DR. PHILIPPA KAYE: I’m so concerned about campaigners pushing women into taking HRT they don’t need – by insisting menopause should be treated as a disease

Last week’s controversial BBC Panorama episode, The Menopause Industry Uncovered, came as a shock to many.

The first half of the 30-minute film raised concerns about the sale of expensive menopause supplements in Britain, despite them having no apparent benefit.

The second part of the documentary, however, was more worrying. It claimed that some private menopause doctors are putting women’s health at risk by prescribing extremely high doses of HRT. The show focused on one specialist and her clinic in particular: famed menopause guru Dr. Louise Newson.

According to Panorama, her private practice – The Newson Clinic – prescribes one in five patients with HRT doses well above the recommended limits.

Dr. Newson and her colleagues argue that these high doses are needed to control the debilitating symptoms caused by hormonal changes, including hot flashes, disturbed sleep and mental health problems. But Panorama highlighted twelve cases of women who claimed to have been harmed by the medication.

As a GP with an interest in women’s health, I am disappointed by the revelations, but not surprised.

I won’t say more about that specific case, and the hospital watchdog that the Healthcare Quality Commission is now investigating. But I have long been concerned about the over-medicalisation of menopause – and about a small but vocal group of campaigners who argue that it is not just a normal stage in a woman’s life, but a disease or ‘deficiency’ that needs to be treated .

It’s an issue I address in my book, The Science Of Menopause, published this week. Because while I understand the theory, I couldn’t disagree with it more.

It reinforces the idea that we are ‘broken’ and inadequate, when menopause is a normal, expected part of aging.

That doesn’t mean I’m against HRT – I’m not.

Women’s lives can be devastated by menopausal symptoms. They can ruin careers, cause relationship breakdowns and divorces, and have a catastrophic impact on mental health. One in ten women consider suicide as a result.

Last week, new data revealed that 60,000 women are on long-term disability due to menopausal symptoms. For many of these patients, HRT can be transformative.

In the past, menopause was something that was never talked about. I am grateful that thanks to celebrities and campaigners – including Dr Newson – this has changed.

It means those who suffer are more likely to get the medical help they need.

But like many colleagues, I think the pendulum has swung too far. The truth is that not every woman needs HRT.

The idea that menopause is a disease is not new; it dates from the 1960s.

A 1966 bestseller called Feminine Forever by Robert Wilson outlined the concept. The British-born, US-based gynecologist claimed that menopause was a hormone deficiency that was “curable and completely preventable… just take estrogen.”

HRT, Wilson argued, was not only useful but necessary to free women from the ‘curse’ of estrogen loss. He believed that it should be taken for life, and not just until the symptoms disappeared.

“Many physicians,” Wilson wrote, “simply refuse to recognize menopause for what it is: a serious, painful, and often crippling disease.”

For anyone who is even remotely convinced of this, he also wrote that HRT will not cause a woman’s breasts and genitals to shrivel. She will be much more pleasant

live with it and not become boring and unattractive.’

Clearly this is misogynistic nonsense. It plays on the idea that women are valued primarily for their appearance, sexual availability and ability to have children.

But amazingly, the current age of social media has breathed new life into this terrible concept.

This time it’s been rebranded as women taking control of their midlife health in an empowering way. Some of these campaigners and celebrities promote dodgy supplements and fad diets that are supposed to help menopausal women ‘turn back the clock’. Others advocate taking testosterone – the ‘male’ sex hormone that women also have in smaller amounts – to increase libido and improve mood, concentration and sleep.

The British Menopause Society only recommends testosterone to tackle low libido – and only in cases where other treatment options have been exhausted.

It has almost made HRT trendy – the latest anti-aging product.

Like most GPs, I regularly receive requests for HRT from women in their 40s and 50s who have no symptoms of menopause.

Midlife can be messy for women, whether it’s the symptoms of menopause, which can be crippling, or simply the stress of juggling busy careers, teenage children, relationships and ailing parents – all on top of the normal aging process.

Some challenges are hormonal, and if that’s the case, HRT can help.

But while it may fix some of these symptoms related to hormone levels, it won’t fix everything. And it’s vital that women don’t have unrealistic expectations about what the treatment can do.

If you’re taking the maximum approved dose of HRT and still have symptoms, the solution may be to look at what else may be causing them and consider adding other treatments – such as antidepressants or talk therapy – rather than increasing the frequency . continue dosing.

For me, empowerment is not about feeling like you have to do something, but about having a choice about what you do.

Menopause is not one-size-fits-all. Like every stage of life, every woman will experience it differently.

For some, simple lifestyle changes – eating healthier and being more active – really help. For one in four who experience severe and disabling symptoms, HRT plays an important role. Modern forms, available as gels, sprays and patches, rather than older-style pills, are safer than ever.

We have good evidence that for women who need it and can use HRT, the huge benefits outweigh the small risk of breast cancer or blood clots.

But there isn’t enough evidence that HRT will protect you from heart disease or dementia unless you’ve gone through early or surgical menopause, no matter what you read on social media.

Claims like these only stoke fear among women who cannot use HRT because they have a history of breast cancer or other serious health problems.

Instead of being told that they are broken or have an illness that needs to be treated, women need to know that they have choices.

I am often asked whether I am for or against HRT. It feels like a strange question. Crucially, I champion what helps my patients – and the solution is not always HRT.

The science of menopause, by Dr. Philippa Kaye, is published on Thursday (DK, £16.99).