Why Hot Flashes Aren’t the Whole Story of Menopause with Dr. Louise Newson

Sameena Rahman (: 00:00

Okay. Hi everyone. Welcome back to another episode of Gynecologist presents sex, drugs and hormones. I'm Dr. Smeena Rahman and I'm super excited to have a world renowned leader at Menopause join us today. Dr. Louise Newsome, welcome to sex, drugs and hormones. So excited to have you. Yeah. I'm so excited. Louise and I met recently. We've been like, you know, friendly with each other.

Louise Newson (: 00:11

Ugh.

Louise Newson (: 00:17

Thank you, thanks for inviting me, it's great to be here.

Sameena Rahman (: 00:28

online for a while, but like we met recently in Dallas and she's just as pleasant in person as she is on online. She's real. Everything you see is real.

Louise Newson (: 00:35

Ha

Louise Newson (: 00:39

Yeah, do you know what? I'm too old to pretend that I'm something different or someone different. It's just not worth it.

Sameena Rahman (: 00:46

But you know, in my intro, you guys heard about this remarkable things that Louise has been doing in the UK and really around the world. It's become, we like to call it in this menopause side track that we have. like a movement of like women empowering each other during this midlife transition. Louise, you want to share anything about how you brought yourself, you came into this movement or and started really deciding that this... I've heard you tell the story. I'm sorry.

Louise Newson (: 01:00

Hmm.

Louise Newson (: 01:10

Yeah, it's funny, isn't it? Because I, yeah, but I was never expected. Like if you'd met, if we'd met each other 10 years ago, I would have said, do know what, I'm quite tired of being a family physician. I can't imagine doing it forever because it's exhausting. I don't feel like making a big impact to my patients. I enjoy medical education and medical writing, but I haven't really found like my

what really ignites me and makes me want to get up in the morning. I'm just doing a job really. But if you'd said to me, you know what you'll be doing, menopause, I would have just laughed and said, don't be ridiculous actually. But now, what's happened, and I think I'm a really honest person and I'm also a very inquisitive person and I'm also a very scientific person. So I ask a lot of questions and I've done it throughout my medical career.

Sameena Rahman (: 01:47

Yeah, isn't that so funny?

Louise Newson (: 02:05

I can't work out why a treatment is working or not working or why guidelines say something. I will always go back to the original evidence and try and work it out for myself. And once I've realized the massive injustice that's happening and is still happening, that's happened for decades for women being denied hormones, and then thinking about how our hormones just work naturally in our body, and then feeling really cross, actually, as a doctor that no one taught me.

My medical clinical practice would have been very different the last 25, 30 years, like lots of ours would, right? And so, but I also, because I'm honest, I want to share what I know with other people. And I've rightly or wrongly, some people think wrongly, I've shared it a lot in a very focal way using sort of, know, tools that we didn't have before. So, you know, social media is important, but also publications, doing research is really important.

Sameena Rahman (: 02:39

Right?

Louise Newson (: 03:04

Working with others is really important because I think a lot of times in medicine, there's a lot of power struggles going on, especially when different research groups or different departments. so medicine can be quite toxic actually. And I don't have an agenda as many of your listeners hopefully know. I don't work with any pharmaceutical companies. I don't work with any brands. My mission is to just improve the house.

Sameena Rahman (: 03:11

I'll see you.

Sameena Rahman (: 03:19

Mm-hmm.

Louise Newson (: 03:32

of as many women as possible and allowing them to have choice about their future health. And so the more I do, the more I expose myself, the more horrendous stories I hear actually. And now it's not just menopause, it's hormones throughout. You know, I see a lot of women with PMDD, increasingly post-natal depression, and no one is joining the dots and thinking about hormones. And I just don't get it. I sometimes feel like I'm living in a parallel world.

