There is a growing trend of women taking dangerously high doses of hormone replacement therapy (HRT) due to misguided beliefs perpetuated by social media, according to top specialists. The proliferation of online messages claiming that “more is better” is driving some women to exceed the recommended limits set by drug manufacturers, warned the experts. Private doctors have also advised certain women to take abnormally high doses, two or three times the licensed maximum, in order to manage mental health symptoms. Previously, such large doses of HRT were rarely seen.
Dr Katie Barber, who runs an NHS gynaecology service in Oxfordshire, identified online forums as platforms where unsafe messages are being propagated. She acknowledged the positive aspect of social media in providing a space for women to support each other during menopause, but also highlighted the negative influence of evidence-lacking views. Dr Barber said, “HRT doesn’t work like that [where more is better]. In fact, very high doses can cause symptoms to worsen. We advise these women to reduce their dose due to safety concerns.”
HRT, which includes estrogen and progesterone compounds, helps alleviate menopausal symptoms such as hot flushes, insomnia, and low mood. Prescribed within recommended doses, these treatments are safe. However, excessive amounts of estrogen may lead to palpitations, anxiety, and mood swings. Moreover, the imbalance between estrogen and progesterone could result in endometrial hyperplasia, leading to heavy bleeding and increased risk of womb cancer. There are also concerns that higher doses of progesterone, needed to protect the womb lining when taking high estrogen doses, may increase the risk of blood clots and breast cancer.
Dr Karen Morton, a consultant gynaecologist, sees women on extreme high doses every week and believes unrealistic expectations about the benefits of HRT are fueled by media coverage and celebrity influence. Some women “are adjusting their doses in an almost cavalier way”, self-prescribing higher amounts to tackle issues they believe are related to hormone decline, she said.
Dr Naomi Potter, a menopause specialist GP, noted an increase in self-prescribing and prescribing outside of medical guidelines, which is dangerous territory. She advised women to consult adequately qualified professionals for menopausal management and referred them to the British Menopause Society for a list of specialists.
The Mail on Sunday’s investigation exposed concerns over Newson Health, a private clinic that prescribes higher than licensed doses of HRT to 20% of its patients. Dr Louise Newson, the clinic’s leader, argues that women struggling with mental health problems may require double the licensed amount of estrogen, but other specialists disagree. Following the investigation, various medical organizations issued a joint alert stressing the importance of not exceeding the licensed limits for patient safety.
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