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

Nuttan Tanna: It’s fascinating when you talk about the Davina effect. I think it’s a brilliant case study. If you were to start… look at the effect of the two documentaries that Davina McCall did. I mean, if I think about it as a case study where I want to look at what the impact was, there’s the media influence on health-seeking behaviour. Women are more aware and are actually now seeing their GPs, actively approaching their GPs and asking for support.

There’s been an effect on demand-and-supply dynamics. Some of the work seems to suggest that it’s maybe because women are more aware and are actually asking their GPs, and there’s more demand for HRT prescriptions. But then I think about the fact that in 2019, the prescribing was getting steadily… increasing steadily post the WHI era. When I talk about WHI, it’s the Women’s Health Initiatives that published their data, and media attention was on the fact that actually oestrogen is actually the reason why we’ve got the extra risk for breast cancer, and the media attention was on breast cancer, which is very emotive.

When you think about a woman reading a newspaper and saying, ‘This medicine that you’re taking is linked to breast cancer,’ her gut instinct will be to stop, and that’s what we actually saw in clinical practice. But coming down to 2019, the prescribing was growing steadily, and then suddenly, we had the Davina effect. 

And, most of the researchers talk about it in this context, that actually she raised awareness. Women were more aware and went and saw their GPs or their health professionals and asked about HRT. There was an increase in prescribing, and actually, the open prescribing data does suggest that in 2021, as a result of the Davina effect, the prescription rate increased, by something like 35%, was some of the figures that were being quoted.

So, as I say, it’s a fascinating case study where you’ve got media influence, somebody who’s a relatable person, somebody that you actually listen to or watch, who’s an influencer, and she’s talking openly about menopause, and suddenly women felt that there wasn’t a stigma attached to this. It was something that validated their feeling, the symptoms that they had when they actually went through menopause, and it validated it for them. It told them that you don’t have to struggle with this. You can go and ask for help, and that’s what we saw in clinical practice.