The Laura Dowling Experience

Dr Louise Newson, GP, menopause specialist and founder of Newson Health and the Balance app, joins Laura Dowling for a frank conversation about hormone replacement therapy (HRT), the barriers women face in accessing treatment and the criticism she has faced for challenging established approaches to menopause care.Louise traces her advocacy back to the 2002 Women's Health Initiative (WHI) study and the publication of NICE's first menopause guidance in 2015. She explains why she believes the risks of HRT have been misunderstood, why prescribing remains low, and why the distinction between different types of hormones matters.Laura and Louise discuss testosterone for women, starting HRT later in life, individual responses to estradiol, and difficult questions around hormone treatment following breast cancer. Louise also explores progesterone, PMS, premenstrual dysphoric disorder (PMDD) and postnatal depression, including the influence of Dr Katharina Dalton's work. These are complex areas where treatment decisions require individual medical advice.Louise speaks openly about professional opposition, BBC Panorama, correspondence involving the British Menopause Society and the scrutiny of her clinic. She reflects on the personal cost of speaking out, why she continues to campaign for better menopause education and what she hopes will change for women's healthcare.🔑 Key PointsHRT prescribing fell off a cliff after 2002Louise kept prescribing HRT as a GP for decades and only realised after NICE's 2015 guidance that many colleagues had stopped, while her friends were being given antidepressants instead.Guidelines are only a guideShe says the NICE guidance mentions risk 22 times more than benefit and groups synthetic and bioidentical hormones together, which leaves busy clinicians confused.The over-60 risk came from synthetic hormonesThe heart attack signal in the Women's Health Initiative study was in women given horse-derived oestrogen and a synthetic progestogen, not the estradiol and progesterone she prescribes.Testosterone has a long history in womenIt was prescribed in the 1940s and '50s for period problems and menopausal symptoms, and she says its reputation comes from the synthetic anabolic steroids of the '60s and '70s.Some women need more than the licensed doseSkin varies in how much estradiol it absorbs, and her clinic's published data shows about a fifth of patients need a higher than licensed dose.Progesterone changed her thinking on PMDDA colleague's own postnatal illness led Louise to Katharina Dalton's work, and her clinic now prescribes progesterone for PMS, PMDD and postnatal depression.Ten years of being targetedLouise says the emails she obtained show people trying to silence her, and the pressure on her and her family brought her close to giving up.Only 5% of menopausal women get HRTEvery menopause guideline calls HRT first-line treatment for most women, yet she says only 14% of menopausal women in the UK and 5% globally are prescribed it.📚 ResourcesNewson ClinicThe hormone clinic Louise co-founded with Dr Rebecca LewisBalanceLouise's free app for tracking symptoms and learning about hormone healthConfidence in HormonesThe hormone health education programme for doctors and healthcare professionals⏱️ Timestamps00:00 — Welcome to The Laura Dowling Experience03:47 — Rereading the WHI study after NICE's 2015 guidance11:18 — Why HRT is scrutinised like no other medicine15:43 — Testosterone's forgotten history in women20:43 — Starting HRT after 6024:43 — "A body of people trying to take me down"29:33 — If she were a male gynaecologist32:07 — Are her doses too high?35:45 — HRT after breast cancer39:43 — Progesterone, PMDD and postnatal depression42:16 — The Care Quality Commission inspection45:47 — Running a private clinic48:27 — Has the pendulum swung too far?53:02 — Advice for young people and the meaning of life

In this bitesize moment pulled from the Laura Dowling Experience back catalogue, Dr Clare Cromwell explains why muscle is just as important as bone in midlife, and lays out a simple twice-weekly strength routine that protects against falls and fractures.We talk a lot about protecting our bones in midlife. But what if the real key to staying steady on your feet, and even to your brain health decades from now, is your muscles?🔑Key Points• As oestrogen drops, bone density naturally declines, but muscle loss speeds up too, especially after menopause• Strong muscles improve balance and reaction time, so you're less likely to fall, and better protected if you do• Aim for at least two strength sessions a week: roughly three exercises for your upper body and three for your lower body, a few sets of moderate reps• It doesn't need to be heavy lifting or a gym membership; a couple of dumbbells at home can be enough, as long as you feel it🎧 Listen to the full episode here.

