Dr Louise Newson: This week Kate Muir is on my podcast for the third time and it's another great conversation talking about how we've worked together to improve awareness and knowledge about hormones and why some people are not so happy about the work that we've done. So I hope you enjoy listening to our conversation today. Kate, this is the third time you've been on my podcast. I don't think anyone else has been on three times.

Kate Muir: Well, that's because you've had such an effect on my life, Louise Newson. And I wouldn't be here and I wouldn't be a menopause campaigner if I hadn't come to consult with you in 2019 and gone away very politicised after having been just a patient. So it made a big, huge difference to me realising that this was a massive topic. In fact, it was a great story.

Dr Louise Newson: Yeah, it was an amazing consultation actually. We've spoken about it before, but for those of you that don't know, Kate is a patient or has been a patient and you were quite straightforward. You'd had a difficult time because you'd been given the wrong type of hormones from somebody else. And so actually, after about 15, 20 minutes, you knew what was going on. So I remember spending the rest of the time just like telling you about how awful it was and how terrible things were for women and about some of the evidence, especially the evidence of the newer body-identical hormones compared to synthetics, some of the debunking of the Women's Health Initiative, WHI study. And I remember you just saying, I'm an investigative journalist. I didn't know this. I need to know more. And then you went off and then we had this, oh, we still have this great relationship where we share papers and talk things through. And then, you know, you're not a documentary maker, but you went off and made a documentary that has had the massive effect on women and prescribing of hormones.

Kate Muir: I mean, Davina McCall was fantastic and did a really good job presenting that and keeping going with that.

Dr Louise Newson: Totally.

Kate Muir: But I think one of the most exciting things is the changing science that we've been learning as we go along. And the more you dig, the deeper you dig into the protective power of hormones, the protective power of HRT, I think the more kind of essential this fight that we are fighting is. And the idea that the menopause is a transition. Keep calm and carry on and not a hormonal deficiency that one way or the other, you have to do something about either holistically or hormonally, preferably both, and it would be mad not to. And that we are portraying this to women completely wrongly makes me so angry, but also work so hard to get this message out in books, in podcasts, in the Substacks, whatever it is.

Dr Louise Newson: Yeah. And I think what's great sometimes is meeting people that haven't got preconceived ideas. You know, you came with a very open mind. You weren't expecting me to talk as much as I did about things. But you didn't go away and just listen to me. You went to other people. I introduced you to lots of people. You read lots of academic papers. Whereas, you know, if I'd met you 30 years ago, we didn't have the internet. We didn't the ability to just do a Teams call with someone in another country or the other side of the world. So you've managed to do things very quickly, but also you haven't had these preconceived ideas, whereas often when I talk to doctors who are very anti-HRT, that you can't change them because that's what they've always talked and they're not going to think, whereas you didn't have any of that negativity going on in your mind, you just had an open mind to think actually let me learn, let me understand. And coming from a place where you're open about it, your mother had dementia, you want to keep really healthy. You really look after yourself and you do your open water swimming, your dog walking. You're an active, healthy person, but actually without hormones, you know you wouldn't be as healthy as you are now.

Kate Muir: I'd be a mess. And I've been thinking a lot because my mum died of Alzheimer's 10 years ago. I've been thinking about it a lot, because I'm about to write a book about Alzheimer's and hormones and all sorts of things. And, I've thinking about sleep and the importance of a good night's sleep. And every hour you lose, you are more likely to build up the amyloid plaques that can be a precursor to Alzheimer's. And literally going from seven hours sleep to six hours sleep to five hours sleep puts you way in the risk zone. And whatever we know about estrogen and progesterone, they really, really help you sleep. They stop those night sweats and that anxiety. And just being able to let women sleep might be the most important thing we can do to prevent the fact that two thirds of Alzheimer's patients are female. The idea that we're not looking at this, that we are not screaming that aloud and the many other things you know HRT can do, it really shocks me and it just has me you know up everyday punching.

