## Trump Receives Clean Bill of Health Ahead of 80th Birthday

President Donald Trump has been declared in "excellent health" following his latest annual medical examination, according to a memo released by the White House on Friday. The assessment, conducted just weeks before Trump celebrates his 80th birthday, confirms he remains fully capable of fulfilling his presidential responsibilities.

Navy Captain Sean Barbabella, the president's physician, stated in the official memo that Trump demonstrates "strong cardiac, pulmonary, neurological and overall physical function." The doctor concluded that the president is "fully fit to carry out all duties of the Commander-in-Chief and Head of State."

## Examination Details and Key Health Metrics

Trump underwent the comprehensive physical at Walter Reed National Military Medical Center earlier this week — his third medical check-up since returning to the White House in 2025. Following the appointment, the president took to his Truth Social platform to announce that "everything checked out perfectly."

As the oldest individual ever inaugurated as U.S. president, Trump's cognitive health drew particular attention. He achieved a perfect score of 30 out of 30 on the Montreal Cognitive Assessment, a widely used standard screening tool for cognitive function, placing him firmly within normal limits.

On the cardiovascular front, the results were equally encouraging. Trump's resting heart rate was recorded at 73 beats per minute, and perhaps most notably, his cardiac age was estimated to be approximately 14 years younger than his actual chronological age.

## Weight Gain and Lifestyle Guidance

Despite the largely positive report, Barbabella did flag areas requiring attention. Trump currently weighs 238 pounds (108 kg), representing a 14-pound (6.3 kg) increase since his medical examination in April 2025. The physician noted that Trump has received professional guidance on dietary habits, physical activity levels, and continued weight management.

The president remains candid about his reluctance to engage in structured exercise. Trump has openly stated that he finds conventional workouts tedious, remarking, "I just don't like it. It's boring." He prefers golf as his primary form of physical activity and has said that extended treadmill sessions are simply "not for me."

Barbabella acknowledged that Trump's packed daily agenda — encompassing high-level meetings, public appearances, and consistent engagement — continues to positively contribute to his overall well-being.

## Medications and Ongoing Health Conditions

The White House memo also shed light on Trump's current medication regimen. The president takes aspirin daily for cardiovascular prevention, along with two separate cholesterol-lowering medications. He is also confirmed to be current on all recommended preventative screenings and immunizations.

The bruising visible on Trump's hands, which had previously prompted public curiosity, was addressed directly in the report. Barbabella explained that the discoloration is "consistent with minor soft tissue irritation related to frequent handshaking" while on aspirin therapy — describing it as "a common and benign effect" of the medication.

Trump has previously disclosed that he takes 325 mg of aspirin daily — significantly higher than the 81 mg dose often recommended by physicians. He told the Wall Street Journal that he prefers the larger dose because he does not "want thick blood pouring through my heart."

### Vein Condition Shows Improvement

Regarding Trump's previously disclosed diagnosis of chronic venous insufficiency — a condition where the leg veins struggle to return blood to the heart, leading to pooling and swelling in the lower limbs — the memo indicated measurable progress. While some mild lower leg swelling persists, Barbabella confirmed there has been "improvement from last year."

## Presidential Health in the Public Eye

Although annual medical examinations are not legally required for sitting presidents, they have become an established tradition in recent decades. Public interest in presidential health has intensified in recent years, particularly following the intense scrutiny surrounding former President Joe Biden's physical condition during the later stages of his term, when he took office at age 78.

President Trump's latest medical exam shows excellent overall health, a perfect cognitive score, but his doctor advises weight loss and more physical activity.

Trump in Excellent Health but Told to Exercise More

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Trump Declared 'Excellent Health' by Doctor, But Advised to Lose Weight and Exercise More

## When a Document Defines Your Existence

For most people, a birth certificate is simply a piece of paper tucked away in a drawer. But for millions around the world, the absence of that document means something far more profound — the absence of a legal identity, access to social services, and basic human rights.

This stark reality sits at the heart of **"The Uncounted"**, a compelling photographic project by Colombian-American photographer and filmmaker Juan Arredondo. Traveling across six countries, Arredondo captured the human stories behind one of public health's most overlooked crises: the failure to document births and deaths on a global scale.

His photographs are currently featured in the open-air Photoville exhibition in Brooklyn, New York, on display through May 30.

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## A Crisis Hidden in Plain Sight

The numbers are staggering. According to Arredondo, nearly **half of all deaths and 25% of all births go unrecorded** every year across the globe. These are not simply administrative oversights — they are gaps in human visibility that carry serious consequences.

Jennifer Ellis, who leads the **Bloomberg Philanthropies Data for Health Initiative**, puts it plainly: understanding what birth and death data tells us is absolutely fundamental to public health. Yet across low-income and remote regions, even when records are created, they often remain unfiled, undigitized, and effectively out of reach.

In many developing nations, the majority of deaths occur at home rather than in hospitals or clinics. As a result, no clinical cause of death is ever recorded. Without this data, communities and governments are left without the tools to identify emerging health threats, track communicable disease outbreaks, or allocate healthcare resources where they are needed most.

---

## From Bangladesh to Zambia: Stories Behind the Statistics

### Bangladesh: Birth Certificates as a Gateway to Aid

In Sirajganj, Bangladesh, a government registration drive made a tangible difference in people's daily lives. Mothers who had never possessed official birth certificates — for themselves or their children — were finally able to obtain the documents through a campaign in Dhamainagar Union. With these certificates in hand, families became eligible to enroll in vital food assistance programs, illustrating how a single document can unlock access to an entire network of social support.

### Rwanda: Bridging Paper Records and the Digital Age

In Rwanda's Musanze District, civil registration officers work diligently to sort through vast paper archives, searching for birth and death records on behalf of citizens tracing their family histories. Rwanda is actively digitizing its civil records, though physical documents are still required for certain official processes. The shift toward digital systems promises to dramatically improve accessibility for future generations.

### Zambia: How Data Saved Children's Lives

Perhaps one of the most powerful examples of data-driven change comes from Zambia. When the Bloomberg Philanthropies program analyzed a childhood mortality study, the findings were alarming: **75% of children born with HIV who went untreated would die before their fifth birthday**.

This data prompted a significant shift in government health policy. Authorities implemented programs to ensure at-risk children were tested and, where necessary, treated. The results were dramatic — the rate of children receiving testing and treatment climbed from a low of just 3% to an impressive **85%**. This transformation would not have been possible without reliable health records driving the decision.