Veterinary surgeon and founder of Village Vets, Charles Cosgrave, joins Laura to share what every pet owner should know about keeping their animals healthy, happy and safe — from neutering and pet insurance to behavioural problems, emergency care and the realities of life as a vet.Growing up on a dairy farm in County Meath, Charles watched his father answer veterinary calls at all hours, even on Christmas Day. After qualifying from UCD and working in the UK, he returned to Ireland and helped build Village Vets, which has grown to 35 locations, including three 24-hour emergency centres.Charles takes us behind the scenes of veterinary medicine, explaining what happens during overnight emergencies, why children can provide the most useful information about a sick pet and how veterinary care has evolved to include specialist treatment for conditions such as diabetes, epilepsy and cancer.Laura also asks the questions many dog owners have: Should you neuter your dog? What should you look for in pet insurance? How can you prevent behavioural problems? And what needs to change to tackle puppy farming in Ireland?They explore the responsibility of pet ownership, the importance of early training and socialisation, the challenges of treating seriously ill animals and the difficult decisions surrounding end-of-life care.Alongside the practical advice, Charles shares the challenges of growing a family business, the shortage of vets in Ireland and why, despite running 35 practices, he still misses working directly with animals.🔑 Key PointsNeutering and pet health: Charles discusses neutering male dogs, potential health concerns and factors owners should consider with their vet.Pet insurance: Why Charles recommends insurance, what to check before choosing a policy and how switching providers can affect cover for existing conditions.Training and behaviour: The importance of socialising dogs early, establishing routines and helping them adjust to people, noise and unfamiliar environments.Puppy farming and microchipping: Charles discusses dog breeding in Ireland, existing microchipping requirements and the challenges of tackling irresponsible breeding.When pets become seriously ill:How vets manage chronic conditions including diabetes and epilepsy, treat cancer and approach difficult end-of-life decisions.Inside veterinary medicine:From overnight emergencies to specialist care, Charles explains the pressures facing vets and the growing demand for veterinary services.📚 ResourcesVillage VetsCharles's practice group, 35 clinics across Ireland and three 24-hour emergency centresUCD School of Veterinary Medicinewhere Charles trained, and still the main route into the professionDog microchippingwhat's required in Ireland, and the measure Charles says would curb puppy farming⏱️ Timestamps02:37 – Growing up with a vet for a father05:36 – How vets treat different animal species07:30 – Building Village Vets10:00 – Veterinary education and the shortage of vets13:44 – Inside 24-hour emergency veterinary care15:45 – Why children notice changes in sick pets17:00 – Pet ownership and rehoming19:20 – Neutering male dogs21:09 – Puppy farming and microchipping23:30 – The responsibility of owning a dog26:30 – Unusual pets and animal stories29:30 – Cats, dogs and different personalities31:54 – Dog training and socialisation33:41 – Pet insurance and switching providers35:25 – Diabetes, epilepsy and chronic illness37:20 – End-of-life decisions and cancer treatment40:20 – Why Charles misses being a practising vet43:00 – Growing Village Vets while maintaining quality50:15 – Be bold, be brave and back yourself

In this bitesize moment pulled from the Laura Dowling Experience back catalogue, Meghan O'Neill, online content creator and mother of two explains how she holds firm boundaries for herself, then how she is teaching her young children about consent, from everyday moments like a kiss or a tickle through to the bigger conversations about porn and never being with someone who is drunk.What if the most important thing you teach your kids about sex has nothing to do with sex, and everything to do with the word no?🔑Key Points• Meghan will not be pressured into anything; she can walk away right up to the last moment if something does not feel right• She wants her kids to know porn is not real, because no one ever told her that• At home, her kids can say no to a kiss or a tickle, and that no is respected straight away• She is direct with her son: never sleep with someone who is drunk, because they cannot consent🎧 Listen to the full episode here.