Dr Louise Newson: Yes but it's so frustrating because it's so obvious when you understand basic science. So you talk about progesterone, estradiol, but also testosterone has a massive effect. And even just knowing that these hormones can improve melatonin, our sleep hormone. You know, it's not rocket science that we sleep more and sleep better actually. I mean, I have less time in bed than I ever did, but I sleep really effectively. But that's because I take hormones, but I also meditate my way to sleep. You know, I exercise, there's lots of things, but we can't always forget how important the hormones are in our brains. And somehow people seem so scared of the way hormones work, especially in our brain, there is always this debate, does HRT reduce risk of dementia or not? But the studies, when you intertwine the synthetic hormones and the natural hormones, you know I said to someone the other day, it's a bit like researching bananas and saying all fruit is yellow. That you can't include synthetic hormones with natural hormones and expect to have good results.

Kate Muir: It's such a total failure in the science, that they are looking at two completely different drugs. It's a big sloppy hole in the science. And what I don't understand is there are some very intelligent people, professors and people with PhDs who are putting out things, old studies about synthetic hormones and mixing them up with transdermal new safer hormones that go straight in the bloodstream, you know, and as we know, are your natural hormones being topped up. If I take a 12-year-old child and tell him or her that, they would understand immediately, these are plastic, these are real and organic. Which one would you like to give your mum? Oh, the organic one. And which is likely to have the best effects? The organic one, and I'm just astounded at the stubbornness and stupidity. And I think it's a sense of maybe shame around confronting the fact that they've been wrong, that so much of the science is wrong and that we're overturning it, or that ordinary people like me, journalists, can look up the science papers...

Dr Louise Newson: There's nothing ordinary about you.

Kate Muir: And look for the holes in them. Ordinary women can look the holes up in the science paper and go, this is not about the kind of HRT I use. And I do not understand why these huge institutions, your International Menopause Society, the Menopause Society in America were putting out things just this week about, you know, hormones don't help with dementia. Now I'm researching a book on this. I can tell you that hormones help with dementia and I can give you dozens and dozens of studies. And it's just bonkers to try and maintain a really strange set of ancient beliefs. And the only thing I can compare it to is the madness of religion. You know, we're on two different sides in this menopause story. But yet we all want women to be better. What is going on here? Why are these institutions holding on to what they're holding on? Why did they attack you, for instance, on that Panorama programme with the BBC? And what do you think?

Dr Louise Newson: I think, there's a lot and I'm very insightful and reflective but I think you're right in that people don't like to admit that they've made a mistake or told wrong information and they didn't do it to be malicious in the past. You know I think about patients I had who had recurrent urinary tract infections that I gave antibiotics to rather than vaginal hormones. I think about people that I gave antidepressants to instead of hormones. But I'm very happy to sit here and say, do you know what, Kate, I've learned so much about our hormones in urinary tract, our hormones and our brain, I've changed my clinical practice. But because I feel bad about what I've done, I'm not just changed my clinic practice, I'm changing the clinical practice for thousands hopefully of doctors and clinicians, but also changing the knowledge for women so they can ask for what they want. And I think that's fine to be able to say, even as a medical society, to say we've got different evidence, we're changing the way we think, but to actually dig your heels in I think is, well it's damaging actually.

Kate Muir: I don't understand it. I don't understand the horrible, creepy kind of schoolyard feeling I get about that, the feeling about bullying and negativity instead of moving powerfully forward for women's health. And I just sort of want to know now that Panorama's over a year ago. And as you know, there were more complaints about your Panorama than there were about Trump's Panorama. And much the same team in terms of the editor and the editor-in-chief were behind both programmes. And we know that the evidence came from somewhere very strange on your Panorama programme. And I mean, it literally seems to me to be a vendetta. And when I look at it, I look the science that was offered up in it, the science is wrong. Quite a lot of it is wrong and they've gone for some very old fashioned versions of the science. So why do you think you were feared and attacked like that?

Dr Louise Newson: I think there's lots of issues. I mean, I've known for years that various people from the medical establishment haven't liked what I've been doing. And maybe it's because I've got a higher profile, maybe because I help women get better. I don't know, but I do know partly there's a patriarchy in medicine. And I've being told this by some people because I'm inverted commas "only a GP" and I'm not a gynaecologist. And I have an issue with that because I don't think anyone is "only" anything, but also, you know, I've got a degree. I've, I'm, I have got lots of qualifications and I've got lots knowledge and I have a huge amount of clinical experience. I don't really know why they decided to do it. I don't even know why the decided to even commission the programme when I look and reflect on the content because it was confusing for women. It portrayed me as some awful doctor. It was very much a personal thing rather than just about my clinic. And it's damaged loads of women.