Sameena Rahman (: 03:59

Absolutely, don't you? Like I feel the same way and I think that

You know, social media has this great benefit of being able to connect with others, but it also puts you under fire a lot, right? Like I've, you know, you've unfortunately been under fire for some ridiculous stuff. Even though you are, you know, educating the masses, a lot of it for free. And you're publishing, you're publishing articles based on the thousands of women you see a year in your practice, in your very large practice. And so I find that to be, you know, I guess it's just part of, people say that's just part of being

Louise Newson (: 04:09

Mmm.

Sameena Rahman (: 04:32

like when you start becoming a little more well-known for something that you go under.

Louise Newson (: 04:36

Yeah, but we didn't go into medicine, you know, we didn't go into medicine to have all these fights. It's, you know, the bigger picture of it, you know, is why is it so hard for women to get hormones? And why is it so easy for women to be given antidepressants? You know, or if you think of the urinary symptoms, why is it so hard to even get some vaginal hormones? Yet anybody can get antibiotics time and time again, for some cystitis. Like, it doesn't really add up, it?

Sameena Rahman (: 04:41

Yeah.

Sameena Rahman (: 04:52

Yes.

Sameena Rahman (: 04:58

Yeah.

Yeah, yeah. It's something about the hormone and the stigmas and, you know, this gatekeeping that happens. I agree with you.

Louise Newson (: 05:09

Mmm.

Yeah.

Sameena Rahman (: 05:13

And so when you look at some of these issues, well, let's talk a little bit. I you mentioned mood disruption a little bit. think that that's a very, for me in my practice, I feel like that's probably one of the biggest reasons that and just sleep disruption. Those two factors are so critical. People don't feel like themselves in perimenopause. It's such a roller coaster with estrogen. Let's speak a little bit to the statistics around that and whether or not, and I always say like hormones aren't the like silver bullet

Louise Newson (: 05:20

Hmm.

Louise Newson (: 05:25

Yeah.

Sameena Rahman (: 05:43

that's gonna solve anything, everything, but it's part of the toolbox that we have to consider. And so, you know, let's talk a little bit about the hormone issues around mood disruption and perimenopause.

Louise Newson (: 05:56

Yeah, and I think it's great you put it out. It's really important to think about basic, like what hormones are. So when I'm talking about hormones, I'm not talking about hormone treatment, I'm talking about hormones we have in our body. They're just biologically active chemicals, if you like, that our body makes. They are natural messengers that go from different tissues and organs, and they go in our bloodstream and they affect every single cell in our body.

And so I think it's really important if we understand the role of hormones in our brains because for decades, a century since the hormones were discovered, it's always been about these hormones from our ovaries. And of course they come from our ovaries. They go in our bloodstream and go everywhere, but they're also made in our brain as well. And a lot of doctors still don't realize that. When something is made in an organ, it's because it's needed in that organ. And so we have different

cell types in our brain, but they all respond to estradiol, progesterone and testosterone. And many people will know we have different regions, areas in our brain that have different roles. So there are areas even in our brain that determine our personality, our memory, our mood, our sleep, our temperature control, our digestion, our metabolism, our breathing rate, our heart rate. Like our brains are so important.

And then when you look at how do these nerves work, how do the messages go from one part of the brain to another? How does the metabolism of our brain work? Then they were all determined by different hormones and neurotransmitters. But estradiol, progesterone and testosterone are neurotransmitters. They have these chemical impulses that go from one place of the brain to another. And then I think it's easy then, because once you understand that...

then you think, right, so if I don't have those hormones stimulating other neurotransmitters, helping the brain to regenerate its nerves and the cells, then of course I'm not going to sleep very well, of course my mood's going to be affected. But what's happened for so long actually is that menopause has been said, it's just something that happens to women and it's a few hot flushes and sweats. And of course people can get flushes and sweats, but it's not the most common symptom.

