Illustration: Lia Kantrowitz
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I don’t know what came first, the symptoms or the targeted ads. But I do know that starting not long after my 40th birthday, two years ago in the early fall, I began to wake up so sweaty that I developed a persistent rash all over my chest. My skin was constantly itchy, and I’d claw my legs in my sleep, leaving bloody scratches that made me look like I’d gotten in a bike accident — which was funny, because my breasts were so excruciatingly sore I could no longer ride a bike or exercise — or drive a car without wearing a sports bra. I had strange new allergies — to hair dye, clothing detergent, alcohol — and I often had a fluttering sensation in my chest that was maybe a heart condition or maybe all in my head. Anxiety and insomnia greeted me along with the rest, but it was impossible to tell whether these were primary features of my mystery ailment or responses to it. Regardless, I now had lots of time in the middle of the night to descend into medical rabbit holes, which both increased my panic and fed my algorithm — which was now serving me up a platter of solutions that, in my desperate, sleep-deprived state, I was ordering by the dozen, boxes and boxes of Amazon products piling up at my door.
My spouse laughed when the first delivery of ice packs arrived. They came in all shapes and sizes, for all the parts of my inflamed body, and filled the top drawer of our freezer. He was amused to see my new all-hemp wardrobe, including $44 tank tops I wore to bed, which I’d read were good for sweat-absorption and resistant to bacteria (the chest rashes had to go). Then came the salves: an anti-itch cream bought in Maine, made from lobster, whose glycoprotein could apparently repair the human-skin barrier; something called Gotucream, an “ancient wonder” for skin inflammation, made from the Ayurvedic herb gotu kola, which somehow was crafted exclusively in Scotland; and a Vaseline solution for “mature” skin, which seemed a whole lot like the cream for immature skin.
When the supplements started to show up, a couple of months in, my spouse began to get slightly concerned. My naturopath had recommended I try something called DIM Evail for my breast pain, made from vegetable phytonutrients, which promised to support “healthy Estrogen balance” ($69.99). Next, for urinary-tract infections, a friend brought over Ellura, a cranberry-extract pill, “clinically proven” to prevent bacteria from sticking to the bladder ($49.99). Being in physical agony was not going great for my mental state, so I purchased an “un-anger” tincture, made with something called chaste tree — and lavender and milk thistle — for $19.99. It didn’t seem to provide the promised “fast acting relief for irritability, anger, and stress,” but the name did make me laugh, which I guess was something.
Over the course of 18 months, I saw half a dozen specialists — doctors who sent me to other doctors, who suggested acupuncture, who told me to adjust the temperature in my bedroom, to up my antidepressant, to perhaps test my apartment for mold. But in the end it was Google — and maybe the fact that I was reading Miranda July’s All Fours on my Kindle, giving the targeted ads a hand — that ultimately led me to the answer: I seemed to be in perimenopause, a stage of life I’d never even heard of before it was apparently happening. It was a lot like menopause, but it could come more than a decade earlier and long before you stopped having a period. Which, um, seemed like something maybe somebody should have mentioned.
As a person of a certain age who spends a lot of time online, I was well aware that menopause was having a “moment.” In the spring I’d read the tabloid stories about Halle Berry’s vagina (she’d been diagnosed with an STD but was actually experiencing menopausal dryness), and I knew Naomi Watts was now selling a line of “scalp to vag” products through her “holistic menopause” company, Stripes (“stripes” as in, she’s earned hers). I’d seen that clip of Drew Barrymore declaring, on live TV in 2023, “I think I’m having my first hot flash!” What I had not been aware of, until perimenopause became the word constantly ringing in my ears, was just how many people — all of these celebrities, not just Watts, and doctors and influencers and entrepreneurs — were now pushing products and services claiming to treat it.