Kate Muir: I also think in terms of your ability to respond to that, you've got patient confidentiality. You're a doctor, you can't say, this is what happened. You are not able to say that. And I think that is also really hard. And it just puts you in a very hard position in terms of comeback. And obviously, Ofcom received all these hundreds of complaints and Panorama received hundreds of complaints. And even I was in Glasgow two weeks ago, talking to the Scotland's menopause warriors who were featured at the beginning section of the programme, talking about people being sold sort of vitamins and fake menopauses cures, and it was about the fake menopause industry. And they are horrified that their bit of the programme was attached to an attack job on you. And they have said so to Ofcom and they said so to me the other week that in no way did they want to say that there was anything wrong with what you're doing. And one of the apps they recommend to women across Glasgow who are not getting the information they want from their doctors is your free Balance app. And, you know, it's just shocking to me that those two things are juxtaposed together in the programme. And everyone in that programme has been misrepresented, you and the Glasgow menopause warriors. And it just makes me so annoyed and that the establishment just sits there and goes, well, we don't care. And if women aren't coming off HRT because they see that and not getting the long-term benefits of it, then people should think about seriously about what they've done.

Dr Louise Newson: You're right, because at the time, it was all very raw. And as you know, I was doing the theatre tour. So it came out on the second night of a theatre tour that was 34 nights. So I had to keep going and it was really difficult. And you think, well, actually, let's just keep going. And it's just going to be a small number of people that maybe watch the programme and it will be okay. But actually it's now over a year, as you know, since the programme. We know the HRT prescribing has plateaued. But we also know that a lot of women have been stopped their HRT, especially if they've been on any higher doses to help with absorption. So, you know, every day in the clinic, we hear from women who have been very stable on their HRT for years. They've been told to reduce it, told to come off it. And then their mental health has worsened, their physical symptoms have worsened. And these women can't afford private care. They shouldn't have to. And doctors are really scared. You know, a lot of people think that I've been struck off by the GMC and I absolutely have not been struck of at all. I, I find it really sad. And I do think a lot about the way that the film was made as well. I mean, we had to involve lawyers before the film came out because they did these consultations as you know...

Kate Muir: Well there was secret filming, which you're only supposed to do when you're trying to expose a crime or something.

Dr Louise Newson: Yeah, and they had no evidence that I'd done any harm at all, but they did this, but they were going to expose the identity of the doctors. And I'm really protective. It's bad enough having my face everywhere, but not for these doctors. So they did change that. And there were other bits that they were going to put in that they didn't. But they did ask if I wanted to go on the programme to talk. And they said what I would, if they could confirm that they wouldn't edit what I said.

Kate Muir: Trump style.

Dr Louise Newson: And thankfully, actually. I was advised to not go on the programme because they would edit it and they agreed that they would edit it. And goodness only knows what they would have portrayed me as.

Kate Muir: I think you're seen as an influencer, but in my world, you are in fact, a public intellectual in the old fashioned sense. You are the menopause enlightenment, right? You and Mary Claire Haver and Dr Rachel Rubin in America and Dr Vonda Wright. There is a great team of around the world, Dr Ceri Cashell in Australia, who are really forward-thinking people, and I would say they are the menopause enlightenment movement who really, really understand a lot of the science. And I think there's a thing happening here where you have been cancelled in a mysterious kind of medical but also internet way that social media is, you know, you've made a huge comeback and you've been really brave and really tough. But that is what is happening, the business of kind of public cancellation and public humiliation. And I think you have to remember you're a public intellectual, you've got a job to give us the medical information and you have to continue to do that.

Dr Louise Newson: It's hard though. It's been really difficult. And, you know, when people call me controversial, I said to someone the other day, could you not just call me clever? And they sort of sat back of it and went, oh, yeah, maybe, maybe you are. And so having the FDA announcement recently has been wonderful, actually.

Kate Muir: About the black box warnings.

