent £2,300 at the clinic.
Consultant gynecologist Professor Janice Reimer said: “I have never prescribed that dose of estrogen to anyone before.”
The email response from the clinic included a price list and made it clear that she would have to pay for her next visit.
Rachel said she had consulted Newson Health several times, but her symptoms had worsened and she was feeling overwhelmed. As a courtesy, she says, she was offered a free 10-minute call with a pharmacist.
She said she eventually went to see her GP, who eventually referred her to a team of NHS specialists who diagnosed her with endometrial hyperplasia (changes in the lining of the uterus that can lead to cancer). Ta.
Professor Janice Reimer, consultant gynecologist at Guy’s and St Thomas’ NHS Foundation Trust and chair of BMS, believes the changes in Rachel’s uterus are due to the treatment provided by Newson Health.
“I have never prescribed that dose of estrogen to anyone, and that dose of progesterone would not have been enough to counteract the effects of estrogen on her endometrium.”
One former Newson Health doctor Panorama spoke to said he felt the solution to reported problems was “always to prescribe HRT or increase the dose of estrogen.”
Another person believes that Dr. Newson has changed the face of menopause care “for the better,” but believes that she has “stopped, reflected, accepted help, and improved the overall health of women going forward.” I hope we can work together to make things better.”
Newson Health said it “strongly disputes” the “characterizations” made by the former doctors we spoke to. The company says it conducts “responsible auditing” to ensure “patient safety and consistent levels of care.”
Although it does not “comment on individual cases”, it operates a “shared decision-making framework” provided by NICE (National Institute for Health Research Excellence) and “complies with GMC guidelines on decision-making and “I’m doing it,” he said. Agree”.
Although Rachel still suffers from the debilitating symptoms of menopause, she is gradually tapering off her estrogen doses in hopes of reducing the thickening of her uterus and, in turn, her risk of cancer.
If that doesn’t work, she has been advised that she may need a hysterectomy.
“I’m scared,” she says. “I want it to be over, over, over, but a hysterectomy is not a simple operation.”
Additional reporting by Kevin Anderson