Once Google (and Instagram, and Amazon, and every other platform I’d allowed to track my movements) knew I was searching perimenopause, my feeds were obliterated. I was served up TikToks of nutritionists who claimed that hot flashes could be controlled by blood sugar (not so simple) and fitness coaches who believe that all women in their 40s need to be on certain hormone therapies in order to “optimize” their metabolism. I began to follow board-certified doctors, whom I thought would counterbalance the pseudoscience, but often they were promoting, and profiting from, unregulated supplements of their own (not exactly an encouraged practice in medical ethics). The information collapse was somewhat familiar — influencers acting like doctors, doctors acting like influencers — but I actually needed answers, and I had no idea what was what.
Soon I was being targeted by the celebrities themselves: Barrymore was now the paid product ambassador for the &ME Daily Ritual Peri + Menopause supplement ($69) from Dr. Kellyann, a company owned by Kellyann Petrucci, a naturopath previously known for her paleo-friendly bone broth. Shouting at me through my phone screen — screaming, really — from a New York City rooftop, and brandishing a single capsule between her fingers, Barrymore said she was no longer having mood swings or hot flashes, that she was sleeping better, she felt empowered, all from “this tiny, one-a-day pill!”
In an Instagram Reel, a more subdued Jennifer Garner sat at a counter covered in capsules and tinctures from Wile — “a super-important company for women 40-plus,” she said, a supplement start-up, the one that made my rage tincture, co-founded by Garner’s friend Judy Greer. “Even if you feel like you’re not in the hot-flash zone yet,” she said, holding up a red-labeled bottle of Hot Flash, there were products for “burnout relief,” for anxiety (an “un-worry” tincture), and one called “stave the crave” for suppressing food cravings. (Garner made a little displeased face as she held that one up.)
Berry — who in May stood on the steps of the U.S. Capitol and declared “I am in menopause, okay?!” as part of a push for federally funded research — had rebranded her wellness company as a menopause “community” platform, called ReSpin, which aims to “re-spin” ideas around menopause, and was now hawking a $495 vaginal red-light tool — a warm, vibrating wand — for a company called Joylux, where she was a major shareholder. The wand uses “thermal energy” and “sonic technology” to promote “hydration,” “sensation,” and “confidence.” (After reading the product description thrice, I was pretty sure the kit was actually covertly promising help for vaginal atrophy — the thinning of the vaginal walls that occurs as a woman’s estrogen decreases, which can lead to itching, dryness, and pain.)
This was a full-on gold rush, and it was starting to feel like a grift. It reminded me a bit of the egg-freezing craze of a decade ago (tens of thousands of dollars to preserve your genetic material with just a 2 to 4 percent success rate per thawed egg) and the women’s corporate-empowerment industry of the 2010s, complete with the grating “girlboss” ethos that I was sure the culture had retired. It wasn’t just that the names of the peri- and menopause start-ups sounded like they’d been churned out by a millennial baby-name generator — Winona for telehealth, Stella for symptom-tracking, Zoe for subscription nutritional powder — it was that they were encouraging women to all but lean in to their new handicap. We were to “make menopause” our “b*tch” (by signing up with a diet coach who’d trademarked the slogan); to “spark menopositivity” (by buying from Womaness; a line of skin-care products for women over 40); to become a “Meno Bosslady” with an online course from an integrative health practitioner and body builder, which promised to help rebalance our bodies and create a “success mindset.” I wondered: Did developing a success mindset mean no longer having symptoms?
By early this fall, I’d spent a small fortune on doctors, labs, supplements, and related accoutrements — according to a careful spreadsheet, I’d shelled out $10,766.78 in 2024 alone. I was no closer to relief. I just wanted to feel better, and I was pretty sure that a baseball cap stitched with “Hormonal,” made by Wile, or a “Menopause Is Hot” T-shirt, by Midi, a new telehealth provider (backed by Amy Schumer and Sheryl Sandberg) wasn’t going to do it. But what was?
Perimenopause may sound nicer than menopause — a kind of baby step, with more collagen, on the path to inevitable decline. Though that’s not saying much: Menopause, in the words of more than a few medical experts, has had “the worst PR campaign in history.” Deemed hysterical or neurotic by Victorian doctors, and dried up old husks by the culture ever since, menopausal women have long suffered hot flashes, brain fog, sleep problems, pain with sex, and more, in isolation, hiding their indignities.
