Case-based learning: menopause and HRT consultations — transcription (audio clip three)

Nuttan Tanna: There was a paper that was published in 2024, where they looked at social media, specifically HRT, and then evaluated what the posts were like. So they reported that 67% of the posts were misleading, in the context where they overstated the benefits but minimised the risks, and it’s actually that balanced discussion that patients should be having. 93% of the content creators had direct or indirect conflicts of interest. So it’s actually where they were using it as an educational model and saying, ‘We are providing education,’ but actually, then, it ended up where they wanted to sell some product that they’d actually formulated. So you need to think about that conflict of interest. Only one in three actually presented their conflicts of interest. Two-thirds of the claims went beyond licensed British National Formulary evidence. So again, I have to be careful here because in the specialist clinic, we do work in grey areas, so we do actually provide advice for patients struggling and presenting with symptoms, but where we know that actually we might be recommending HRT on an off-label basis or recommending testosterone on an off-label basis. But it’s actually being very clear and actually helping the patient understand that the evidence base is poor.