#AD - This episode is sponsored by AstraZenecaDr Tonya Leonard was a GP when she found a lump she was sure was a cyst. By half past nine that morning, she was being told it was breast cancer and asked to decide by the following week whether she had finished her family. Her twin boys were just 18 months old.Sixteen years, a second primary cancer and a diagnosis of advanced breast cancer later, Tonya joins Laura alongside Helen Forristal, Director of Nursing Services at the Marie Keating Foundation, for an honest conversation about living with advanced breast cancer.They discuss metastatic or secondary breast cancer, breast cancer recurrence and the signs and symptoms women should be aware of, alongside treatment, scans, scanxiety, cancer fatigue and the difficulty of planning life beyond the next result.Helen explains why advanced breast cancer remains largely invisible in Ireland, with no official count of how many women are living with it, and discusses the importance of specialist cancer support. Tonya shares the reality of living life in three-month segments, navigating mental health after diagnosis and learning that palliative care does not only mean end-of-life care.The conversation is part of Living Loudly, Dying to be Heard, a campaign by AstraZeneca and supported by the Marie Keating Foundation, highlighting the experiences of people living with advanced breast cancer.🔑 Key PointsAdvanced breast cancer means it has spreadThe cancer has moved from the breast to another organ; in Tonya's case, to lesions on her lung and under her arm.Life in three-month segmentsWith a scan every three months, Tonya finds it hard to plan past the next result, the anxiety Laura calls scanxiety.Fatigue is not the same as tirednessTonya describes cancer fatigue as like an injection of horse tranquilliser: once she feels it rising, she has minutes to lie down.Women are living longer with itHelen calls it the long middle, moving through lines of treatment; one woman in her group has lived with advanced breast cancer for 21 years.Nobody is countingRecurrences aren't recorded the way first diagnoses are; Helen's estimate is around 30% of women with primary breast cancer, and a University of Limerick project has started counting.Know the signs of a recurrenceSymptoms depend on where it spreads, from a cough and breathlessness to weight change or bone pain; if something hasn't settled in three weeks, ask your doctor, "Could this be cancer?"Mental health support needs to be specialistTonya waited eight weeks to see a psychologist; psycho-oncology services now run in Ireland's eight cancer centres.Palliative care is not only for the end of lifePalliative teams help manage symptoms and support families, and the CLIMB programme supports children aged 5 to 12 who have a parent with cancer.📚 ResourcesLiving Loudly. Dying to be HeardA campaign by AstraZeneca and supported by the Marie Keating FoundationPositive LivingThe Marie Keating Foundation's support programme for people with advanced cancerCLIMBThe HSE programme for children aged 5 to 12 affected by a parent's cancer⏱️ Timestamps00:00 — Welcome01:52 — Helen Forristal and the Marie Keating Foundation02:51 — Dr Tonya Leonard’s breast cancer diagnosis06:21 — Advanced cancer support and Positive Living09:28 — Scanxiety and living between results12:08 — Living longer with advanced breast cancer17:14 — Cancer fatigue22:58 — Fertility and “Have you finished your family?”29:17 — How many women are living with advanced breast cancer?30:41 — Signs and symptoms of recurrence37:57 — Mental health and psycho-oncology46:45 — What palliative care really means51:40 — Family, milestones and living with uncertainty56:28 — Advice for young people

In this bitesize moment pulled from the Laura Dowling Experience back catalogue, Dr Clodagh Campbell shares two client stories about reclaiming time for yourself, then walks through the Four Ds, a simple way to sort an overwhelming to-do list into what to delete, delegate, delay or do.When your life feels too full, the answer isn't to try harder. It's working out what can give. Psychologist Dr Clodagh Campbell shares two client stories and a simple tool for figuring out what to drop.🔑Key Points• When life feels too full, the question isn't how to cope better, it's what can change and what can give• Alice, a successful business owner, worked herself into the ground out of a deep fear of letting her parents down• By the end of their work together, Alice had hired a manager, taken a three-month sabbatical and learned that rest could be as simple as walks on the beach• Nikki, a mother of three, couldn't imagine one hour a week for herself, until a small boundary around one yoga class let her husband step up too🎧 Listen to the full episode here.