### Philippines: Recording Life From Its Very First Moments

At the Agusan del Norte Provincial Hospital, nurses carry out initial health checks on newborns precisely on the date of their recorded birth — a practice that ensures each new life enters the official record from day one. Meanwhile, in Quezon City, initiatives are underway to support families who cannot afford funeral expenses, offering free services while simultaneously ensuring that deaths are properly documented.

---

## Verbal Autopsies: Giving the Uncounted a Voice

In Rwanda's Rulindo District, a quiet but meaningful process takes place in homes across the region. Verbal autopsy officers visit families to document the circumstances surrounding a loved one's death. By speaking directly with relatives and gathering detailed accounts, these officers help create death records for individuals who passed away without ever entering a hospital or clinic.

It is a deeply human approach to a deeply human problem — and it forms part of Rwanda's broader national effort to improve the accuracy and completeness of its vital statistics.

---

## The Bigger Picture: Why Every Record Matters

Arredondo's project was developed in collaboration with the **Bloomberg Philanthropies Data for Health (D4H) Initiative**, alongside public health organizations **Vital Strategies** and the **CDC Foundation**. Together, these organizations are working to close the documentation gap that leaves hundreds of millions of people invisible to the systems designed to protect them.

The lesson woven through every photograph in "The Uncounted" is both simple and urgent: a life recorded is a life acknowledged. Every birth certificate issued is a child granted rights. Every death properly documented is a potential health crisis prevented.

In a world where data increasingly drives policy, the people left out of the data are the ones most at risk of being left behind entirely.

Photographer Juan Arredondo's project exposes how millions of unrecorded births and deaths impact global health, rights, and access to vital services worldwide.

The Uncounted: How Birth and Death Records Shape Health

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The Invisible Millions: How Birth and Death Records Shape Global Health

## A Breath of Fresh Air for Critically Ill Patients

For the first time in two months, 29-year-old Hollie Allan was lifted out of intensive care and taken upward — not to another clinical ward, but to the open sky above King's College Hospital in south London. As the elevator doors parted and sunlight washed over her face, tears followed almost instantly.

"I forgot what it feels like to be outside," she said, wiping her eyes. "It's so beautiful."

Still connected to feeding tubes and life support equipment, Hollie became the very first patient to experience the hospital's groundbreaking rooftop intensive care ward — a facility unlike anything else in the United Kingdom.

## What Makes This Ward Unique

Designed to accommodate up to six critically ill patients simultaneously, the outdoor ward features individual bays equipped with waterproof power and oxygen supply units positioned beside each bed. Purpose-built canopies provide weather protection, ensuring that even the most vulnerable patients can safely receive full medical care while being exposed to the natural environment.

The rooftop garden has been seamlessly integrated into King's College Hospital's expansive 60-bed intensive care unit — one of the largest critical care facilities in the country. Patients may spend several hours at a time in the outdoor space, weather permitting.

"Even if it was thunderstorms, I'd be out here," Hollie said with a smile.

## The Science Behind Outdoor Recovery

The concept is not merely aesthetic. A growing body of research suggests that exposure to fresh air, natural light, and green surroundings can meaningfully improve patient wellbeing and potentially shorten hospital stays. While hospital gardens have existed for decades, they have historically been inaccessible to critically ill patients who require continuous life support and monitoring.

Dr. Phil Hopkins, an intensive care consultant at King's, believes this new model could change that. He explains that patients who spend prolonged periods in hospital can become institutionalised, effectively "ripped from their reality." Reconnecting them with natural elements, he argues, is a vital component of holistic recovery.

"We don't just want to save lives," Dr. Hopkins states. "We want to return them to their lives as quickly as we can."

The medical team will rigorously track key clinical indicators — including heart rate, respiratory rate, and pain levels — to measure the tangible impact the outdoor ward has on patient outcomes.

## A Garden Designed With Purpose

The rooftop planting was conceived by award-winning garden designer Sarah Price and the late landscape architect Nigel Dunnett, who previously collaborated on the celebrated Olympic Park for the London 2012 Games. Dunnett passed away before the project reached completion.

The garden features an aromatic and tactile selection of plants — honeysuckle, jasmine, and lavender among them — alongside textured grasses and foliage that patients can reach out and touch or smell directly from their beds.

"You can see the change not only on their face, but just in the way that they breathe," Price observes.

### Benefits Extend Beyond Patients

The positive impact of the rooftop space is not limited to those receiving care. Intensive care staff will also have access to the garden during breaks, offering a much-needed sanctuary from the pressures of one of medicine's most demanding environments.

## A £2 Million Investment in Recovery

The project, funded entirely through charitable donations to the hospital's charity, cost in excess of £2 million to construct. Hospital chief executive Clive Kay is optimistic the investment will yield measurable returns — not just in patient experience, but in reducing the length of critical care stays and optimising the use of NHS resources.

Should the results prove compelling, the model could be replicated across hospitals throughout the National Health Service, offering a new blueprint for how intensive care environments are designed in the future.

For Hollie, who is awaiting a life-saving heart operation and had been too unwell to venture outside even before her admission, the rooftop ward has already delivered something profoundly meaningful.

"When you're stuck inside all day, there's no motivation to try and get back to normal life," she reflects. "You get tired of fighting."

The sky above King's College Hospital may just be helping her find that motivation again.

King's College Hospital launches the UK's first rooftop intensive care ward, giving critically ill patients access to nature, fresh air, and faster recovery.

UK's First Rooftop ICU Ward Opens at King's College Hospital

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Sky-High Healing: UK's First Rooftop Intensive Care Ward Transforms Patient Recovery

## A New Exhibition Captures the Raw Emotion of AIDS Activism

From striking photographs of mass demonstrations in Trafalgar Square to hand-stitched fabric body parts crafted by HIV-positive women, a compelling new exhibition at the Wellcome Collection in London charts the profound impact that activism and community care have had on the rights and dignity of people living with HIV.

Entitled *Tenderness and Rage*, the show examines how diverse groups touched by the HIV epidemic — including gay men, women of colour, and refugees both in the UK and across the globe — discovered strength, solidarity, and even moments of joy through advocacy and mutual support.

---

## Looking Back at London's AIDS Crisis

### The Landmark: A Sanctuary in South London

The exhibition opens by transporting visitors back to the epicentre of London's AIDS crisis during the early 1990s. A documentary film titled *Dancing Whilst Diagnosed* chronicles the story of the Landmark, a drop-in centre located in Tulse Hill, south London, which served as a lifeline for people affected by HIV and AIDS.

Former staff and volunteers speak candidly about the violence, discrimination, and deep-seated stigma that accompanied an HIV diagnosis at the time. Yet alongside these harsh realities, they also describe the remarkable sense of community that flourished within the centre — evenings filled with DJs, drag performances, and African music provided a rare space where people could simply exist without fear or judgment.

