Not the Whole Truth about Menopause ..

The BBC has responded to my letter which had criticised their documentary “The Truth About Menopause” which was broadcast on BBC One in November.

Whilst I think we should be pleased that a one-hour documentary on the subject of menopause was shown, I was unhappy with many things about it and their response does not change my view.

It could have been a great deal better than it was.

The programme failed to address the concerns of the majority of women who tell us they can’t get the right  kind of help and support from their GP. And also:

  • Mariella Frostrup featuring her own Harley Street Gynaecologist felt very much like a plug and was not representative, as this sort of private care is out of reach of the majority of women.
  • It discussed whether there was a “male menopause” – a totally different subject.
  • It may have misled a lot of people to think that yearly scans are a necessity – they are not.

We are already familiar with the views of the BBC presenter Jeni Murray  on Hormone Replacement Therapy (she’s against it) and I think she did not need another opportunity to air views that have already been expressed a number of times on radio and television.

My letter and their response are printed below, so you can make you own minds up whether programme really did the subject justice.

And I stand by the conclusion of my letter.  I hope that the points that I have raised will be enough to persuade the BBC a one hour programme is simply not the right vehicle to explore such an important topic which will directly affect every woman and indirectly affect every man.

I suggest that the BBC look at a series of programmes which explore this subject more thoroughly.

Charlotte Moore

Director, BBC Content

BBC Broadcasting House

Portland Place
London
W1A 1AA

27th November 2018

Dear Charlotte

I am writing in response to the broadcast of The Truth About Menopause on BBC One last night. I should begin by saying that I was delighted to hear from the production team earlier in the year that this project was underway and was very happy to offer information and signposting to the team. As you can imagine I was very much looking forward to seeing the result last night but having watched it I felt it was a missed opportunity, let me explain.

I spend much of my working life supporting and educating women, men and organizations about menopause and the key is to offer factual, evidence based information and to dispel the many myths and stories that have grown up around the subject. Whilst the programme started well looking at up to date facts about HRT with Janice Rymer from the RCOG all the good work was immediately undone by interviewing Jenni Murray sharing her well known very personal views which has left many women even more confused.

It is unfortunate that time that could have been used to explore the challenges women face when seeking advice and support from NHS GP’s focused instead on whether or not there is a male menopause. The reality for the majority of women is that they do not have access to private care or Harley Street physicians but instead face a lottery of care depending upon whether their GP has shown an interest in the subject and attended additional training.

There was no mention of those who undergo hysterectomy surgery resulting in a surgical menopause or the 110,000 women who have experienced premature menopause or those who are diagnosed with gynaecological or breast cancers and offered little in the way of management for their symptoms with many being flatly refused the option of HRT.

The inclusion of the medical research in to tissue preservation and Neurokinin B was certainly interesting but would have been more suitable for the last in a series of programmes investigating what the future holds.

The reality for many women is that they have no idea what is happening to them when their symptoms start, as for many the symptoms are psychological and typically those women are told they are depressed and prescribed anti depressants. The physical symptoms, once they come along, can be equally debilitating, including very heavy periods, crashing fatigue and destroyed sleep patterns.

Menopause is a very individual experience and whilst it was interesting to see the group using CBT, which can be helpful for some, many women felt that the 100% success rate of the study group in the programme gave an unrealistic view. As some have pointed out no amount of breathing or changed thinking would have addressed their severe symptoms.

The interview about diet told us nothing new and provided little in the way of information or advice and was an ideal example of time that could have been spent focusing on some of the more pressing issues for women around the country.

Women are losing jobs due to debilitating symptoms and a lack of organizational support, relationships due to a lack of understanding between partners and in the very worst case scenario their lives when symptoms become completely overwhelming. The current statistics show that the highest rate of suicide amongst women is between the ages of 50 and 54, the average age of menopause is 51.

Whilst I appreciate that the programme was only an hour in duration so many of the key points were missed, there was very little time dedicated to  brain function or heart health and the research regarding long term health and HRT. Libido, urinary symptoms and vaginal symptoms which affect so many women were not addressed at all and considering the amount of elderly women who continue to suffer with these symptoms this would have been an ideal opportunity to share vital information.

I hope that the points that I have raised will be enough to persuade you that a one hour programme is simply not the right vehicle to explore such an important topic which will directly affect every woman and indirectly affect every man. I would like to suggest that the BBC look at a series of programmes which explore this subject more thoroughly. I would, of course, be delighted to speak with you about this.

I look forward to your reply

Yours Sincerely

Psychotherapist and Menopause Expert

Dear Diane,

Thank you for your letter.  It has been passed to us as producers of the programme. 

HRT is an emotive and divisive subject and we wanted to investigate where the fears surrounding HRT originated and why many women are still afraid to take it.  However, we also wanted to make sure that we went on to put the real risk in perspective in as clear a way as possible, so that women feel equipped to make their own informed decision. 

Jenni Murray is someone who has been vocal in the media about her personal experience and fears about HRT.  Her story helps to communicate why there has been concern around the issue.  There is a link between breast cancer and HRT – but Jenni herself acknowledges that she also qualified for other lifestyle risk factors in terms of alcohol intake and weight.  And as Mariella states in the film although this is a powerful individual story she wants to investigate how big the risk really is overall by speaking to an expert.

When Mariella meets Professor Janice Rymer, title, we discover that the risk of HRT is much smaller than other lifestyle factors.  Janice very clearly talks us through the relative risks and states that the risk with HRT has been ‘over egged’ in her words. 

At the end of the film Mariella decides to keep taking HRT, even though she has already been on it for 5 years. Her gynaecologist advises Mariella to keep taking it and states that she will personally take HRT ‘until the day I die’. 

We believe the film overall is pro-HRT.  But we felt it necessary to tell the full story of why there has been so much fear and concern surrounding the issue.  We took advice from many experts when researching and editing the film as a whole, but especially this story. 

We appreciate your concerns but feel strongly that we have been very careful to cover the subject responsibly. In the response we’ve had to the programme many people have said it has really helped them understand how small the risk actually is.

The question of whether men do have a menopause is valid one to ask, and we felt it worthy of investigation in a programme that tried to cover as many aspects of the menopause as possible.

The CBT story featured a small group of women but the positive results we reported for them were accurate.  This was clearly a very small group, but our results do reflect those found by Professor Myra Hunter in much larger studies.  We were very keen to feature the options available to women who do not take HRT for whatever reason and the research in CBT is very promising and supported by scientific evidence.  The diet story also aimed to communicate effective information about nutrition and the menopause and we feel that we achieved this.     

As you mention in your letter, the documentary was only an hour long.  The menopause is clearly a huge subject, affecting women in many different ways and there were always going to be areas that we couldn’t include.  We set out to produce a programme that would give clear, effective and new information to as many women as possible in an engaging way. 

Best wishes,

kate

Kate Pringle, BBC Science