Louise Newson (: 08:15

The most common symptoms are symptoms affecting our mood, our memory, our sleep, like you say. But women have, and they still are, just gaslit and told, it's because you're stressed, because you're tired, because you're this. Yes, of course. But actually, let's think about hormones. And I'm really keen to even take it further and not even really talk about menopause. Let's think, has this woman got a progesterone deficiency? Has she got an estradiol deficiency?

Sameena Rahman (: 08:40

Yeah.

Louise Newson (: 08:43

or does she have a testosterone deficiency? Because I see a lot of people in my clinic who are young, they're in their 20s, they're having regular periods, but the few days before their periods, they can't get off the couch. They're really tired, they're really fatigued, they're quite irritable, they're finding it hard to go to work, and their period comes and they feel fine. So these people have got premenstrual syndrome, or some of them when their more severe symptoms is premenstrual dysphoric disorder, PMDD. But a lot of those women are

Sameena Rahman (: 08:46

Yeah.

Sameena Rahman (: 08:55

Yeah.

Louise Newson (: 09:12

still producing hormones, they're still having regular periods, but they're really just a little bit lower in progesterone and often quite low in testosterone. So we need to think of them as different hormones having different effects in our body. And the problem is it's been sort of lumped together really as menopause. So then women think, if I'm still having my periods, then it can't be a hormonal issue. And of course it can. And so we need to really like...

Sameena Rahman (: 09:20

Yeah.

Sameena Rahman (: 09:29

Yeah.

Sameena Rahman (: 09:34

Right. Right.

Louise Newson (: 09:38

And I think that's what we're all doing differently to other generations of doctors is that we are educating women. Like I didn't, we've both got two roles, haven't we? We're healthcare professionals, but we're also patients as well. And so I feel cheated as a menopausal woman, but I probably spent about 10 years of my life being testosterone deficient and I had no idea it was related to my hormones. I just thought, I've had my third child.

Sameena Rahman (: 09:52

Yeah.

Sameena Rahman (: 10:00

Yeah.

Sameena Rahman (: 10:04

Yeah.

Louise Newson (: 10:05

I can't cope, I'm tired, I'm irritable, I'm losing everything, I can't remember anything, I can't sleep. And it was only when I had testosterone back, I'm like, wow, my brain is back. This is how it used to be in my 20s and 30s. you know, and I feel cheated. feel robbed as a woman that I struggled, you know, and it was everything was like wading through treacle and now it's easier. So it's not fair that I've got knowledge as a patient and a healthcare professional.

Sameena Rahman (: 10:12

Yeah.

Sameena Rahman (: 10:17

Yeah. Yeah.

Sameena Rahman (: 10:29

Yeah.

Louise Newson (: 10:34

that we can't share with others and that's what we're doing differently I suppose.

Sameena Rahman (: 10:38

Yeah, and I think it's interesting because we have the privilege of being in the system and we understand it and we still have struggled and we still have had our own, because people always talk in the big ivory towers to follow the guidelines and all the things, but the reality is we're deficient in the amount of research that we've done on women. 1993 was the first time in the US that women were allowed.

Louise Newson (: 10:46

Yeah.

Louise Newson (: 10:58

Yeah, totally.

Sameena Rahman (: 11:04

in research. mean, it's really, you know, otherwise we're small men or we're mice. Like what? Right.

Louise Newson (: 11:04

Yeah, to be in studies. It's a madness.

Louise Newson (: 11:11

Well, it's fair, but isn't this, I think this discussion is very so interesting because, you know, I qualified as a doctor in 1994. So everything that I studied at medical school was based on men. So the statins, the blood pressure treatments, the painkillers, antibiotics, male studies. But then somehow in 2025, when we talk about testosterone, we've got so many people saying, no, there's not enough studies in women. We can't use the male studies.

Sameena Rahman (: 11:24

Right?

Sameena Rahman (: 11:29

Yeah.

Sameena Rahman (: 11:39

Yeah. Right.