Marc Thompson, who first visited the Landmark as a service user before later pursuing a career in HIV prevention and sexual health, described its significance with clarity: "It was the only place that I felt really safe about my HIV. I didn't have to disclose it to anybody. There was no guessing or hiding, so that really helped me navigate those early years of my own diagnosis."

Thompson also reflected on why the exhibition's title resonates so deeply with his lived experience. "We were so hurt and damaged by everything that we were experiencing that the rage came out through loss or through protest," he explained. "The tenderness resonated with me because of places like the Landmark. That was a place that we could go to get some of that rage soothed and looked after — to be nursed and given a balm."

---

## Confronting the Cost of Treatment

### Act UP and the Fight to Make AZT Accessible

One of the exhibition's most thought-provoking sections addresses a contentious chapter in the Wellcome Trust's own institutional history. A dedicated cabinet displays photographs, newspaper clippings, and campaign posters documenting Act UP's fierce campaign to reduce the prohibitive cost of AZT — the first antiretroviral drug proven effective against HIV.

At the time, the medication was manufactured by a pharmaceutical company in which the Wellcome Trust held a 75% ownership stake, placing the drug well beyond the financial reach of many patients who desperately needed it.

Rob Archer, a co-founder of London and Edinburgh Act UP, took the bold step of purchasing shares in the company, which granted him and fellow activists the right to challenge its leadership directly at the annual general meeting in January 1989. While Archer questioned the company's pricing practices inside the boardroom, other campaigners picketed outside, brandishing placards reading "We££come AZT Profiteers" and "People Not Profits."

Archer recalled the confrontation with quiet satisfaction: "I was quite pleased I got under his skin." The sustained pressure of the campaign ultimately forced the company to significantly reduce the price of AZT, making it far more accessible to those who needed it most.

---

## Humanising HIV Through Photography

### Gideon Mendel's Intimate Portraits

Also featured in the exhibition are images from photographer Gideon Mendel's acclaimed series *The Ward*, which documents the care and daily lives of four young gay men — John, Ian, Steven, and Andre — receiving treatment on the Broderip and Charles Bell wards at Middlesex Hospital.

The series is celebrated for its deeply intimate portrayal of patients, their loved ones, and healthcare workers sharing moments of tenderness — hugging, holding hands, simply being present with one another. At a time when tabloid media was actively dehumanising gay men with HIV, these images offered a powerful counter-narrative rooted in humanity and compassion.

Mendel reflected on the atmosphere those wards deliberately cultivated: "They tried to make a place which was very emotionally supported. Staff were encouraged to hug the patients. Touch was really important."

He also acknowledged the courage it took for the four men to participate. "It was a particularly brave and powerful thing that those four young men did because there was a lot of stigma around. The rumour was that there were photographers from the tabloids with long lenses trying to photograph people in the ward. So people were very afraid of the camera."

Mendel remains active in HIV advocacy today, and the exhibition also showcases *Through Positive Eyes*, a project he co-founded that empowers people living with HIV to share their own stories in their own words.

---

## HIV in the Present Day: Funding Cuts and Global Impact

The exhibition does not confine itself to history. Among those profiled is Phindile, an AIDS counsellor from Johannesburg, South Africa, who recently lost her position at a clinic after the Trump administration withdrew the international funding that had sustained it — a stark reminder that the fight for adequate HIV support is far from over.

Adam Rose, the exhibition's curator, explained that *Tenderness and Rage* was designed to reflect the evolving demographics of HIV and highlight "which groups are more likely to come into contact or experience greater barriers to accessing treatment."

Rose emphasised the importance of drawing a direct line between the activism of the 1990s and contemporary campaigns worldwide. The exhibition exists, he said, to underscore why this work "continues to be so urgent, particularly in the context of ongoing cuts to HIV funding."

---

## Memory, Motherhood, and the Body

### Personal Stories of Survival and Identity

The intimate personal dimensions of living with HIV are also given powerful expression within the show. A memory store created by Angelina Namiba — containing a published diary of her pregnancy and her daughter's framed handprint — represents the experience of HIV-positive mothers. During the early 1990s, pregnant women were encouraged to assemble such keepsake boxes so their children would retain something tangible to remember them by, should they not survive.

Elsewhere, a collection of hand-stitched fabric representations of female body parts — breasts, lips, and vulvas — created through Catwalk4Power's workshops with HIV-positive women, addresses body image, intimacy, sexual health, and the complex emotional landscape of living with a chronic illness. Playful yet purposeful, these objects open conversations that society has too often refused to have.

---

## Exhibition Details

*Tenderness and Rage* runs from **29 May 2026 to 30 May 2027** at the **Wellcome Collection, London**. The exhibition brings together decades of history, personal testimony, and ongoing advocacy to remind visitors that behind every statistic is a human story — and that care and protest, far from being opposites, have always walked hand in hand.

Explore how London's Tenderness and Rage exhibition at the Wellcome Collection documents decades of HIV activism, community care, and hard-won dignity.

Tenderness and Rage: The Power of HIV and AIDS Activism

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Tenderness and Rage: How AIDS Activism Gave Strength, Solidarity, and Joy to Those Living with HIV

## England's Resident Doctors Announce 16th Strike Amid Ongoing Pay Dispute

Resident doctors in England are preparing to stage yet another round of industrial action in June, marking the 16th walkout in a prolonged and bitter dispute over pay. The British Medical Association (BMA) confirmed that its resident doctor members will strike for four days, beginning at 07:00 BST on Monday, 15 June, and concluding at 06:59 on Friday, 19 June.

## Strike Follows Breakdown in Talks With New Health Secretary

The decision to strike was announced in the wake of a Wednesday meeting between the BMA and newly appointed Health Secretary James Murray, who stepped into the role earlier this month following the departure of Wes Streeting. According to reports, Murray made his position clear during those discussions — the government would not be revisiting the question of pay, describing the union's financial demands as both "unrealistic and unaffordable."

The announcement marks a swift deterioration in relations with the new Health Secretary, with the BMA expressing disappointment that a change in leadership has failed to bring any fresh momentum to the negotiations.

## What Doctors Are Currently Earning

Over the past four years, resident doctors in England have received cumulative pay increases totalling 33%, which includes a 3.5% rise this year alone. As a result, entry-level salaries now exceed £40,000, while the most experienced resident doctors can earn up to £76,500 in basic pay. Additional earnings from unsociable hours and overtime can push these figures considerably higher.

Despite these increases, the BMA maintains that when adjusted for inflation, doctors are still earning approximately 20% less than they were back in 2008 — a key point of contention at the heart of this dispute.

