GRACE'S MUSINGS: The great menopause scandal

More than two weeks on, and everybody’s still talking about The Menopause Industry Uncovered, the BBC Panorama episode devoted to “controversial” women’s health specialist Dr Louise Newson.

Newson is a GP who has, for years, championed hormone replacement therapy – also known as HRT – for women in menopause, often flying in the face of a historically cautious medical establishment. The documentary, presented by Kirsty Wark, argued that the high dosages of oestrogen sometimes prescribed by the Newson Health Menopause & Wellbeing Centre were not backed up by clinical evidence. As far as the NHS is concerned, best practice is still that HRT should be given at the lowest dose and for the shortest time possible to control symptoms.

Newson Health’s website states that “manufacturers in the UK have set a recommended maximum dose for each HRT medication. This does not mean that higher doses are not safe, though.

“There is no robust evidence that higher doses of oestrogen are associated with a greater risk to a patient as there have been no randomised controlled trials undertaken in this area.”

“No randomised controlled trials” – you read that right. There’s a scandal erupting here, for sure. But it’s not the one you might think. It’s about the NHS yet again failing to put women’s health first in a system that is primed to keep men alive. This is an area that is chronically underfunded, undervalued and under-researched – and I’m sick of it.

Kate Muir, the menopause campaigner and author of Everything You Need to Know About the Menopause, has spoken out about the issue: “This programme will leave women in fear of hormone replacement therapy once again, just when they were getting their confidence back,” she said. “When I go out to talk in workplaces about menopause, women are often struggling to get HRT on the NHS or have been turned away if their cases are complex, and that’s why they go to the private sector.”

Mariella Frostrup, the TV presenter and co-author of Cracking the Menopause, said on her Instagram page that Newson had been a “pioneering voice” for women, and that there was a “terrifying whiff” about the Panorama documentary, in that it would set back medical attitudes to the safety of HRT. “I’d say the Newson scandal is a microcosm of a much more important and bigger one of women being abandoned by the NHS,” Frostrup wrote. “We need women’s health to be taken seriously, not just as fodder for headline-grabbing stories.”

Frankly, I’m horrified that we’re even having this debate at a time when women in the UK are so woefully underserved for all healthcare. Back in July, Dr Henrietta Hughes, England’s patient safety commissioner, revealed that women who raised concerns about NHS care were being “gaslighted, dismissed and fobbed off”. Not only that, but the majority of GPs are still untrained in menopause provision – a service that up to 51% of their patients might need to access in midlife and beyond.  

And the problem doesn’t stop there. A new Manchester University report has found that the bias in treating heart disease as a “men’s condition” is killing “thousands of women”, too. More than 3.6 million women in the UK are currently affected by ischaemic heart disease – and it kills one in 14 of us. Women are dying “unnecessarily” because we are underdiagnosed, undertreated and under-represented in clinical trials. Experts conclude that there is a “discrepancy” between men and women when it comes to diagnosis, with women less likely to receive certain treatments or tests. And so we die.

Women’s voices are routinely being ignored in our NHS. We are chronically underserved when it comes to care around reproductive health and menopause. Safe delivery of treatment across the board is all we’re asking for. I’m sick and tired of midlife women being fobbed off or told to get over it when our health is suffering. And the scandals that erupt are missing the point. So I’m going to shout about this for as long as anyone will listen. I hope you’ll join me.