Louise Newson (: 11:40

And it's like, hang on, we've used the male studies for every single other meditation. Why is it suddenly, because it suits various people's agenda, that we can't look at the male testosterone because it's the same hormone, just different levels. You know, it's just... Yeah, totally. Absolutely.

Sameena Rahman (: 11:49

Yeah.

Sameena Rahman (: 11:53

Yeah, yeah. Or even looking at transgender studies, right? Like you have an ex-ex-person that you're transitioning with high super physiologic doses of testosterone. So you know what the consequences can be. And we try not to be super physiologic. We want to keep it physiologic. But yeah, it's very interesting when one...

Louise Newson (: 12:01

Yeah.

Yeah, yeah, totally.

Louise Newson (: 12:13

And the same way with estrogen, know, some people who are transitioning have very high doses of oral estrogen and they don't have the clots, they don't have the sort of side effects or risks that others have talked about. So it's very incongruous, it doesn't really add up and I think it's just all about trying to control women in the wrong way really. it's, and just sort of thinking beyond symptoms, you know, I've...

Sameena Rahman (: 12:22

Enough.

Sameena Rahman (: 12:34

Absolutely.

Louise Newson (: 12:39

I'm a physician, I'm not a gynaecologist and I'm very interested in preventing disease. And so when we think about these hormonal changes, because they're so important for the way our cells work, we know that our cells, our bodies, our tissues, organs don't work as well without those hormones. And so these risk of conditions, really common conditions like cardiovascular disease, so heart attacks, raised blood pressure, strokes, but dementia, type 2 diabetes, different cancers.

osteoporosis, mental health conditions like you say, even psychosis and kidney disease. These all increase without hormones and this is something we need to even shout louder about because we're so much longer as women. know, a hundred years ago we didn't live quite so long so it didn't really matter. But you know, none of us really, if we can avoid it, we don't really want to spend the last ten years of our life in a care home.

Sameena Rahman (: 13:27

Right. Right.

Sameena Rahman (: 13:36

Yeah.

Louise Newson (: 13:36

We don't want to have osteoporosis of our spines. We don't want to be dependent on others. And so we all work really hard with exercise and nutrition and looking at what else we can do. Yeah, and obsessively going to doctors measuring our blood pressures, making sure we're not hypertensive, having medication for that, that somehow the health risks of untreated hormone deficiency seem to be lost on people.

Sameena Rahman (: 13:41

Mm-hmm.

Sameena Rahman (: 14:03

Yes, absolutely. And I think...

What's interesting is even looking at like, you the, heart and fast rules we had around starting it with age and other things. I mean, you look at someone like, you know, Caitlyn Jenner, who's like, you know, you know, older and started like high doses of estrogen, you know, to transition in the other way. And so, you know, like you have to, and, know, we all have patients who are like, you're going to pry these hormones out of my dead cold hands, right? Cause they know how they feel on it. And so we know there's some hard stops for some patients, but like the reality is, you know,

Louise Newson (: 14:23

Hmm.

Louise Newson (: 14:30

Yeah, totally.

Sameena Rahman (: 14:36

everyone deserves a conversation around it.

Louise Newson (: 14:39

Yeah, definitely. We see a lot of older women in our clinic and they're actually usually mothers of our patients who say, you know what, I've missed out on this because of that WHI study. Can I try it? And people are often concerned when it's more than 10 years because they're looking at the WHI data, which is a synthetic preparation. Very, very different to natural hormones. So we often give the natural estradiol, the natural progesterone, the natural testosterone.

Sameena Rahman (: 14:45

Yeah. Yeah.

Louise Newson (: 15:07

In low doses and transform women's lives, a lot of women who've got a bit of cognitive decline, maybe some muscle weakness, if they have to use a zimaphone, you know, they can get rid of those. They can feel better. They sleep better. You know, if we sleep better, that's really good for our future health. If we can build muscle, it's going to be better for our future health. So you can visibly see these women, they wake up and then their last 10 years is transformational.