Dr Dan McCartney, dietitian, lecturer in Human Nutrition and Dietetics and Programme Director of the Human Nutrition and Dietetics programme at TU Dublin and Trinity College Dublin, joins Laura to discuss the vitamins and minerals many of us simply aren’t getting enough of — and why that matters for our health. Drawing on Ireland’s national food intake data, Dan reveals striking levels of inadequate intake across essential nutrients including vitamin B6, folate, vitamin C, vitamin A, zinc, magnesium and selenium. At least half of the Irish population have inadequate intakes of magnesium and selenium, while more than 40% have inadequate vitamin C intakes. Laura and Dan also discuss the European Food Safety Authority (EFSA) and proposals to lower or restrict the levels of certain vitamins and minerals available through supplements. Dan questions the rationale for reducing these levels when nutrient intakes are already low, discussing proposed levels for vitamin D, as well as restrictions affecting magnesium and the importance of vitamin C. He explains why he believes a restrictive, one-size-fits-all European approach may not meet the nutritional needs of the Irish population. They also explore whether some recommended daily amounts are focused more on preventing severe deficiency than achieving optimal health, including vitamin C recommendations based around preventing scurvy and vitamin D recommendations historically centred on bone health rather than immune function. The conversation returns to Dan’s early research into vitamin D and COVID-19, before moving into nutrition and immunity, healthy ageing, dementia, pregnancy and epigenetics — and why the nutritional choices we make today can influence our health decades into the future.🔑 Key PointsHalf the population are falling short on key nutrientsDan discusses inadequate intakes of magnesium, selenium, vitamin B6, folate, vitamin C, vitamin A and zinc in Ireland.Why are nutrient intakes so low?Poor diet quality, low fruit and vegetable intake, low wholegrain consumption and highly refined diets.EFSA and proposed supplement restrictionsLaura and Dan discuss EFSA and proposed European changes affecting vitamin and mineral supplements, including vitamin D and magnesium, and why Dan is concerned about further restrictions.Are recommended intakes actually optimal?Dan questions whether some guidelines focus on preventing severe deficiency rather than supporting optimal health.Vitamin D, immunity and COVID-19Dan revisits the research that led him and Dr Declan Byrne to propose a link between vitamin D deficiency and severe COVID-19 in 2020.Nutrition across a lifetimeFrom pregnancy and epigenetics to ageing and cognitive health, Dan explains why nutrition today can affect health decades later.📚 ResourcesOptimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19Dan and Declan Byrne, Irish Medical Journal, 2020Vitamin D Deficiency and ARDS after SARS-CoV-2 InfectionFaul et al., Irish Medical Journal, 2020Autocrine vitamin D signaling switches off pro-inflammatory programs of TH1 cellsChauss et al., Nature Immunology, 2022Nutrition, immunity and COVID-19Philip Calder, BMJ Nutrition, Prevention & Health, 2020European vitamin D supplementation trials, meta-analysisRupprecht et al., Nutrients, 2023⏱️ Timestamps00:00 — Cold open02:07 — Meet Dr Dan McCartney04:03 — Vitamin D and COVID-1906:10 — The 2020 research13:49 — Why vitamin D levels run low19:08 — Vitamin D and immunity32:00 — Ireland’s nutrient inadequacies34:02 — Poor diet quality35:09 — Zinc, magnesium and selenium37:24 — Are nutrient guidelines out of date?38:03 — Scurvy vs optimal health45:48 — EFSA and proposed supplement restrictions46:24 — Vitamin D supplement levels50:11 — Magnesium restrictions51:03 — Nutrition guidelines for Ireland54:35 — Primates and vitamin D55:51 — Ageing and dementia57:39 — Pregnancy and epigenetics1:02:43 — Why good habits compound