## BMA Accuses Government of Unwillingness to Engage

Dr Jack Fletcher, the BMA's resident doctor leader, expressed frustration at what he described as a familiar stalemate. "We had hoped that a change in leadership at the Department of Health and Social Care would lead to a change in approach," he said. "Sadly, we have run up against the same unwillingness to move we encountered under Mr Streeting."

Dr Fletcher added that the union had been prepared to allow Murray time to settle into his new role before resuming the work left unfinished by his predecessor. "He had a genuine opportunity to break this logjam with fresh energy and ambition. He has not taken it," Dr Fletcher said, criticising the government for offering "vagueness on new jobs and no further money on the table."

### Previous Offer Rejected, Followed by April Strikes

In March, the government put forward a package that included additional training positions, accelerated career progression pathways, and reimbursement for out-of-pocket professional expenses such as exam fees. The BMA rejected this offer outright, and resident doctors subsequently carried out a six-day strike in April.

## Government Stands Firm on Pay Position

Health Secretary Murray pushed back strongly against the BMA's decision, stating he was "disappointed" that the union had chosen to pursue strike action rather than continue meaningful dialogue. "After a 33.4% pay rise for resident doctors over the last four years — the highest anywhere across the public sector — the BMA's demands for further substantial pay increases this year are unrealistic, unaffordable and unsustainable," he said.

## Healthcare Leaders Warn of Patient Impact

Matthew Hopkins, representing The NHS Alliance — a body that speaks for health managers across the country — condemned the planned walkout as "rash and wholly irresponsible." He warned that patients would ultimately bear the consequences of the action, and that the strike risked undermining significant recent progress in reducing waiting lists and improving NHS productivity.

With both sides entrenched in their positions and no fresh talks scheduled, the dispute shows little sign of reaching a swift resolution, leaving thousands of patients facing further disruption to their care.

Resident doctors in England announce a four-day strike starting June 15, marking the 16th walkout in an ongoing pay dispute with the government.

England Resident Doctors Plan 16th Strike Over Pay Dispute

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England's Resident Doctors Set for 16th Strike as Pay Deadlock Continues

## UK Birth Rates Reach Their Lowest Point in Nearly Half a Century

The number of babies born in England and Wales has fallen to levels not seen since 1977, as economic hardship, global instability, and shifting cultural values lead more people to delay or forgo parenthood altogether.

According to the Office for National Statistics (ONS), there were approximately 585,000 live births recorded in 2025 — a drop of 10,000 from the previous year and the fourth consecutive annual decline. The fertility rate has now fallen to just under 1.4 children per woman, a sharp decrease from 1.9 in 2010.

## 'The World Feels Different Now'

For Stacey Waring, a 40-year-old nurse from Nottingham, the decision to remain child-free was a deeply considered one. Global uncertainty, a changing childhood landscape, and a desire for personal freedom all played a role in her choice.

"It's just not a very nice world to bring people into, and why would I consciously do that when I can choose not to?" she explains.

Waring reflects on growing up in a simpler era — one of the last generations to play freely outdoors without the constant presence of smartphones — and questions whether modern childhood offers the same richness.

She also points to the practical realities of raising children today. "If I'd had children, I'd have had to reduce my hours at work," she says. "I'm a huge traveller and go away whenever I can in my camper van, which I wouldn't be able to do if I had children."

Waring acknowledges feeling fortunate to live in an era that gives individuals genuine choice over whether to start a family.

## The Financial Burden of Raising Children

While some are choosing not to have children, others who already have families say the cost of living is preventing them from having more.

Georgina Tuffour, a 35-year-old trainee nurse, lives with her Uber driver husband and their three children, aged six, eight, and ten. Despite wanting a larger family, she says the financial strain makes the idea feel out of reach.

"My daughter wants to register for everything at school, my son loves to play the drums and that costs £50 a month," she says. "I've had to say to them that I cannot afford to sign all of them up, and that breaks my heart — so imagine having another?"

Tuffour acknowledges that the government has made some efforts to support young families, but believes far more needs to be done, particularly around subsidising childcare costs.

## Experts Point to Broader Cultural and Economic Shifts

Dr. Paula Sheppard, an anthropologist at the University of Oxford, says the rising cost of living is a central factor pushing people to wait longer before starting or expanding their families.

"They're waiting for a better job, better salary, better house, better neighbourhood, and it takes longer to get those things in the current climate," she explains.

She notes that the financial demands of raising children have intensified across the board. "People have always wanted the best for their kids, but the cost of having children is increasing — food costs more, clothes cost more — so absolutely the economy makes a difference."

### A Global Phenomenon, Not Just a British One

Dr. Sheppard is keen to stress that falling birth rates are not unique to the United Kingdom. The trend is being observed across the globe, including in Scandinavian countries renowned for their family-friendly social policies.

"Even in the Nordics, with their family-friendly social policies, they don't see an increase in birth rates," she says.

She attributes much of the decline to a fundamental cultural shift in how families think about parenthood — a move toward "investing in fewer children rather than having lots of children with fewer things."

### A Self-Reinforcing Cycle

Dr. Sheppard also warns of a psychological feedback loop that may deepen the trend over time. As fewer children are born, future generations grow up in environments with less exposure to babies and young families, making the idea of parenthood feel increasingly foreign.

"If you grow up in a society not seeing lots of babies, then it becomes harder for you to have babies yourself," she says.

## Key Statistics at a Glance

- **585,000** live births were recorded in England and Wales in 2025
- The fertility rate stands at **under 1.4** children per woman, down from 1.9 in 2010
- Women are now having their first child at an average age of **29.6 years** — roughly two years older than in 2010
- **40%** of births now involve at least one parent born outside the UK, up from 30% a decade ago

As birth rates continue their downward trajectory, the conversation around family planning, economic support, and social policy is becoming increasingly urgent for governments and communities alike.

England and Wales recorded just 585,000 live births in 2025, the lowest since 1977. Economic pressure and cultural shifts are reshaping family planning decision

UK Birth Rates Drop to Lowest Level in 50 Years

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UK Birth Rates Hit 50-Year Low as More People Choose Smaller Families or None at All

## 'We Knew Someone Would Die' — And Nobody Listened

Laura Kenny carries memories she cannot shake. For years, she was a patient at a mental health unit in Middlesbrough, and she watched the situation around her deteriorate until the unthinkable happened.

"We'd been warning everyone," she recalls. "We wrote letters to everyone we could think of, saying one of us is going to die."

Her friend Christie Harnett was also receiving treatment at the same unit. Christie later took her own life — becoming one of three young women who died by suicide within months of each other while under the care of the Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV).

