Most people can’t name five menopause symptoms beyond hot flushes and the biggest problem might start with the word itself. In this episode, Dr Karan Rajan speaks with Dr Louise Newson, a hormone and menopause specialist, about what’s actually happening biologically, why symptoms get missed or mislabelled, and how evidence, guidelines, and real-world prescribing shape care.
In this conversation, we cover:
Why “menopause” as a label can obscure the underlying hormone biology
The three-hormone framework: Oestrogen, progesterone, testosterone
Why symptoms like brain fog, mood changes, and gut symptoms can be misattributed
Bioidentical vs synthetic hormones (and why molecular structure matters)
Osteoporosis risk, prevention, and what “healthy ageing” should include
Dosing and absorption: Patches vs gels, and why some people need higher doses
Why “guidelines” are a guide and where personalisation matters most
🎬 Chapters
01:22 – Most people can’t name five symptoms beyond hot flushes
01:56 – The definition problem: “A year without a period” doesn’t explain biology
02:59 – Back to basics: oestrogen, progesterone, testosterone
04:24 – Is menopause “just ageing” or a treatable deficiency state?
06:21 – Misdiagnosis: IBS, brain fog, depression and missed hormone deficiency
08:40 – Why “hard to measure” symptoms got ignored in research and guidelines
09:04 – Hormones and inflammation: metabolic risk shifts in perimenopause
10:32 – Osteoporosis risk and prevention: Why this matters clinically
11:22 – Sponsor: Loam
12:14 – Bioidentical vs synthetic hormones: The “key and lock” explanation
14:59 – Contraindications and breast cancer conversations
17:12 – Guidelines vs optimisation: Why safe does not always mean best
18:31 – How to read guidelines: Who wrote them, conflicts, and cited studies
20:18 – Dosing: “lowest effective dose” and why needs vary
22:25 – Louise’s own dosing story: Symptom improvement within days
24:14 – Absorption science: Skin variation and patch placement differences
26:01 – When to consider hormones: Symptoms and quality-of-life impact
27:18 – PMS and PMDD: Severe pre-period symptoms and hormone strategies
28:58 – The timing hypothesis and what WHI got wrong
31:04 – The “stop at 60” myth, synthetic-hormone data, and fear headlines
32:26 – The risks of not taking hormones
34:07 – Sponsor: Throne
35:11 – Gut microbiome and hormones: Reflux, bloating, and symptom shifts
41:29 – Outcomes and personalisation: The metric is quality of life
42:15 – Mental health outcomes discussion and clinic data
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🧬 Sign up for my Microbiome Course waitlist: https://drkaran.kit.com/microbiome-course-waitlistAbout Dr Karan:Dr. Karan Rajan is a doctor, author, and educator dedicated to making health and medical science accessible to all. Through evidence-based analysis, he addresses topics such as gut health, brain health, and healthy lifestyle choices, while dispelling common medical myths with a touch of dark humour. His content provides reliable, research-driven insights designed to inform and empower viewers to better understand their health.📱Connect with me:Instagram: / drkaranrajanFacebook: / drkaranrTikTok: / dr.karanrX: / drkaranrajanWebsite: www.drkaranrajan.com
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