In this bitesize moment pulled from the Laura Dowling Experience back catalogue, Dr Denis O'Driscoll, pharmacist working in the HSE addiction services gives a straight, compassionate answer on how hard it is to come off drugs and stay off, and why staying stable on treatment counts as success too.Is staying on treatment for life a failure, or is that thinking part of the problem? Dr Denis O'Driscoll gives an honest answer.🔑Key Points• Coming off drugs and staying off is never easy, and that is worth saying out loud• Recovery is not one straight line; staying stable on treatment is a positive outcome, not something to be ashamed of• Coming off completely is wonderful when it happens, but it is very challenging, and it is not the only measure of success• Relapse is part of recovery, not a failure, and the priority afterwards is getting people back into support quickly💛 If you or someone you love needs support, the HSE Drugs and Alcohol Helpline is there on 1800 459 459.🎧 Listen to the full episode here.

Kenneth Keavey has a PhD in chemistry and spent his early career in pharma and biotech. He now grows organic vegetables on twenty-five acres outside Galway, and he's the first to point out the irony: he was an organic chemist, and now he's an organic farmer.In this episode he takes Laura through what's actually on the food we eat, and how little of it we're told. Around 95% of conventional fruit and veg has had some treatment or another. Citrus is dipped or sprayed after harvest in waxes containing quite toxic, in some cases carcinogenic, chemicals to stop fungus growing on the skin. Most of it is legal, disclosed somewhere, and almost never read.Then comes the detail that stops the conversation. In the EU you're allowed 10mg of glyphosate per kilogram of wheat and 20mg per kilogram of oats — twice as much of a probable carcinogen in your porridge as in your toast. Kenneth and Darina Allen went to the Department of Agriculture to ask why. They were told that people eat less porridge than they do toast.It isn't all alarm. Kenneth refuses to scaremonger and is as clear about what isn't known as what is. He's also quietly hopeful: his own land is full of insects and birdsong, and he has watched how fast nature comes back when you let it.🔑 Key PointsHe was an organic chemist before he was an organic farmerHis PhD is in chemistry and his first career was in pharma and biotech, which is where the caution comes from.Around 95% of conventional fruit and veg has had some treatmentPost-harvest waxes on citrus contain toxic and in some cases carcinogenic chemicals, and some produce carries up to fifteen applications.You're allowed twice as much glyphosate in porridge as in breadThe EU limit is 10mg per kilogram of wheat and 20mg per kilogram of oats. Kenneth and Darina Allen asked the Department of Agriculture why, and were told people eat less porridge than they do toast.The safety data usually comes from the manufacturersUnlike medicines, pesticide safety data is largely supplied by the companies selling the chemicals, and permitted limits have risen since the 1990s as application increased.80% of the world's insect biomass is goneA test anyone can run from memory: a windscreen after a night drive used to be covered in insects, and now there's virtually nothing on it.Ireland has gone from 600 vegetable growers to about 60The sector has hollowed out in twenty years, we import 85% of our fresh fruit and veg, and vegetables are the one thing that hasn't risen in price — which is why a 39c bag of carrots is a problem, not a bargain.Nature comes back faster than you'd thinkHis farm is full of insects and birds, with nine native Irish honeybee hives that out-produce every other apiary his beekeeper runs.📚 ResourcesGreen Earth OrganicsKenneth's organic farm and nationwide home delivery service in Co GalwaySilent SpringRachel Carson's book on the effects of blanket pesticide use, discussed in the episodeIARC (World Health Organization)The classification of glyphosate as probably carcinogenic to humans⏱️ Timestamps01:26 — Twenty years of Green Earth Organics02:35 — From a PhD in chemistry to organic farming03:57 — Around 95% of conventional fruit and veg has had some treatment06:34 — Glyphosate, the most applied chemical in history06:59 — Twice as much allowed in your porridge as in your toast07:17 — What the Department of Agriculture said when they asked why10:39 — Silent Spring, and the year the birdsong stopped12:25 — 80% of the world's insect biomass is gone22:15 — From 600 vegetable growers to about 6050:06 — Five summers of farm work, three sheep, and the leap