And for us to look at old data and say this window of opportunity, can only have it and we'll start it when we're under 60 makes no physiological sense at all.

Sameena Rahman (: 15:44

Absolutely. And I feel like that's the patient population I'm starting to see more of too. Where it's like, what about me? I got missed out on this. And so we do. We have nuanced conversations. And then sometimes I have to talk to the internists that are involved. And we kind of try to negotiate something if they're good candidates and if it looks like it's going to be beneficial to them. But it's worth looking at, right? It's worth looking at for all these women.

Louise Newson (: 15:50

Yeah. Yeah. Yeah.

Louise Newson (: 16:10

For sure, you know, even if you just look at preventing osteoporosis, because osteoporosis is so common when we age without hormones, you know, there are lots, the drugs that are otherwise given to treat and prevent osteoporosis are highly toxic. They're far more toxic in the cardiovascular system than even synthetic hormones actually. So we have to be, and this is where, you know, as clinicians, we should be involving our patients. You know, I'm sure you're the same.

Every consultation I have is different. People have different concerns, they have different worries, they have different beliefs. And patients are quite used to dealing with uncertainty. You know, we buy cars and we don't have a randomized control study telling us that this car's safe and this one isn't. You know, we make choices that are right for us. And I think that's what's happened since the WHO is women have been left out of the conversation.

Sameena Rahman (: 16:51

Yeah.

Sameena Rahman (: 16:57

Yeah.

Louise Newson (: 17:06

and it's the doctors that are deciding whether they are allowed or not allowed. know, the number of times I've spoken to them and they say, oh no, my doctor won't allow me to have formage. Is it their decision? Do they know how you're feeling? You know, we can't do this as doctors. You know, I really feel we're there as advocates for our patients. We can share our knowledge and uncertainty and choice really with patients.

Sameena Rahman (: 17:17

Yeah.

Yeah.

Sameena Rahman (: 17:31

Absolutely. And I feel like that's kind of where it's different for us that are now treating patients, like trying to remove the patriarchal way we've learned, right? Yeah. And so I think I was always like, well, you put your big girl panties on today, so let's talk about whether or not this is something that, you know, is good for you from a medical perspective, but you have to tell us how you feel. then, you know, I believe you. I believe you when you tell me that. That's not, that's how you feel.

Louise Newson (: 17:37

Mm.

Absolutely, yeah.

Louise Newson (: 17:57

Absolutely, I think that's so important and I learnt that very early on as a junior doctor, you must listen to your patients, you must believe your patients and you know the number of women I see in the clinic who are told, my doctor has told me my joint pain can't be due to my hormones and it's like well I have no idea whether it is or isn't but I can tell you let's give you hormones and see if it helps. We can never categorically say something to patients.

Sameena Rahman (: 18:10

Yeah.

Sameena Rahman (: 18:20

Right.

Louise Newson (: 18:26

I think that's a shame because it's not fair on the patients. don't know where else to go and who to talk to.

Sameena Rahman (: 18:31

Absolutely. Oh, speaking of joint pain, I saw your abstract at Ishwish. There were two that you presented, I think, or that was presented on your behalf, because I know you were in Australia doing great things at the time. But one of them was around musculoskeletal syndrome and menopause and using a combination of estradiol, progesterone, and testosterone versus just, I think, just estradiol and progesterone. that right? Do you want to talk a little bit about?

Louise Newson (: 18:42

Yeah.

Louise Newson (: 18:47

Yes.

Louise Newson (: 18:56

Yeah, yeah. And it, yeah, I mean, it's what we see a lot in the clinic all the time, actually, but what we would do, because we collect symptom data on our patients. So we were looking at our patients and seeing if symptoms of muscle and joint pain improved with standard, if you like, HRT, which is estradiol and progesterone. And we tend to prescribe the natural through the skin, estradiol and the natural progesterone, and then adding in testosterone as well. And the addition of testosterone made it.

big difference to women, but any type of hormone actually did. And we know that, you know, musculoskeletal symptoms are incredibly common and these hormones work as anti-inflammatory agents in our muscles and joints. So it's no surprise, but it's very important to share that data and show people this improvement in symptoms.