**Warning: This article contains distressing content relating to suicide and self-harm.**

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## A Trust Under Scrutiny

TEWV is responsible for mental health services across a wide area of northern England, including North Yorkshire, County Durham, and Teesside. Over recent weeks, journalists spoke with more than a dozen former patients — both young people and adults — who described serious failures in the quality of care they received.

In addition to Christie's death, the trust's care has been linked to other tragedies. Nathan Evison, aged 19, died by suicide in 2019. Laurent McNamara passed away the following year. Both had been receiving care through TEWV outside of a hospital setting at the time of their deaths.

Across all these accounts, a troubling pattern emerges: staff who lacked compassion, a near-total absence of meaningful therapy or treatment, and a culture where serious warning signs were routinely dismissed.

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## What Patients Experienced Inside the Unit

Laura spent much of her teenage years as an inpatient at West Lane, a specialist mental health facility for young people based in Middlesbrough. Her struggles began at age 13 with a severe eating disorder that left her dangerously underweight, eventually progressing into episodes of self-harm and suicide attempts.

She describes how staff responded to incidents of self-harm in ways that were either aggressive or entirely passive.

"Their reaction would be to either leave you for hours headbanging or self-harming, or to just restrain you very quickly to the floor and inject you," Laura explains. "The idea was to sort of just shut you up."

Christie Harnett's stepfather, Michael, echoes this deeply troubling picture. He recalls what Christie told him about how staff handled her self-harm episodes.

"They would literally just pin her down, sedate her, put her in bed, and then that was it," he says.

---

## Independent Report Confirms Failures

An independent inquiry commissioned by NHS England and published in 2023 examined the deaths of Christie Harnett, 17-year-old Nadia Sharif, and 18-year-old Emily Moore. Its findings were damning.

The report confirmed that patients had been subjected to excessive and inappropriate physical restraint. Staff had allegedly been instructed not to intervene during episodes of self-harm. Systemic failures, rather than being addressed, had been allowed to persist with the knowledge of management.

The unit itself was described in the report as **"chaotic and unsafe"** — language that aligned closely with what patients and families had long been saying.

Following the report's release, TEWV issued a formal apology and stated that significant changes had been made. However, many bereaved families and former patients remain unconvinced that the lessons from these tragedies have truly been absorbed — particularly given that three years have passed with little visible accountability.

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## Calls for a Public Inquiry — And Frustrating Delays

Hundreds of former patients and grieving families united in demanding a full statutory public inquiry into TEWV. That inquiry was officially announced in December of last year, giving hope to those who had waited so long for answers.

Unlike the earlier independent review, a statutory public inquiry carries legal authority — including the power to compel witnesses to testify, demand the disclosure of documents, and focus specifically on preventing future harm.

But progress has stalled. Families were promised meaningful updates by the end of February. A meeting held on 31 March with the Department of Health and Social Care left them no closer to knowing who would chair the inquiry, when proceedings would begin, or where they would take place.

"While our clients appreciate these things take time, they are worried about the continued care being offered by a trust under scrutiny and how, in three months, there appears to be no firm developments," said Alistair Smith of Ison Harrison Solicitors.

The Department of Health and Social Care responded by stating it is working "at pace" to confirm the inquiry's leadership, adding: "We are committed to ensuring the voices of patients and the families affected by failures at TEWV are at the heart of this inquiry."

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## What Families Are Really Asking For

Beyond formal proceedings and legal frameworks, the people most affected by TEWV's failures have a simpler, more human goal: they want to understand what went so catastrophically wrong, and they want some form of justice for those they have lost.

For Laura Kenny — now in her twenties and studying law at university — the fight is both personal and purposeful. She is determined that Christie's death, and the deaths of others like her, should not be forgotten or minimised.

TEWV declined to take part in an on-camera interview and stated it would not comment on individual cases. In a written statement, chief executive Alison Smith, who has held the role since last September, said the trust would "co-operate fully with the public inquiry with honesty, openness, humility, grace and kindness."

For those who lost loved ones, and for those who survived but carry lasting scars, words of cooperation are a start — but they are not enough. What they need now is action, transparency, and a genuine commitment to ensuring that no other family has to endure what they have been through.

Former patients and families reveal how repeated warnings about dangerous care at TEWV NHS Trust went unheard — and cost young people their lives.

NHS Trust Failures: Young Mental Health Patients Ignored

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Voices Unheard: How NHS Trust Failures Cost Young Mental Health Patients Their Lives

## A Dangerous Mission on Two Fronts

For Vanny Birungi, a Red Cross volunteer working in eastern Congo, every awareness campaign comes with an invisible second assignment — managing her own safety. As suspected Ebola cases inch toward 1,000 in the Ituri province, Birungi and her colleagues have been met not only with the threat of a deadly virus but with stones, insults, and outright hostility from the very communities they are trying to protect.

"We continue to tell them the disease is out there. Some accept, and others don't," she told the Associated Press while conducting outreach in a working-class neighborhood of Bunia, the provincial capital at the center of the crisis.

## A Rare Strain With No Medical Safety Net

This outbreak involves the Bundibugyo strain of Ebola — one of the rarest forms of the virus and, critically, one for which there is currently no approved vaccine or treatment. Health authorities initially tested samples for a more common Ebola variant, losing precious weeks before the correct identification was made. Experts are still working to determine exactly when the outbreak began.

The World Health Organization's Director-General, Tedros Adhanom Ghebreyesus, confirmed Monday that suspected cases have surpassed 900 and suspected deaths have exceeded 220. "We are now playing catch-up with a very fast-moving epidemic," he warned.

Both the WHO and the Africa Centers for Disease Control and Prevention believe the true scale of the outbreak is significantly larger than official figures currently reflect.

## Distrust Runs Deep in a Traumatized Region

Decades of armed conflict have left residents of eastern Congo deeply suspicious of outside intervention. Many locals openly reject the idea that Ebola is a genuine threat.

"These people should stop bothering us. They just want to get rich. Let's not forget that Ebola is a white man's invention," said Pierre Basola, a 56-year-old Bunia resident, before walking away.

Mado Nditamba, 70, reflected a different kind of fear — one rooted in helplessness rather than denial. "This epidemic today is worse. We go to the doctors in the hospitals, but they also die. That's what worries us. We don't know what to do and we leave everything to God."

Heather Kerr, country director for the International Rescue Committee in Congo, stressed that community trust is not a secondary concern. "Trust is almost as important as the health response, because if you get this massive distrust in the communities, they're not going to go to the health centers," she said.

## Violence Against Healthcare Infrastructure

The breakdown in trust has escalated into direct attacks on medical facilities, severely disrupting response efforts.

