A major menopause and hormone treatment conference in Sydney next month has ignited a heated debate among medical professionals, highlighting divisions over hormone therapy dosages, the role of social media in medical advice, and the influence of big business in women’s healthcare.
The So Hot Right Now conference, scheduled for March 1-2, has become a flashpoint in the ongoing global debate over menopause hormone therapy (MHT), formerly known as hormone replacement therapy (HRT). The event features international speakers whose views on treatment dosages and methods are controversial, drawing criticism from established medical organizations.
The Core of the Controversy
At the heart of the dispute is the growing number of doctors prescribing higher-than-recommended doses of hormones, particularly estrogen and testosterone, for perimenopausal and menopausal women. Proponents argue these higher doses can significantly improve symptoms, while critics warn that such practices stray from established medical guidelines and pose potential health risks.
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“The menopause wars are alive and well,” said Professor Jayashri Kulkarni, a psychiatrist at Melbourne’s Alfred Hospital, who will be on a panel at the conference’s public session at the Sydney Opera House. “Millions of women go through menopause without issues, but for others, the experience is horrendous. They deserve treatment options that help them live their lives as they wish.”
However, Professor Susan Davis, an endocrinologist at Monash University and a leading expert on menopause, has voiced concerns about the conference. The Australasian Menopause Society (AMS), which provides evidence-based guidance on menopause treatment, does not support the event.
“I can’t pre-empt what they will say, but based on their past statements, it’s concerning,” Davis said. “Some of these doctors push treatment beyond evidence-based guidelines. What motivates them? Are they simply convinced they know better, or is there a commercial angle?”
International Influencers Under Scrutiny
Much of the controversy surrounds the conference’s three headline speakers, each of whom has built a significant online following and commercial empire:
- Dr. Louise Newson (UK): A general practitioner with more than 640,000 Instagram followers, Newson operates a chain of menopause clinics and an educational app, Balance. She has drawn criticism for advocating doses of estrogen that exceed standard guidelines. Newson argues that some women do not absorb hormones efficiently and require higher doses. However, her approach has been questioned by regulatory bodies, and she lost her British Menopause Society accreditation in 2024 after a BBC investigation raised concerns about her high-dose prescriptions.
- Dr. Mary Claire Haver (USA): An obstetrician-gynecologist with a massive 4.6 million followers across Instagram and TikTok, Haver has positioned herself as an influential voice in menopause education. She promotes hormone therapy for uses that some doctors say stray from official medical guidelines. Additionally, she sells menopause supplements and diet plans under the brand The ‘Pause Life. Critics argue that such endorsements create conflicts of interest.
- Dr. Kelly Casperson (USA): A urologist known for her social media presence and outspoken advocacy for menopausal health. She has been accused of promoting hormone therapies without sufficient clinical backing.
The Risks of High-Dose Hormone Therapy
A major sticking point in the debate is the safety and efficacy of high-dose hormone therapy. The AMS and other medical organizations caution that exceeding standard hormone doses can increase the risk of breast cancer, blood clots, and endometrial thickening. They argue that doctors prescribing such treatments should do so within formal clinical trials rather than standard practice.
Davis explains that official guidelines cap the maximum dose of estrogen at 100mg patches, a limit based on clinical trials and risk assessments. Higher doses, she warns, could carry unknown risks.
“Standard doses allow us to provide patients with accurate risk information,” Davis said. “If doctors exceed those doses, they should be part of a clinical study to ensure safety. Women deserve transparency about potential risks.”
Newson, however, defends her methods, saying hormone absorption varies widely among individuals.
“Every woman is different, so a ‘one-size-fits-all’ approach to HRT isn’t the best,” she said. “Some women need higher doses to achieve the same benefits. We have published audit data showing this.”
Social Media’s Role in the Menopause Debate
The rise of social media influencers in menopause treatment has further complicated the issue. Many women struggling with symptoms turn to Instagram, TikTok, and YouTube for advice, often finding more guidance there than from their doctors.
While some experts see this as empowering, others worry that untested claims and commercial interests are influencing medical decisions.
“It’s a double-edged sword,” said Davis. “Social media has raised awareness, but it has also created a space where medical advice is sometimes shaped by popularity rather than science.”
Newson, Haver, and Casperson argue that they are simply filling a gap left by traditional medicine. Many women report feeling dismissed by their doctors, leading them to seek answers online. However, critics worry that some influencers blur the line between advocacy and marketing.
The Future of Menopause Treatment
As the conference approaches, the broader debate over menopause care continues. The controversy highlights a disconnect between traditional medical institutions and a new wave of menopause advocates who argue that existing treatment guidelines are too conservative.
Despite the criticism, the speakers maintain that their work is grounded in patient advocacy.
“I am here to help women get the treatment they need,” said Newson. “The real issue is that menopause is under-researched and underfunded. We’re trying to change that.”
As the So Hot Right Now conference unfolds, the debate over menopause treatment is unlikely to cool anytime soon. Whether it leads to meaningful change in medical guidelines—or further deepens the divide between traditional medicine and the new wave of menopause specialists—remains to be seen.