Sameena Rahman (: 19:47

And even the other abstract I think was around patients who had chronic pain and were on opioids, I think.

Louise Newson (: 19:56

Yeah, so we do a lot of deprescribing and so we've presented that data, we've presented other data recently actually in EMATH in Valencia in Spain showing that women on opioids with antidepressants as well, we can reduce their prescribing by around 38 % or so, especially when we add in testosterone as well. you know, testosterone is very important in our brain and the problem is, as you know, a lot of the guidelines will only talk about libido and...

Don't get me wrong, libido is very important. Of course it is for lots of people and we always talk about that. But you you're not going to have a libido if you're not sleeping, if you can't concentrate, if you've got joint pain, if you're feeling tired, if you're feeling low and irritable. And testosterone can really help with those symptoms as well. And so this data was showing that when we add in testosterone as well to HRT, we can de-prescribe. And we've got more data that we're presenting.

Sameena Rahman (: 20:26

Yeah.

Sameena Rahman (: 20:34

Yes.

Sameena Rahman (: 20:51

That's really...

Louise Newson (: 20:54

It seems a bit weird, doesn't it, as a doctor saying we want people to come off medication. But actually it's really important, know, antidepressants are not as safe as we first thought when they came out. They're addicted, they increase risk of osteoporosis, for example. So coming off those drugs can be really good for people and antipsychotics and painkillers, you know, and it's more of a problem for people, I think, in the US, but it's pretty bad over here.

Sameena Rahman (: 20:58

Yeah.

Sameena Rahman (: 21:04

Yeah.

Sameena Rahman (: 21:17

Yeah.

Sameena Rahman (: 21:22

Yeah.

Louise Newson (: 21:22

or you know these drugs are highly addictive you know and they're not without risks and people get them very easily and we know chronic pain is a real problem it's a real drain on resources and it's very so much more common in women and we've got to be thinking about hormones.

Sameena Rahman (: 21:26

Right.

Sameena Rahman (: 21:39

Yeah, absolutely. And I think, you know, for so many women, their pain's never been really...

taken seriously, right? Like you can look at the statistics on medical bias, medical racism when it comes to, you know, how we look at pain differently in different sexes and in different races. And I feel like, you know, when you have this sort of like all we call it epistemic and this is where you're not taken seriously where your, your story isn't taken, you know, as something that is true, then it really builds a problem for, for women. so just by allowing

Louise Newson (: 21:48

Mm.

Louise Newson (: 22:10

Mm.

Sameena Rahman (: 22:17

them to understand that this is something that we take seriously, that this is something that we are going to, you we believe you if you're in pain, but we're not going to just try to treat it with opioids. We're going to try to understand why and what's happening. And so think that's very important. Because, you know, opioids, if you think about it, really, like if you look at your brain too as the biggest sexual organ, like opioids really are inhibitory when it comes to sexual function also. Yeah.

Louise Newson (: 22:41

Absolutely. That's so important. also, the way that pain is perceived by people on hormones or not, we've known for many years and I'm very interested in the modulation of our pain receptors with hormones. Even if you just look at some of the data showing that women who have PMS, for example, before their periods, are more likely to feel pain from the same stimulus than after.

The only difference is that they've got more hormones on board and our hormones will stimulate the opioid receptor. They'll still help with the pain pathways. Whereas most pain consultants, most doctors and specialists who deal with pain will never prescribe hormones. So they'll never see the results either. And if the women don't know to ask, of course then they take all these painkillers with lots of side

Sameena Rahman (: 23:12

Yeah.

Sameena Rahman (: 23:26

Yes, yeah, absolutely.