### A Week of Targeted Attacks

On Sunday, a group of young men stormed a hospital in Bunia that was treating Ebola patients, forcing staff to evacuate under gunfire. The day before, residents set fire to a Doctors Without Borders treatment tent in Mongbwalu, causing more than a dozen suspected patients to flee the facility. On Thursday, a response center in Rwampara was burned to the ground after community members were prevented from collecting the body of a suspected Ebola victim for traditional burial rites.

The tension surrounding burial practices is significant. The Ebola virus spreads through direct contact with the bodily fluids of infected individuals — including blood, sweat, vomit, and feces — making traditional handling of the deceased extremely dangerous. Yet preventing families from participating in final rites has deepened resentment and fueled conspiracy theories.

## Health Workers Are Dying Too

Frontline responders are paying a devastating personal price. An unknown number of healthcare workers have contracted the virus, and some have died. A Congolese doctor was reported dead on Sunday in Rwampara, according to Rubens Dhedgia, who coordinates the Ebola response in the region.

In neighboring Uganda, where a smaller cluster of cases has emerged following cross-border travel, at least three health workers have been infected.

Perhaps most alarming is a disclosure from the International Federation of Red Cross and Red Crescent Societies: three of its volunteers are believed to have died in Mongbwalu after handling bodies on March 27 — work unrelated to the Ebola response at the time. If confirmed, this would push the outbreak's true start date back significantly earlier than the first officially confirmed death in late April.

## Structural Weaknesses Hamper the Response

The region's infrastructure presents enormous logistical challenges. Travel from Bunia to Mongbwalu requires navigating roads through active conflict zones. The main airport serving as a humanitarian hub has been under rebel control for more than a year. Many health clinics operate on generators, and laboratory capacity for testing the Bundibugyo strain remains critically limited.

Disease surveillance in the area has also been weakened by cuts to U.S. and international aid funding, which experts say contributed to the delayed detection of this outbreak.

Health workers on the ground have told journalists they feel underprepared and underprotected, with shortages of both personnel and equipment at a moment when the epidemic is accelerating.

## Community Engagement Seen as the Only Path Forward

Humanitarian organizations working in the region are emphasizing that rebuilding community trust is not optional — it is essential.

"The only way to go, as far as this particular virus is concerned, is community engagement," said Yakubu Mohammed Saani, country director for Action Aid in Congo. The organization noted that significant skepticism persisted among residents surveyed in mid-May, shortly after the outbreak was publicly announced.

How to meaningfully improve that engagement — and do so quickly enough to contain a rapidly spreading virus — remains an open and urgent question. Congo has experienced 17 Ebola outbreaks and the WHO maintains the country has the capacity to respond. But with a rare strain, damaged trust, active conflict, and a delayed start, the path to containment has never looked more difficult.

Congo's rare Bundibugyo Ebola outbreak nears 1,000 cases as aid workers face violent attacks and deep community distrust with no vaccine available.

Congo Ebola Outbreak: Rare Strain, No Vaccine, Community Att

Community Hostility and a Rare Ebola Strain Are Pushing Congo's Outbreak Toward Crisis

## Health Inequality Is Not a Personal Failing

A seasoned public health researcher has spoken out against a growing narrative that places the burden of poor health squarely on the shoulders of individuals. Professor Jennie Popay of Lancaster University, who has devoted decades to studying health equity, argues that this framing is not only misleading — it actively distracts from the root causes of health disparities.

Her response came after a Guardian report highlighted findings from the Oxford Longevity Project, which suggested that at least 80% of the responsibility for ill health in later life falls on the individual. Popay was quick to challenge this conclusion.

## Decades of Research Tell a Different Story

According to Popay, the scientific community has long reached a clear consensus on what truly drives poor health outcomes. It is not reckless personal behaviour or lifestyle choices that sit at the heart of health inequality — it is the material conditions that people are exposed to throughout their lives.

The circumstances into which a person is born, the neighbourhood they grow up in, the nature of their work, and the environment in which they age all play a far more decisive role in determining their health than individual decisions alone. These structural factors create profound and measurable gaps in wellbeing across society.

### A 20-Year Gap That Cannot Be Ignored

The scale of this inequality is staggering. There is currently a **20-year gap in healthy life expectancy** between the most and least advantaged groups in the United Kingdom. Popay attributes this not to irresponsible personal choices, but to widening inequalities in access to material resources, social power, and economic privilege.

For Popay, framing this crisis as a matter of personal responsibility obscures the systemic forces that keep disadvantaged communities locked in cycles of poor health — and lets policymakers off the hook.

## Questions Around the Study's Funding

Professor Popay also raised concerns about the Oxford Longevity Project's primary financial backer: **Oxford Healthspan**, a commercial company that markets a product called "whole-food spermidine" supplements.

While early-stage laboratory and observational research into spermidine has shown encouraging results, the picture from human clinical trials remains far less conclusive. Popay suggests that this commercial connection deserved greater transparency in media reporting of the study's findings.

## The Bigger Picture

The debate surrounding this study touches on one of the most persistent and consequential tensions in public health: the balance between individual agency and structural determinants of health. While personal habits do matter, reducing complex health inequalities to a question of individual willpower ignores the powerful social, economic, and environmental forces that shape people's lives long before they make any lifestyle choice.

A more honest and effective approach to improving public health must acknowledge that where you are born, where you live, and where you work are among the most powerful predictors of how long — and how well — you will live.

Professor Jennie Popay argues that health inequality stems from social and economic conditions, not personal responsibility. A 20-year life expectancy gap prove

Structural Inequality Drives Poor Health, Not Personal Choic

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Where You're Born and How You Live Shapes Your Health More Than Personal Choices

## Understanding UV Radiation and Why It Matters

Ultraviolet (UV) radiation from the Sun is a double-edged sword. While some exposure is necessary for good health, too much can cause serious and lasting harm — including skin cancer. Understanding how UV levels work and how to protect yourself is one of the most important steps you can take for long-term wellbeing.

## What Is UV Radiation?

UV radiation is a form of energy emitted by the Sun that passes through the Earth's atmosphere and reaches our skin. On the positive side, it triggers the body's production of vitamin D — a nutrient critical for healthy bones, blood cells, and a functioning immune system.

However, UV exposure also carries significant risks. It damages the DNA within skin cells, which can lead to skin cancer over time. It accelerates visible skin ageing, contributing to wrinkles and sagging skin, and has been associated with eye conditions such as cataracts.

"Every exposure to UV, especially every sunburn, increases our risk of skin cancer," warns Professor Dorothy Bennett of St George's, University of London. "Melanoma, the most dangerous form of skin cancer, is now the fifth most common cancer in the UK."

