Abstract
Professor John Studd, consultant gynaecologist, passed away on 17 August 2021. He was well known to members of the BMS for his immense contribution to the field menopause and women’s healthcare in general.
John William Winston Studd was born on the 4th March 1940. He had a difficult start to life; his father passed away when he was just 6 months old. His mother worked as a cinema usherette and the young John Studd would often be seated in the back row of the cinema while his mother was working. His mother was unable to provide for John and he was cared for by a number of foster parents and for some time by the Dr Barnado’s Children Home. His father had worked for the Royal Navy as a civilian which qualified John to attend the Royal Hospital School, a boarding school in Suffolk that accepted the children and the orphans of members of the Royal Navy. This was transformative for the young John Studd; it provided him with the support and stability which was lacking in his early years. He excelled academically at the Royal Hospital and developed his lifelong love for classical music and literature. He was the first from his school to gain a place at medical school when in 1957 at the age of 17 he was accepted by the University of Birmingham.
After house jobs in Birmingham and Hereford he briefly worked as a GP in Ross on Wye, he enjoyed the idyllic setting and took up fishing, but this was not intellectually challenging for him. In 1963, he took up a Senior House Officer post in Bulawayo in what was then Rhodesia working in general surgery, obstetrics and gynaecology. He returned to Birmingham in 1965 working for Professor McLaren initially as a clinical registrar and then research fellow when he undertook research in proteinuria in pregnancy which led to the awarding of an MD.
It was while working with Hugh Philpot in Rhodesia that he saw the use of the partogram, which was highly effective in preventing prolonged labour and the consequences of obstructed labour in rural villages.
John Studd briefly worked with Professor Robert Greenblatt in the 1960s where he developed an interest in hormone replacement therapy. He set up the UK’s first menopause clinic in Birmingham while still a trainee. At that time, HRT was considered to be unethical and the local health authority closed it down after protests from the British Medical Association. This did not deter John Studd and he re-established it a few months later and the Midlands menopause clinic still thrives to this day. John’s early research interest in the menopause was in the use of progestogens to prevent endometrial hyperplasia, and he demonstrated that cyclical progestogen can avoid the risk of endometrial pathology reported with unopposed oestrogen.
He was appointed consultant gynaecologist in Nottingham a year later and accepted a post at King’s College Hospital. John felt that all practising clinicians should be actively involved in research, and as a consultant at King’s College Hospital he continued his research in menopause and set up the King’s College Hospital Menopause Clinic. He was also interested in obstetrics and continued his work on the active management of labour as well as the management of sickle cell disease in pregnancy. He helped to popularise the use of the partogram and the ‘Studd Curves’. He published numerous papers on this subject and edited the highly popular book, The Management of Labour.
John Studd carried out important research in osteoporosis and demonstrated that the skeletal response to oestrogen is dose dependent. He also demonstrated that the skin of women becomes thinner with reduced collagen content and that these changes can be reversed with oestrogen replacement. He also reported similar changes in the skeleton and skin in women with anorexia nervosa.
John Studd recognised that oestrogens play in an important role in mental health and described the association of PMS, post-natal depression and menopause as oestrogen or hormone dependent depressive disorders and coined the term ‘reproductive depression’. He felt very strongly that women with mood disorders in midlife were wrongly diagnosed as suffering from a psychiatric illness and that were often treated inappropriately with anti-depressants rather than HRT. His outspoken criticism on the use of anti-depressants for the treatment of these symptoms sometimes caused controversy amongst psychiatrists, but more recently he was able to convene meetings where he collaborated with psychiatrists. He conducted important research into the use of transdermal hormonal treatment in the treatment of PMS and post-natal depression. He also recognised the challenges of progestogen intolerance with HRT, which is particularly prevalent in women with reproductive depressive disorders and proposed regimens that would minimise these side effects.
He was a great advocate of testosterone supplementation in women; he frequently had to remind colleagues that testosterone is an important female hormone for the alleviation of distressing low sexual desire and potentially benefits other symptoms. This is another area that some still regard as controversial. He accepted that female sexuality was complex which he summarised as being determined by the ‘heart, head and hormones’.
After many years as a consultant at King’s College Hospital, John later moved to the Chelsea & Westminster Hospital as a Consultant Gynaecologist and Professor of Gynaecology in 1993. He quickly set up the menopause clinic at the Chelsea & Westminster which remains a busy clinic looking after women with menopausal problems. His academic output was recognised by the University of Birmingham through the award of a DSc in 1994.
John Studd retired from the Chelsea & Westminster and continued to work privately establishing the London PMS and Menopause Clinic. John was passionate about women’s healthcare and was founder chairman of Women’s Health Concern (1977–1978), now the patient arm of The British Menopause Society. He was also co-founder and past Chairman of the National Osteoporosis Society, now the Royal Osteoporosis Society.
He was an inspirational teacher and a great supporter of female trainees. He encouraged trainees to undertake research in O&G rather than take time out of the specialty to obtain the Fellowship of the Royal College of Surgeons as was the vogue at the time. Many of his trainees went onto set up research units of their own and become successful clinicians and academics. Many consultant specialists owe a great debt to John’s wisdom and teaching.
John Studd was a larger-than-life character, always great company. He had a wide knowledge of literature, history and politics. His views today may seem a little controversial, but John was always honest and the frankness with which he expressed views may sometimes have caused offence, but one of his endearing qualities was that he held no grudges.
In 1981, John Studd married Margaret Johnson who was then a trainee respiratory physician and now Professor of Medicine at the Royal Free Hospital. They had three children Thomas, Sarah and Josie to whom he was a devoted father. He continued to enjoy classical music, particularly the operas of Wagner. He was widely read and could often recite poetry that he had learnt many years previously.
His contribution to women’s healthcare was recognised by the Royal Society of Medicine who awarded him the Blair Bell medal for lifetime achievement in Obstetrics and Gynaecology. He was a visiting professor in many institutions. He was past chairman of the British Menopause Society and served on the council of the Royal College of Obstetricians and Gynaecologists for many years. He has published more than 500 papers and numerous books. His series of books, Progress in Obstetrics and Gynaecology was published between 1985 and 2003 and was essential reading for candidates sitting their Part II examination.
John Studd is survived by his wife Margaret, his son, two daughters and three grandchildren.