Sameena Rahman (: 23:33

Yeah, I'm just so glad we got a name to it last year with with with bond doing her.

Louise Newson (: 23:37

Mmm.

Sameena Rahman (: 23:40

naming it the musculoskeletal syndrome and I think it gives a little more validity to some people when they see this symptom metallurgy. So, and so what do you think Louise is on the horizon for, you know, women, you know, in the midlife when it comes to do you think there's new things we should be considering hormone wise or I know that there's some pestries that you've been involved with as well, you know, in terms of some of what I've seen in your

Louise Newson (: 23:45

Mmm.

Louise Newson (: 24:08

Yeah, think, I think thinking about these three hormones separately, it's very, very important. We need to be talking about that more. I think we can't be ignoring the vagina and then and the urinary tract symptoms. around a fifth, a quarter of women who take systemic hormones still need vaginal hormones. And I think this is an area that it's probably not spoken about enough, but but actually, crucially important. So

We've got vaginal oestrogen, we've got oestradiol and oestriol, two different types of oestrogen that have been available for a long time as vaginal pesares, creams, gels, and so forth. But we've got prasperin, and you've had it in the US a lot longer than we've had it in the UK. for those that don't know, yeah, prasperin is DHEA, so it converts to oestrogen and testosterone in the vagina, the pelvic floor, the surrounding tissues you will retract.

Sameena Rahman (: 24:52

I love it. I give it out like

Louise Newson (: 25:07

And I personally find it transformational for women. I don't prescribe vaginal estrogen anymore. Yeah. Yeah. And, you know, and I'm speaking as a patient as well, who's had lots of uni tract infections. I've had pilonophitis, I've had cystitis where I just, it's been horrendous.

Sameena Rahman (: 25:11

Absolutely. I love it. I don't either. I always will with press conference.

Sameena Rahman (: 25:23

.

Louise Newson (: 25:31

like so horrendous, it's awful. I know it's mad because I'm married to a urologist and he's watched me in pain. He's watched me like doubled over. it's, something about your nootractic infection. You just, your eyes are watering, your toes are curling. It's, get these shivers and wriggles and it's just horrid. And most of us have had them. And never once for the last 30 years did I think about my vagina and giving myself vaginal hormones and

Sameena Rahman (: 25:35

Yes.

Sameena Rahman (: 25:44

Yeah.

Sameena Rahman (: 25:50

Yes.

Louise Newson (: 25:59

It was only after his direct to me that really flawed my bladder that I just thought I've got to try something because I was on all these antibiotics, feeling really poorly, had a catheter in for six weeks. And then I just thought, actually, I'm just going to try some clustering because I give it to my patients. So I got a doctor to prescribe it for me. And it's revolutionized just my life. I don't want to speak too soon, but I haven't had a urinary tract infection for so long. I don't even remember. I used to carry antibiotics with me because I was

Sameena Rahman (: 26:09

Yeah.

Sameena Rahman (: 26:28

Yeah.

Louise Newson (: 26:29

The sooner I take them, the better. But I see that in my patients. There's people that have interstitial cystitis, painful bladder syndrome, they've had recurrent urinary tract infections, they've had lichen sclerosis, they've had awful localized symptoms, they've had painful, painful sex where they've avoided it for so long. And Prosterone is incredible. And it makes sense, again, if you go back to why you're giving it, well, we've got receptors for estradiol and testosterone everywhere.

Sameena Rahman (: 26:31

Yeah.

Sameena Rahman (: 26:54

Yes.

Sameena Rahman (: 26:57

the vagina, the pelvis.

Louise Newson (: 26:58

and a lot more testosterone androgen receptors in various parts of our anatomy. So why would we not replace it, you know?

Sameena Rahman (: 27:04

Yeah. Yeah. I think that was just really revolutionary even for me to realize for when I was studying with ISWISH and when I spent some time with Dr. Goldstein and Irwin Goldstein. And it was, wow, this is something that you just totally missed the boat on for so many patients. Postpartum patients, right? The lactation issues that are just like menopause.