Dr Louise Newson: Just basically saying that estrogen is safe, a lot safer than we've said for decades. It just validates some of the work that I do and having the people that you name and Kelly Casperson of course as well, you know, there's lots of people that are now saying the same that I've said, for many, many years. And you know when you have something really awful happen to you, it makes you very reflective and thinking, oh, have I been too gung ho? Have I said things that weren't right? But all I've done is gone back to the evidence, gone back to basic science, gone back to physiology. And I know that I haven't done anything wrong at all. And in fact, as you know, we did involve lawyers to complain to the BBC because you have to complain BBC before you can go to Ofcom. It's very drawn out process. BBC wouldn't uphold our complaint. And then we found out beginning of October that Ofcom wouldn't up hold our complaint either. Without any reason, they said it was a fair and impartial programme. Well, even if you didn't know the subject matter, you'd know that it wasn't very impartial. But it's been confusing because one of the things that we kept saying to them is that there are different types of hormones as well. And so what they're doing is demonising HRT, natural body identical HRT. As you say, it's the exact molecular structure as our own hormones. Yet the doctors on the programme all prescribe contraceptives. Which are equivalent, a lot higher dose. Of course they are, but they're usually oral or they might be the implant, but they are all synthetic. And your second book about hormones was really a lot about the contraceptives.

Kate Muir: I mean, sometimes you need them and sometimes you need a coil and God knows I have one, but I'd rather not have one. And I know so much with so many young women struggling with different progestins and how so many of them are risky. And I just am astonished again at the sort of intellectual vacuity of people who aren't looking into that, you know, in the kind of, you know, women's health area. I mean, why aren't we talking about it? Why are we trying to stay safe and give people the £1.50 pill, the microgynon or the rigevidon, which, you know, lots and lots of girls have a miserable time on and that there's no good replacement for that yet. There's no, you know, we're lucky older women got the fantastic, you know, natural hormones, younger women getting the kind of ultra processed food. That's basically what's happening. And yes, sometimes you need it, but it would be great if it was so much better and people cared to research something better.

Dr Louise Newson: But people don't understand. And I think it is like you're saying about being bullied at school. Sometimes people forget what they're getting so cross about as well. They've just got this innate hatred for somebody or something. And they just keep going round and round and not putting their head up and not thinking maybe this person's got a point. And it becomes really damaging for so many other people. It's not just an internal debate. And you know I think in medicine especially, people can agree to disagree. My husband, as you know, is a surgeon. He does different type of operations to other people. He does a lot of showcase operating. People learn, but every so often people say, well, I wouldn't hold the suture like that. I wouldn't use that suture material. I wouldn't put a cut there. I would do it here. And they'll have a really great discussion about when it works and when it doesn't work and the reasons between. And that's what, Panorama could have been an amazing programme if we'd had a really open discussion. Because a lot of my work is just about choice. You know, you can choose to do open water swimming. I can choose do yoga. We're not right or wrong. It's just a different thing. You know what I mean? And I think, but it's great to be able to talk about it.

Kate Muir: Yeah but I just think that was very, very old fashioned and very sort of stuck in a time before. I think if we look at in 10 years' time, how will we look back on this time and what's happening with hormones? And actually, if you look at the market predictions around transdermal hormones and the size of the market, it's going to double. So, you know, the economists are like, this is a good idea. This is going to happen. The medical establishment is very much, you know, stuck in the mud behind and women are going to make this change for themselves with good doctors like you who are helping to lead the way. But it's coming from women up. It's women doing their own research, women desperate to read about the menopause. And you know the whole business of the kind of menopausal snake oil industry and people selling supplements is because of the failure in leadership among ordinary doctors. And I know some absolutely brilliant GPs that I'm friends with them and they are doing amazing things like mass consultations in their surgeries. So you know, there are these fantastic people, but there is a great big kind of fatberg of people holding this back. And we really, really need to change that because this generation is coming up and I don't want to see them getting Alzheimer's or diabetes or you know stiff joints or whatever it is. And I just can't believe this is not part of health policy. This is not what Wes Streeting is changing. Although great to add menopause to the 40-something consultation. Well done, everybody! But it is good, because it will get to all sorts of communities.

Dr Louise Newson: It will start conversations, but...

Kate Muir: But, you know, the idea that it wasn't there when it was the biggest metabolic change in midlife, and you didn't mention it in the midlife consultation, just tells you how bonkers the whole thing is.

