Dr. Louise Newson

The guidelines are very clear that women should have the lowest effective dose.

And so for some women, the lowest effective dose is more than the licensed maximum dose.

And the licensed maximum dose has been not actually set on any good quality data.

And we've known for decades that some people need higher doses or different doses than others when we put a substance through the skin.

A bit like if someone was having a nicotine patch, some people have different doses because they absorb differently through the skin.

And that's the same with Estradiol as well.

And since Panorama, we've published a peer review article about some of our data in the clinic, showing about one in four women

who come to our clinic have low levels of Estadal in their body, despite being given the maximum dose.

Well, there aren't any side effects of having the dose that people need.

The risk is not having adequate amounts.

As you probably know, Estadal is very anti-inflammatory in the body.

So it reduces inflammation.

But if our levels of oestrogen are too low in the body, either because we're menopausal or we're putting on a patch or gel that's not being absorbed adequately into our bloodstream, then our inflammatory system worsens and there's more inflammation in the body.

So there's harm if people are not on the right dose.

Some of the confusion has been the risks of synthetic hormones.

So if someone is on ethanol estradiol, which is an all but one combined oral contraceptive pill, that dose is so much higher than any dose that we give as estradiol.

But it's a synthetic hormone which is associated with risks.

But I don't prescribe synthetic hormones.

So the risks are not there that they are with all contraceptives.

and synthetic hormones that, like I say, were in old types of HRT.