Women must have HRT or they’ll kill themselves, activists claim…but where’s the evidence?

Is menopause so terrible that it drives some women to suicide? It’s an alarming claim that is often presented as fact – at least in recent years.

Most recently, high-profile menopause guru Dr. Louise Newson – a general practitioner and founder of the private chain of clinics Newson Health, which treats approximately 4,000 patients a month, all seeking treatment for menopausal symptoms.

A Mail on Sunday study published earlier this month revealed concerns about her clinic, which prescribes HRT overdoses to one in five of its patients.

Experts have warned that these high doses should only be used in “extraordinary” circumstances, accusing them of putting patients at risk because large amounts of some hormonal drugs can increase the risk of uterine cancer.

Dr. Newson, on the other hand, emphasized that her approach helps at-risk women struggling with suicidal thoughts.

An investigation by Mail on Sunday raised concerns about dr. Louise Newson, who prescribes HRT doses above the legal limits to one in five of her patients (File photo of a woman taking HRT pills)

She added: “The permitted doses are simply the doses with which the pharmaceutical companies have conducted their trials.”

READ MORE: Celebrity menopausal doctor Davina McCall and Mariella Frostrup accused of putting women at risk of cancer by prescribing ‘alarmingly high’ doses of HRT

Following our report, Dr. Newson – who is backed by celebrities including TV presenter Mariella Frostrup – told another newspaper about her position.

The play told the story of a woman in her 40s who suffered from a series of worsening mental health problems. Antidepressants “didn’t make a difference,” but high-dose HRT helped. DR Newson said that “a lot of women” who visit her clinic “have a lot of negative intrusive thoughts that mean they feel like they shouldn’t be here”.

She added that there is “no evidence that antidepressants help improve the psychological symptoms of menopause” and that “HRT saves lives”.

So is she right? First, it’s important to look at the big picture: Mental health problems are widespread. One in six adults suffers from depression, ten percent of them severe. It is about twice as common in women as in men. And some will go through menopause.

But does that mean menopause is the cause or the trigger? That’s hard to answer – not that you know from other recent headlines. “Women are at risk of suicide in the face of a shortage of HRT products as menopause wreaks havoc on their lives,” read a report last April about the much-publicized HRT shortage. Another said simply: “HST life and death crisis”.

Most of these articles quoted activist and Labor MP Carolyn Harris as saying that women in her Swansea East constituency are “literally killing themselves” because they cannot get HRT.

Meanwhile, Katie Taylor of Latte Lounge, a menopause support group that charges £99 for a year’s membership, said: “It’s no coincidence that the highest suicide rate among women is in the 45-55 age group. [when most go through the menopause].’ But is it? The ONS, which compiles cause-of-death figures, reported 5,583 suicides in 2021 – the most recent year on record. Three-quarters (4,129) were men, and most of these deaths occurred in middle age (45 to 49 for women and 50 to 54 for men).

And it is clear that men do not go through menopause.

Mail on Sunday health editor Barney Calman

Among women, the largest increase in suicides is among women under the age of 24, while suicide rates among women under the age of 45 have decreased significantly since 1981. – a “fact” believed to have been spread by a menopause campaign group. But that’s not right.

A key factor in what drives people to commit suicide, according to the ONS, is socio-economic status – suicide rates are twice as high in the most deprived areas as in the least deprived. And this divide is most evident in middle age.

Financial problems and debt, unemployment, broken relationships, and “the demands of middle age”—caring for children and aging parents—all play a role.

As Samaritan points out, “Usually there is no single event or factor that will lead someone to commit suicide.” Could menopause symptoms be such a burden that they push some women over the edge? It is very possible. But a single drug treatment, or lack thereof, is unlikely to make a difference in such nuanced cases.

In its media guidelines for responsible reporting of suicide, Samaritan advises against speculating about a trigger or cause because “suicide is extremely complex”. In light of this, the rhetoric ‘women must have HRT or they will kill themselves’ seems an oversimplification.

There is some evidence that during perimenopause – the transitional phase before menopause when hormones begin to fluctuate – there are on average 10 percent more reports of depressive symptoms or bad mood.

“The role that hormones play is not easy to determine,” says Professor Myra Hunter of Kings College London, a psychologist with more than three decades of research into women’s health. “But symptoms such as bad mood, sleep problems, stress and hot flashes can often work together in a vicious cycle and seriously impair quality of life.”

For this reason, explains Professor Hunter, NICE guidelines state that HRT, which is highly effective in reducing all these symptoms, should be considered alongside cognitive behavioral therapy for low mood during menopause.

Doctors are also discouraged from routinely offering antidepressants to women with menopausal symptoms unless they have been diagnosed with depression. “For depression that can cause suicidal thoughts, antidepressants and cognitive behavioral therapy are proven treatments. And HRT can be used in combination when menopausal symptoms are a contributing factor.’

Labor MP Carolyn Harris (right with Lisa Snowden, left and Penny Lancaster in Parliament) said women in her Swansea East constituency were “literally killing themselves” because they couldn’t get HRT

In the 1980s, gynecologist and HRT pioneer John Studd routinely used very high doses of HRT to treat women with mental health problems during menopause. His research also revealed a phenomenon called tachyphylaxis, in which some overtreated patients require increasingly higher doses to control their symptoms.

And some have developed serious mental health problems as a result. So it is clear that more HRT is not always better for mental health. But more importantly, Prof. Hunter, like many others I’ve spoken to over the years, worries that a generation of women is picking up on the cold messages that menopause will be hell.

Research suggests that this worry can worsen symptoms. In reality, most women have no serious problems. But when they do, there are a number of evidence-based interventions that can help—not always HRT.

As Prof Hunter says: “There are many factors that affect mental health in middle age. Hopefully we won’t blame all women’s problems on our hormones.”