Millions of Women Need Menopause Symptom Relief. Anne Fulenwider and Monica Molenaar Are Here for Us.
written by Stacey Lindsay
“We know that what we need is, by extension, what our friends and sisters and other women in this age group also need.”
On one hand, the company Anne Fulenwider and Monica Molenaar founded, Alloy, couldn’t be more straightforward. The digital women’s health platform offers science-based treatments and information for perimenopause and menopause relief. But Alloy works much deeper, at a level that provides consolation, validation, and camaraderie around our health—a facet of life that has, for too long, been surrounded by misinformation and gaslighting. The company makes access to doctors who are certified menopause experts (across all 50 states, plus Washington D.C. and soon Puerto Rico) and hormone therapy affordable and easy. That’s right—easy, with digital care and prescriptions sent directly to women’s homes.
This ease was something Anne and Monica were searching for. The two women met in their late forties, climbing the mountains of raising adolescent children and “dealing with the stresses of life,” says Anne, who built a career in the high-profile media landscape, including as editor-in-chief of Marie Claire. “We were both in a moment where we wanted to be intentional about the rest of our lives. And we were thinking: What else can we do? “
Like most women, health was at the forefront of their minds. Anne had just lost her mother to a sudden heart attack. Monica, a longtime entrepreneur, was years into early menopause, which happened when she preventatively had her ovaries removed after she received a positive test for the BRCA gene. “We were in it,” says Monica. “And we were like, what do we need? And we know that what we need is, by extension, what our friends and sisters and other women in this age group also need.”
Since meeting several years ago, the two founders have built the platform for the need. Each year, 47 million women globally enter menopause, with a mere 6 percent of those who seek symptom treatment relief receiving it. The need is colossal, as is the shame and misinformation surrounding the topic of menopause, with much confusion around the use and benefits of hormone replacement therapy. But a more recent and brighter light on the science shows that supplementing the body’s natural hormones, the anchor of Alloy’s care (the company also offers skincare and sexual wellness products), can unequivocally help menopausal symptoms and improve women’s lives. “With hormones, the conversation has become so strange, and it’s taken away all the agency from women to be a part of the shared decision-making around their health, treating symptoms and what type of disease prevention they want to engage in,” says Monica, who credits supplementing estrogen and progesterone the relief she found while struggling with menopausal symptoms after removing her ovaries.
Anne and Monica tell me that what’s been so great about building Alloy is to create a company that solves their own needs. As we dig deeper, we see that is what they want for every woman.
“Because no one is going to just hand it to us,” adds Monica. “That much we know and have seen. The change has to come from women themselves, demanding better care. And we’re here for it.”
Chatting with Anne Fulenwider and Monica Molenaar
Thankfully, women's health is claiming more recognition these days, but we still have much further to go. So, talking about the big picture, and considering the 47 million women globally who enter menopause every year, what is exciting you right now and keeping you up at night?
Anne: Even back when I was the editor of Marie Claire magazine, I was blown away by the slightly younger generation and seeing people connect online through social media and creating these growing online communities around various things like PCOS and endometriosis and periods. And also by seeing celebrities start to talk about their health issues. That's been a boon to everyone. It reflects the frustration that there isn't enough information, but it's also been an inspiration. And frankly, this is what we're experiencing now. We're trying to solve our own problem. Menopause is so large that we are just sticking in our lane. It's been gratifying to see that what we're doing is working and that women are responding. On the other hand, it certainly motivates us every day to get up and do what we are doing, having both decided to pivot and leave our former careers and throw everything we have into this. We have been blown away by the scale of the need, and the suffering, and all the support groups around menopause we see and the messages we receive from customers and from women who are frustrated because they can't find [what we offer] in their country.
The biggest shock and surprise is that every single room we walk into, whether it's a room of well-resourced people or a support group of people from all over different walks of life or of people all over the country, no one has the right information—including most of the doctors—to get women not just the symptom relief that they need, but also all the preventive benefits to create a much more healthy aging scenario for women as we are living longer.