Louise Newson (: 27:19

Hmm.

Louise Newson (: 27:24

Yes.

Louise Newson (: 27:28

Yeah, and women on contraception as well because, you know, that's the other thing that I'm spending a lot of time on over the next few months really is I'm picking a lot of evidence, some of it's quite bad actually, about synthetic hormones and what they do to women. But also we know that they're more likely to have urinary tract symptoms because their hormones are being blocked by synthetic hormones. So allowing women to think about having vaginal hormones because

Sameena Rahman (: 27:52

Yes.

Louise Newson (: 27:57

know, urinary tract infections are, you know, they're a big inconvenience. can say they cause a lot of pain and distress, but they also cause death. You know, about 30 % of sepsis is due to urosepsis, urinary tract infections, especially as women age. And we can't ignore that.

Sameena Rahman (: 28:04

Yes.

Sameena Rahman (: 28:08

Me too.

Yeah. And I think what the statistic is like 6 % of those women die, you know, from UTIs. And that's why we always say radical estrogen and DHEA are life-saving for so many patients. So.

Louise Newson (: 28:18

Yeah, yeah, it's high. Yeah, so.

Louise Newson (: 28:25

Yeah, and that's where Rachel Rubin's work is phenomenally good because she uses such big data sets. You can't ignore the numbers and you can't ignore basic physiology. If we're told a drug works and has good results, but you can't quite work out why the drug works, I'm always a bit skeptical, especially if it's been funded by the pharma industry, but this is basic physiology or just replacing like with like and it works and so great and it's safe.

Sameena Rahman (: 28:50

And we'll see.

Louise Newson (: 28:52

And it's also safe in women who've had breast cancer, and that's important too.

Sameena Rahman (: 28:55

It's very convenient. It's safer across the board. So I think that's wonderful. And so what's coming up for you? I know you went on tour last year too, right? We had a little tour going on.

Louise Newson (: 29:04

I did. Yeah, that was fun actually. It was good. I talked a lot about the history of Cornwall as well. So some shocking stats. So I'm doing three small tour dates in October and then I'm going on another tour next year actually. Gonna hit the road and go and speak to some more people. So that would be good. I'm doing quite a lot of writing, quite a lot of researching. We've got more publications coming out. We've had two this in the last week. We've got some more.

academic research coming out with our education program that's already global for healthcare professionals. We're relaunching it in the next few months, so it's going to be even better. So we've got a lot of stuff going on actually, which is good.

Sameena Rahman (: 29:46

wow.

I mean, I always say that people will say, how can we improve the situation? It's like, we have to teach the clinicians who have been practicing for the last 20 years under the false pretenses of the WHO, right? So that's a big health care gap. Yeah, I mean, I can teach residents now and I can teach students, but the patients, the people that are on the ground right now, they have to be re-taught so much of menopause.

Louise Newson (: 30:03

you

Louise Newson (: 30:11

Yeah. Yeah.

Sameena Rahman (: 30:12

And so we'll put all your links in the show notes and everything. But I want to be cognizant of your time. I'm so glad that we got to speak today. And we could go on forever, but I'll be cognizant of your time. And thank you for joining me today, Dr. Louise Newsome from the UK. And I hope that we get to see each other. Are you coming to the US? Any time soon.

Louise Newson (: 30:21

it's been great. Thank you.

Louise Newson (: 30:27

Hehehe

Louise Newson (: 30:37

I've got some plans, so hopefully we can link up, definitely.

Sameena Rahman (: 30:40

All right, nice. Thanks for joining me today, guys, for Guide on Girl Presents, Sex, Drugs, and Hormones. I'm Dr. Samira Rahman. Remember, I'm here to educate so you can advocate for yourself. Please join me on my next episode.