The Dr Louise Newson Podcast

Dr Zoe Hodson returns to the podcast this week to talk to Dr Louise Newson about the hormone testosterone. Zoe is a GP and senior doctor at Newson Health, and together they discuss the impact of low testosterone on your daily life, why it can be difficult to get hold of, and gender inequalities in healthcare provision when it comes to this particular hormone.

Zoe is on a personal mission to ask every local health commissioning group if their clinicians can prescribe testosterone and, if not, why not? Change is happening slowly within primary care and Zoe and Louise are committed to continue to push for testosterone to be regarded as an integral part of menopause care at a free, local level for all.

Zoe’s 3 asks for change:

1. We need to normalise testosterone in women, so please keep talking about it. If you take it already, tell people, and tell your healthcare professionals about the difference it makes to you.
2. Keep alerting your GP practice to the ‘Confidence in Menopause’ course on fourteenfish.com. It is now free for all healthcare professionals across the globe.
3. If you’re going to a menopause clinic and they haven’t mentioned testosterone, ask them about it.

Zoe would like to thank all her followers on social media for their wonderful support and encouragement to keep speaking up for women and trying to bring about change for good. You can follow Zoe on Instagram @manchestermenopausehive

Rachel was a very active 45-year-old, who loved the outdoors and her job as a specialist teacher when her fit and healthy body began suffering with one problem after another. Joint problems and crushing fatigue curtailed her hobbies of hiking, climbing and cycling. The following months saw her list of unexplained symptoms grow and grow from being in constant pain, migraines, and gum problems, to palpitations, dry mouth and eyes, anxiety and electric shock sensations. Within 2 years, she describes herself as ‘just a shell who couldn’t leave the house’, she had given up her job, and living with this version of Rachel had a huge impact on her husband and son. After multiple trips to the GP and blood tests, she was given a diagnosis of chronic fatigue syndrome.

In this episode, Rachel tells her story to Dr Louise Newson and takes listeners through her journey, including self-diagnosis and battles to get the help she knew she needed. After beginning on estrogen replacement and seeing some mild improvements but still experiencing severe fatigue, she learnt about testosterone and its importance for energy and stamina. Now, 6 months after starting on testosterone, Rachel describes the improvement as ‘life-changing’. She feels a fully functioning human again, is able to work part time, and even manage a 5 mile walk.

Dr Newson explains what testosterone does, why we need it, and why it can be so hard to get hold of the hormone at your local GP practice. Louise reassures listeners that she is working hard with NHS England on this very matter and is hopeful that change will come.

Both Louise and Rachel agree that testosterone should not be described as the ‘icing’ on the HRT cake but a crucial ingredient of the cake itself.

Rachel’s top 3 tips:

1. Remember GPs aren’t trained in peri/menopause, so go armed with useful information and the NICE guidelines to help you have a factual conversation.
2. Don’t give up trying to get the help you need.
3. Be kind to yourself and listen to your body.

Note: Rachel had to see a menopause specialist to get her initial prescriptions for testosterone. After lots of persevering on her part, it has now been agreed to be prescribed via her usual NHS GP.

Professor Isaac Manyonda, professor of obstetrics and gynaecology at St George's Hospital in London, makes a welcome return to the podcast to discuss the important hormone, testosterone, with Dr Louise Newson.

The experts discuss why awareness of testosterone in women is usually overshadowed by estrogen and they describe what type of symptoms can be greatly improved by replacing testosterone, as well as the different preparations available, licensing issues and challenges of accessing the medication on the NHS.

Isaac’s top 3 tips if you’re considering testosterone:

1. Understand that testosterone isn’t just a male hormone, it is a key female hormone, and tell your doctor this if they are unaware!
2. Be clear (with your doctor) about what symptoms testosterone can help specifically that estrogen alone may not fully alleviate, such as brain fog, sleep disturbances, lack of energy, and low libido.
3. If your usual doctor will not prescribe testosterone for you, look into what other NHS clinics in your region will, it can take a bit of finding out how to receive it. It should be something you can access via the NHS, but change is slow.

In this week's podcast, Dr Newson is joined by Lauren Redfern, a researcher who has been exploring the experiences of women using testosterone as part of their HRT treatment. Lauren has been spending time at Newson Health Menopause and Wellbeing Centre over the past year observing many different aspects of women’s care; from the moment they make contact with the team right through to their consultation. She is interested in hearing stories from women first hand about their treatment journey and is particularly interested in the gendered aspects of hormonal care. Lauren hopes that her work will provide insight into the realities facing women negotiating menopausal care in the UK today; something that she feels is currently vastly underrepresented in both social and public health research.

If you would like to know more about Lauren’s research you can visit her website www.laurenredfernwrites.com or follow her on Instagram @laurenredfernwrites where she posts about everything from the history of hormones to updates on her research.

Lauren's Top Three Facts about Testosterone and Menopause care:

1. Time is an underestimated benefit in healthcare. Women need longer than 10 minutes to adequately explain their symptoms to a doctor.
2. Menopause isn't just hot flushes and something to "get through" - the symptoms can have a massive impact on a woman's life.
3. Testosterone is not just the male hormone, it is essential for re-balancing female systems, just as it is for men.

Newson Health Research & Education

Athena Lamnisos is the Chief Executive of the Eve Appeal which the only UK national charity raising awareness and funding research into the five gynaecological cancers – womb, ovarian, cervical, vulval and vaginal. In this episode Dr Louise Newson and Athena talk about the importance of diagnosing these cancers early which leads to better outcomes for women. Many women are ignoring signs of potential cancer such as vaginal bleeding due to fear or denial which needs to change. Athena talks about ways the charity is working to improve early detection of cancers and also with the research they are involved in and the discussion also includes managing menopause in women who have had treatment for their cancer and how important it is for them to receive the right treatment and advice.

Athena's Three Take Home Tips for Understanding your Gynae Health:

1. You need to know your menstrual health and cycle and know what's normal for you. If you no longer have periods, you need to know when your last one was.
2. We need to break down the stigma and taboo around gynaecological health. Learn and use the correct terminology for your body parts so you can describe any symptoms properly.
3. Know your body! Have a look at your vulva and know what is normal for you. This will help so much should you have to explain anything to a medical professional.

https://eveappeal.org.uk/