Monica: I'm heartened by the information that's getting out there, thanks in part to us and all the other people who are in the space right now talking about it. The Women's Health Initiative study did a *disservice to women over the last 20 years. The information is starting to get out more widely that this was misreported, and therefore we've been living unnecessarily in a culture of fear. As a result of not treating our menopausal symptoms in time, we have to over-medicalize all of the chronic diseases that affect women proportionally more than men, including heart disease, osteoporosis, and dementia. The news is that estrogen does not cause breast cancer and that starting to take hormone therapy within the first 10 years of entering menopause (if not during perimenopause!) can be extremely beneficial for women. That information is now starting to get out there and it's heartening and helpful. We're trying to get more women treated for their own good, but also, systemically, for the world to have fewer sick women over the last 30 to 50 years of their lives is certainly better.
[*Editor's note: The Women's Health Initiative, the most extensive women's health study in the US, published studies between 2002 and 2006 linking one combination of hormone therapy to increased risks of breast cancer, coronary heart disease, and other diseases, causing widespread panic around the use of estrogen. More recently released information looks more closely at the matter and shows estrogen therapy to have no links to increased risk in breast cancer and has immense benefits.]
Monica: One of the things that kind of keeps me up at night is the whole idea of innovation. While innovation is sometimes good, pharmaceutical companies profit by creating something new when we've had a tried and true solution since the 1940s. We have almost 100 years of data on estrogen use and women and how important it can be for your overall healthy life. So sometimes innovation for innovation's sake (and profit), and not actually looking at what we have and doing the right thing for people and women, is disappointing. Otherwise, I think we're really on the right track, and the information is starting to take hold.
I believe there's a much bigger groundswell of women our age embracing this. I just turned 50, but I still feel very young and vital. I'm engaged every day in work, family life, and activities. The beginning is now, and if you can actually feel well and embrace that and not feel like this is the good times and not the beginning of the bad times, then that's a really powerful position to be in.
How is women's advocacy changing? As you said, Monica, there's a groundswell of women wanting this information and the treatment. How are you seeing this shift in what women are asking and how they're educating themselves?
Anne: Our doctors have said they have noticed a change in questions on the platform. They're seeing more women come in with more information before they start the conversation, and ask more specific questions. They're also seeing more women know what perimenopause is and ask those questions.
Back to the innovation piece Monica brought up, I heard some entrepreneurs say that everyone thinks that to be an entrepreneur, you must have a brand-new idea. But you just need an idea about how to make something that's already out there better. The healthcare system has really failed us, and we see that so much in menopause. Our innovation is that we are throwing the information out there. Women are absorbing information, which is great to see—but we still have more women to reach. But really, all these things we're offering women are actually hidden in plain sight, and our innovation is meeting you where you are and then just getting it to you in a way that the healthcare system has basically broken down and forgotten about. Everyone 40 and up has a lot going on in their lives. You just go onto our website, you type in your symptoms, you get matched with a doctor in your state, that doctor and you can message for the whole duration of your membership Alloy, and then once you agree on a treatment plan with your doctor—who is a menopause-trained physician—then you get the treatment plan, it gets mailed to your door. So, we're giving you almost two weeks of your life back. That is revolutionary in women's lives. We're not inventing a new molecule, we're not shooting things into space, we're listening to women, hearing their problems, and how they feel. It's said that there are 34 symptoms of menopause, but there are more like 100. But the root cause of menopause symptoms for absolutely everyone born with ovaries who get menopause is the decline in hormone production in your body. That's universal. So the solution, replenishing those hormones in your body, is universal.
This is deeply personal for both of you–Anne, as you said, 'you and Monica are in this for yourselves.' How did your health journeys inform Alloy?
Monica: It did start with my own health journey, but my health journey continues. That's something women don't realize: Menopause is technically a day, but it's also 30 or 40 years. You're never out of menopause. Your symptoms may change and morph, and your hot flashes may or may not dissipate without treatment, but then you may get other symptoms like vaginal dryness or bladder issues, and urinary issues. Many women think, " Oh, if I grit my teeth, I'll get through it, but you don't ever get through it. The research that we are seeing from people like Dr. Lisa Mosconi and others doing brilliant brain research is discovering that Alzheimer's is not a disease of old age; the symptoms are noticeable in old age, but it develops in middle age when you lose estrogen in your brain. We have estrogen, progesterone and testosterone receptors throughout our body. Without hormones, we cease to be human beings who can function as we're used to. So it's also a question of: How do you want to live the rest of your life? Do you want to live with intention and make decisions for yourself in concert with an expert opinion? Or do you want to ask “permission” and be told whether or not you're “allowed” to have X, Y, or Z?