## What Is the UV Index?

The UV Index (UVI) is a globally recognised scale that measures the intensity of ultraviolet radiation at any given time and place. The scale begins at zero and can exceed 10, with higher numbers indicating greater potential for skin and eye damage — and a shorter window before that damage begins to occur.

### UV Index Levels at a Glance

- **Low (0–2):** Minimal risk; no protection typically required
- **Medium (3–5):** Some sun protection recommended
- **High (6–7):** Sun protection essential
- **Very High (8–10):** Extra protection required
- **Extreme (11+):** Maximum precautions necessary

In the UK, UV levels during summer typically sit between 5 and 6, rarely climbing above 8 even in exceptional conditions. By contrast, countries near the equator experience far more intense UV exposure throughout the entire year. Nairobi, Kenya, for instance, regularly records UV levels above 10 year-round, according to the World Health Organization (WHO). Even European destinations like Majorca in Spain can reach a UV index of 9 during June and July.

## When Is UV at Its Strongest?

UV radiation levels are not constant throughout the day. Intensity peaks during the four-hour window surrounding solar noon — the point at which the Sun is highest in the sky — typically spanning from late morning through to early afternoon. Planning outdoor activities outside this window can meaningfully reduce your exposure.

It is also important to note that UV intensity is not determined by air temperature. "Your skin can burn just as quickly whether it is 30°C or 20°C," cautions BBC Weather presenter Helen Willetts. A cool, overcast day can still carry a significant UV risk.

## How to Protect Yourself from UV Damage

### Choose the Right Sunscreen

The NHS recommends using a sunscreen with a Sun Protection Factor (SPF) of at least 30, combined with a minimum of 4-star UVA protection. Apply it generously to all exposed areas — including the face, neck, ears, and scalp if you have thinning or no hair — ideally 30 minutes before heading outdoors.

As a practical guide, adults covering the full body should use approximately six to eight teaspoons of sunscreen. Reapply every two hours, and sooner if you have been swimming, sweating heavily, or towel-drying.

### Children Need Extra Care

Children are significantly more sensitive to UV radiation than adults. They require sun protection at lower UV index levels and should be kept in the shade during peak hours, dressed in protective clothing, and have sunscreen applied regularly.

### Skip the Tan — Seriously

Despite its cultural popularity, there is no safe way to achieve a tan, according to the NHS. Dr Bav Shergill of the British Association of Dermatologists explains that a tan is actually the skin's emergency response to UV damage. "When you tan, ultraviolet light stimulates your skin cells to produce pigment to try and protect the DNA of skin cells — but that protection is minimal — the equivalent of SPF 4. That is not much protection at all, so you can still burn very easily," he cautions.

For those who prefer a sun-kissed appearance without the risk, self-tanning products offer a safer and equally effective alternative.

## Stay Sun-Safe Year-Round

UV awareness should not be limited to summer holidays. Monitoring the UV index daily — particularly during spring and summer — and adopting consistent protective habits can dramatically reduce the long-term risk of skin cancer, premature ageing, and eye damage. Your skin will thank you for it.

Learn what UV index levels mean, when radiation is most dangerous, and how to protect your skin and eyes with expert-backed sun safety advice.

UV Levels Explained: How to Protect Your Skin and Eyes

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Understanding UV Levels: How to Shield Your Skin and Eyes from Sun Damage

## A Long-Overdue Rename for a Misunderstood Condition

A metabolic condition that affects more than 170 million women around the world has been given a new name — and health professionals say the change is a significant step toward better understanding, diagnosis, and treatment.

Polycystic ovary syndrome, long known as PCOS, has officially been renamed **polyendocrine metabolic ovarian syndrome (PMOS)**. The International PCOS Network introduced the new name on 12 May, with the goal of reflecting the condition's true impact on the entire body — not just the ovaries.

---

## Why the Old Name Fell Short

For decades, the term "polycystic ovary syndrome" suggested the condition was primarily an ovarian issue. But medical understanding has evolved considerably, and experts now recognize PCOS/PMOS as a complex, full-body metabolic disorder.

Jessica Pinel, a nutritionist and chair of PCOS Jersey, believes the former name was misleading. "The term PCOS limited the condition to having an effect on women's ovaries, whereas we know that it is a full-body condition," she explained.

Pinel, who was diagnosed with the condition three years ago after spending over £3,000 pursuing answers, works closely with women navigating PCOS/PMOS. She describes the spectrum of symptoms as vast and deeply personal.

"We know that it can be fatigue, hair growth in unwanted places, acne, brain fog, irregular periods, and infertility," she said. "It is that full-body condition with a range of different symptoms, and hopefully the name change allows more women to get support and treatment because the condition affects us in unique ways."

According to the NHS, those living with PCOS/PMOS typically have elevated levels of male hormones and may experience irregular menstrual cycles and weight gain, among other symptoms.

---

## A Condition Rooted in History — and Overlooked for Too Long

PMOS was first identified roughly 70 years ago when two male surgeons — Dr. Irving Stein and Dr. Michael Leventhal — operated on women experiencing absent periods and observed a distinctive appearance in their ovaries. They originally named it **Stein-Leventhal Syndrome**, which was later changed to PCOS.

Jersey GP Dr. Jessica Langtree-Marsh notes that the historical framing of the condition has contributed to its ongoing mismanagement in clinical settings.

"PCOS is widely overlooked, and we see it as just simply: 'Come back when you want to have a baby and we'll fix it then,'" she said. "Actually, we need to look at this as a lifespan condition."

Dr. Langtree-Marsh describes PCOS/PMOS as "hugely under-researched and hugely misunderstood," stressing that early diagnosis and proper education are essential for patients at every stage of life.

---

## What the New Name Means for Treatment

Beyond semantics, Dr. Langtree-Marsh hopes the rebrand will open the door to more comprehensive treatment approaches. Rather than defaulting to contraceptive pills as the standard response, she envisions a broader toolkit that includes metabolic medications better suited to addressing the condition's underlying mechanisms.

"The rebranded PMOS is trying to appreciate that it affects women more generally rather than just the ovaries — so that it's a whole-body condition," she said. While she acknowledged that the new name "doesn't exactly roll off the tongue," she welcomed the shift away from an ovary-centric definition.

However, she was candid about its limitations: "What it doesn't do, and what we still don't know, is address the core reason why PCOS — or PMOS — actually happens."

---

## Navigating Misinformation and Seeking Proper Support

One of the most pressing concerns surrounding PCOS/PMOS is the spread of misinformation online. In 2024, BBC reporting revealed that social media influencers were actively promoting fake cures for the condition — a troubling trend given how many women turn to platforms like TikTok, Instagram, and Facebook for health guidance.