Dr Louise Newson: But also, you know, not acknowledging the millions of women who are under the age of 40 as well with hormonal changes is just crazy too. It's just, so much has got to change. But I think, you know what you've done with the documentary, what we've both done working together, sometimes behind the scenes a bit, is that we've allowed women to wake up and understand what's going on. And I think that's where I've tried to be silenced by the medical establishment. They can't silence me getting to women and giving people a choice. And it's a choice that they've not had for decades. You know, in the 60s, they did have this choice about sexual liberation and the contraceptive, but in some ways that was potentially damaging because that was synthetic hormones that had never been tested in the long-term. We didn't know. This is quite different because these are the natural hormones. Replacing like for like, we know that metabolically, they work so well in the body. And women are understanding that quicker than healthcare professionals. And I know a few years ago, I went to the Royal College of GPs, because I'm a fellow there, and they said, Louise, your work has got to really stop and slow down because your media influence means that too many women are now asking for hormones to the detriment of other appointments because too many woman are coming every day to see GPs and we can't get through the people with back pain and other conditions, but you can't shoot the messenger, can you?

Kate Muir: But that's just daft because the minute they're on hormones, most of them, maybe a three-month follow up, but you know, they won't be bothering you for diabetes and they won t be bothering for various kinds of arthritis and things like that. It really, really, it's really important.

Dr Louise Newson: Short-term pain, but longer-term gain, you know, and I think we see this in other areas of medicine as well. You know, you can prescribe antidepressants very quickly, but you can't prescribe exercise in the same way. It takes a lot longer to explain about lifestyle and...

Kate Muir: But I think of hormones as the door opening. And for me, it was a door opening to, you know, a portal to the second half of my life and a different life and possibly a different brain. I mean, my brain, I think, is probably different than it would have been. And it's also the time when you have the kind of strength once you've got the hormones to take on your health and decide to do things like, in my case, stop drinking alcohol. Start cold swimming, go running, eat less awful food. All these things, once you've lifted up onto that step of hormonal normality and also having your hormones the same every day instead of them going up and down, which is such a joy, then you can look after your health. And the idea that people are, serious academics are talking about, oh, the holistic health is how we need to deal with menopause and not hormones. I absolutely agree with every single thing on the holistic health board. I think you should add it if you possibly can to hormones at the same time. I know you've got to do both things because your body is changing and your mind is changing, and God knows to what extent we're able to replace our own hormones, and we do age. And we've got deal with ageing well because we've got to work till we're 67. And the idea that there's a holistic, natural, unnatural divide when hormones are natural just makes me really annoyed philosophically. None of it makes any sense. If you take a sort of intellectual point of view on this. It's just, you know, it just doesn't work.

Dr Louise Newson: Well, it doesn't because we have to spin it on its head and think what are the risks of not taking hormones? And that's something we need to spend this year. It's the beginning of the new year, 2026, thinking about that as well. Because, you know, we need to be making decisions that are right for us. So your book's just come out in paperback. Just very quickly, I'd like three reasons why people, if they haven't got the hardback version, why they should be thinking about your book.

Kate Muir: Well, it is called How to Have a Magnificent Midlife Crisis. And I realised that, you know, when I was campaigning on menopause and hormones, there was so much else going on around it. And that women at this time in their lives, I think, first need to make a five-year plan or a 10-year plan and reassess their lives and have one midlife crisis or possibly even two and really decide how am I going to live the next half of my life. So that was really important. The other thing in the book is it's about creative renaissance and I've had a real creative renaisance in a mad way via you because I've become a mad scientist writer person and not what I expected to be having been a film critic. But here you are on a different trajectory doing a different thing and you've got the energy because your body's working and your mind's working to do this and to help people and to have time to help people. And I also think the third thing is about all the different things you can do in terms of self-compassion at this stage in our lives. Because we've looked after other people, we've looked after our colleagues at work, we've looked after our children. In our 50s, we need to look after ourselves, our health, and then go out there and make a difference in the world. And I think those are the things that the book is about.

Dr Louise Newson: It's such good advice. And of course, it's such a brilliant book as well. So thank you for coming on for the third time to my podcast Kate.

Kate Muir: Thank you.