You two met at a pivotal moment in both your lives. Tell us more about that.
Anne: We were in our late forties, dealing with adolescent children and aging. I had just lost my mom. Around that age, what often happens is you've been in a rabbit hole of raising children, and you pop up and realize they don't need you every single minute. We were both connected because we wanted to be intentional about the rest of our lives, which is very emblematic of this stage of life. Because many women have been doing things the way they were told or the way they thought they were expected to for a long time. Then all of a sudden, you get to this point, you're like, Okay, Who am I? And what do I want to do now? I had been in service to the fashion, beauty industry for a long time. I wanted to do something hands-on and practical for women's lives.
Monica: My mother had breast cancer twice, and so did my grandmother. I have always been treated as if I had the BRCA gene, but I wasn’t willing to do anything surgical yet. Then, when I was 40, Angelina Jolie had just done her prophylactic surgery, so there were more stories around it. I saw one story, a statistic that said that if you're BRCA positive and have your ovaries removed, by the time you're 40, you can further reduce your risk of breast cancer by 50 percent. So I thought, Okay, well, I'm not having more kids. I'm 39, so maybe I should do this. But literally nobody talked to me about the fact that I was going to go into menopause the next day, and they didn't offer any hormones, which I asked the surgeon at Sloan Kettering. He told me, 'Yeah, you can get a prescription when you need it. You won't need it right away because you'll still have estrogen in your body.' But what did that mean? I didn't have hot flashes, which was the only [menopausal] symptom that I knew of. But I wasn't sleeping, and I was gaining weight. I was moody and anxious. But I didn't connect any of it. Women weren't talking about it, and I didn't know what to expect.
The old guidelines from The Menopause Society said that hormone therapy is only for “symptomatic women who need symptom relief”, but that is the worst advice you could possibly give. Women are so used to gritting our teeth, and we can get through anything. And if you think that having treatment for some pain is giving into something dangerous, then you're going to live with those symptoms for as long as possible. That's certainly been happening to women for the last 20 years. Women are, really, really suffering out there. This is a universal problem. But if you do know what to expect, and you understand that those symptoms are not benign, the more nights that you don't sleep for years, that affects your brain, that affects your ability to make good choices in terms of your exercise, or your food or you know, it's a downward spiral. So, making women wait to be symptomatic means that they're basically in a crisis before they're out there seeking help. Plus, the longer you wait, the less you benefit from the protective effects of estrogen to your bones, your brain and your heart.
There's also such shame wrapped around this. Looking ahead, what do you hope to bring to women with Alloy now and in the future?
Anne: Our real goal in starting Alloy was to help the women who are in the acute need state right now, and there are 55 million in menopause and 75 million if you include perimenopause. And we saw across the board from Monica's health to what Oprah went through. So now, to get the word out and the proper treatment and amplify the expertise across the technology so we can get it to those women, we started. We want to get to the point where when they turn 40, or maybe even 35, they go, 'Oh, it's time for me to visit Alloy,' so there will not be these years and years of suffering.
We still have a lot of work to do. And we have a lot more messaging to do. There are so many women who are in it right now. And they come to us all the time saying, 'Thank you, I can't believe this. I can't believe I didn't know all this. I can't believe my mother didn't tell me this.' So, our hope and mission is to get those women, all of them, feeling better. And then they'll tell their daughters, they'll tell their friends, their younger sisters, their younger cousins. Much like periods, postpartum depression, breastfeeding, and other things that have broken through, menopause is the next one. So there's more conversation, and we are here for it.
Monica: The other thing that is so important to note is that this time does not have to be doom and gloom. I've been in menopause for 10 years; I'm asymptomatic. I have time, space, and energy to do something like this—to change careers, start something big and be devoted to it, and use all of the wisdom and experiences we've developed for the last 50 years and use it going forward. So, that is part of the intentionality.
And also, we're having a great time.
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Anne Fulenwider and Monica Molenaar are the founders of Alloy. To learn more visit myalloy.com.
“The biggest shock and surprise is that every single room we walk into, no one has the right information to get women the symptom relief that they need.”
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