"We can't just put the onus on the women themselves to seek out that sort of education — there is so much misinformation online," Pinel warned. "We've got to be really, really careful."

She strongly advises anyone who suspects they may have PMOS to consult a qualified healthcare professional rather than rely on social media. She also encourages women to advocate for themselves if they feel unheard.

"In terms of diagnosis, you are always entitled to a second opinion," Pinel said. "I wasn't diagnosed the first few times. If you feel like you're not being seen or heard, please go and seek that second opinion — because you deserve it."

---

## Looking Ahead

The Jersey government has confirmed that a women's health strategy — a requirement under the Government Plan — is set to be published later this year, signaling growing institutional recognition of conditions like PMOS.

For millions of women living with this condition, the name change represents more than a linguistic update. It is a call for the medical community, policymakers, and the public to finally see PCOS/PMOS for what it truly is: a complex, lifelong, whole-body condition that deserves comprehensive care, serious research, and unwavering attention.

PCOS has been officially renamed PMOS to reflect its impact as a whole-body condition. Experts explain what this means for diagnosis, treatment, and awareness.

PCOS Renamed PMOS: What the Change Means for Women

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PCOS Gets a New Name — And Experts Say It's Long Overdue

## The Rise of Perimenopause Misinformation Online

More women than ever are turning to social media for guidance on perimenopause — and experts are growing increasingly alarmed. While online communities have helped reduce the long-standing stigma around menopause, they have also become fertile ground for health misinformation that can lead to serious consequences, including unintended pregnancies and untreated medical conditions.

Healthcare professionals are urging women to seek qualified medical advice rather than rely on viral posts, influencer recommendations, or supplement marketing campaigns that may do more harm than good.

## What Exactly Is Perimenopause?

Perimenopause is the transitional phase that precedes menopause. During this time, the body experiences fluctuating levels of hormones — particularly oestrogen and progesterone — which can trigger a wide range of physical and emotional symptoms.

Common signs include:

- Irregular or heavy menstrual periods
- Hot flushes and night sweats
- Mood changes and irritability
- Sleep disturbances

According to Dr. Zara Haider, president of the College of Sexual and Reproductive Healthcare, perimenopause can begin as early as the late 30s, though it most commonly starts in the early to mid-40s.

## Why Online Misinformation Is Dangerous

The consequences of acting on inaccurate perimenopause information can be significant. Dr. Haider has observed a troubling trend: women in their late 30s and early 40s are incorrectly assuming they are perimenopausal based on social media content — and some are using this assumption as justification to abandon contraception.

This is particularly concerning because perimenopause symptoms closely resemble those of other conditions, such as primary ovarian insufficiency. Without proper medical evaluation, these conditions can go undiagnosed and untreated.

"We are seeing people turn to supplements or alternative treatments marketed online, sometimes instead of established, effective options — often at significant personal cost," Dr. Haider noted.

Her advice is straightforward: if you suspect you may be perimenopausal, consult your GP before making any decisions about contraception or treatment.

## Contraception During Perimenopause: What Are the Options?

One of the most common misconceptions is that contraception becomes unnecessary during perimenopause. In reality, women who have not yet reached menopause and do not wish to become pregnant still need reliable contraceptive protection.

There is no universal best method — the right choice depends on the individual's health profile, lifestyle, and preferences. Options include:

- **Condoms** — also protect against sexually transmitted infections
- **Hormone-free coil (IUD)** — though potentially unsuitable for women with heavy periods
- **Progestogen-only contraceptives** — including the mini-pill, patches, injections, implants, and intrauterine systems (IUS)
- **Combined contraceptive pills** — containing both oestrogen and progestogen

### The Benefits of Hormonal Contraception

Dr. Paula Briggs, a consultant in sexual and reproductive health, emphasizes that hormonal contraception offers far more than just pregnancy prevention.

"There are other non-contraceptive benefits: reduction in bleeding, pain, fibroids, improvement in endometriosis, acne — loads of other things," she explained.

While certain hormonal contraceptives have been associated with a marginally elevated risk of breast cancer, they can simultaneously reduce the risk of other cancer types, making the overall picture more nuanced than many online sources suggest.

## The Truth About Combined Pills and Older Women

A widespread myth circulating online is that women over a certain age simply cannot use the combined contraceptive pill. Experts firmly reject this oversimplification.

"Age alone is not a contraindication," said Dr. Briggs. "It's about assessing for individual risk factors, which include migraine with aura, being overweight, and hypertension — but even then, if conditions are managed, a patient might still be able to access the combined pill."

### Traditional vs. Next-Generation Combined Pills

Conventional combined pills contain ethinyl estradiol — a potent synthetic oestrogen — alongside a progestogen. Professor Channa Jayasena, a reproductive endocrinology expert at Imperial College London, explains that ethinyl estradiol is "an incredibly strong steroid with some oestrogen-like properties" that can increase the risk of blood clotting, particularly in older women or those with certain health conditions such as obesity or those who smoke.

However, a newer generation of combined pills has been developed that addresses this concern.

"It contains natural oestrogen, which doesn't carry that same blood clot risk," said Professor Jayasena. "These are really good modern, next-generation contraceptive pills with a safety advantage — much more suitable for women in their 40s and even their 50s."

Essentially functioning as a mini-pill enhanced with natural oestrogen, these newer formulations represent a significant advancement in reproductive health options for perimenopausal women.

## Does HRT Provide Contraceptive Protection?

Another dangerous misconception is that hormone replacement therapy (HRT) can double as contraception. It cannot.

Although HRT contains oestrogen — and progestogen for women with an intact womb — the doses are too low and the compounds insufficiently potent to prevent ovulation. Women who have not reached menopause, are under 55, and do not want to conceive must use a separate form of contraception alongside HRT.

## Body-Identical Hormones: Are They Superior?

Body-identical hormones are laboratory-produced versions of the oestrogen and progesterone naturally found in the human body. They are already used in certain HRT formulations, and early research suggests they may offer some advantages over synthetic alternatives.

However, experts caution against blanket claims of superiority. Whether body-identical hormones are the better choice depends entirely on the individual's health circumstances and treatment goals — a determination that should be made in consultation with a qualified healthcare provider, not based on social media trends.

## The Bottom Line

Perimenopause is a complex and deeply personal experience that deserves accurate, individualized medical attention. While online platforms can offer community and general awareness, they are no substitute for professional healthcare guidance. Women navigating this stage of life are encouraged to speak openly with their GP or a reproductive health specialist to explore the options that are truly right for them.

Experts warn that social media misinformation about perimenopause risks unintended pregnancies and missed diagnoses. Here are the real facts you need to know.