But for all the dread that menopause may cause, it at least has a clear definition. It’s when a woman’s reproductive cycle ends, typically in her 50s, and it technically has a precise date: the day marking a full 12 months after her last period. Perimenopause, on the other hand, does not have a distinct initiation. It might be signaled by one’s period becoming irregular, or it might not. It could start with any of the dozens of possible symptoms; it affects some people intensely and others not at all. It can begin as early as your mid-30s and can last between two and ten years. What’s more, perimenopause can actually feel more volatile than menopause, with hormones fluctuating much more wildly. Symptoms range from the totally weird — burning tongue, loose teeth, “frozen shoulder” (what it sounds like!) — to the unfortunately commonplace: forgetfulness, fatigue, muscle aches, hair loss, and loss of libido, in addition to the menu of delights I’d been experiencing.
If you find yourself wondering, “Is it perimenopause, or do I have a thyroid problem? Is it perimenopause, or is it the state of the world?” lucky for you, there is no accurate test to provide a diagnosis, despite kits promising clarity via hormone-level measurements (peeing on a stick, finger pricks, and saliva samples available for $19.98, $99, and $189, respectively). “One of the hardest things about perimenopause,” says Rebecca Dunsmoor-Su, a board certified OB/GYN and the chief medical officer at Gennev, a menopause telehealth company, “is that you can’t prove it’s happening.” Rachel Rubin, a urologist specializing in sexual health and assistant clinical professor at Georgetown University, told me, “If it sounds confusing, that’s because it is confusing. There aren’t very clear definitions.” The Mayo Clinic, for example, identifies perimenopause vaguely as the stage “around menopause.” Doctors who treat menopausal patients, for their part, tend to describe it as just a time when things start to feel wacky, like puberty, but in reverse.
This lack of clarity, combined with a massive gap in medical care presents a prime business opportunity, a softball down the strike zone of the wellness, women’s health, and beauty industries. There are just 3,151 medical practitioners certified by the Menopause Society, the field’s top governing body, and at least 50 million American women currently in menopause, not counting those in perimenopause. Market analysts don’t yet differentiate between the two stages — doctors hardly know the difference themselves — but American women ages 35 and up currently spend $13 billion annually on treating menopause symptoms, and it’s estimated that the industry will reach $24.4 billion by 2030. Millennials, meanwhile — a massive wave of new consumers — have only begun to age in. As Alisa Volkman, the founder and CEO of The Swell, a community platform and planned future subscription service for “people in the second half of their lives,” put it, “Menopause for the TikTok generation is coming.”
In the last five years, dozens of new companies have stepped up to the plate, and some $10 billion is being spent on fully nonmedical treatments, a category that includes experiences (from communal retreats in Mallorca to educational salons), beauty products (lots of night creams), sexual-wellness aides (especially vaginal moisturizers and lubricants), and a variety of wearable tech, including a wristband that monitors hot flashes and emits cool sensations via a thermoelectric pump.
A number of telehealth start-ups now connect patients with menopause-trained clinicians directly, among them the previously mentioned Midi and Gennev; the Gwyneth Paltrow and Cameron Diaz-backed Evernow; and Alloy, whose chief medical officer was previously Michelle Obama’s OB/GYN (she called her “a godsend”). The primary remedy these companies offer is FDA-approved hormone therapy — the gold standard for menopause care — in the form of pills, creams, gels, and sprays, but most of them also provide treatments and supplements that haven’t been subject to approval or regulation by any agency. The M4 face cream, from Alloy, promises to boost collagen by combining standard emollients with estriol, an estrogen hormone that peaks in women during pregnancy and is sometimes prescribed for vaginal dryness (to be applied, yes, to the vagina). Evernow sells a topical hair-loss serum that combines minoxidil (the active ingredient in Rogaine) with finasteride, which has not been approved by the FDA in non-oral form for anyone — and has not been approved for use by women at all.
Supplements make up the greatest share of the market overall — possibly as much as 95 percent — and the vast majority of these capsules, powders, and potions are unregulated. For every data-backed product — usually single-ingredient standards like magnesium for sleep and vitamin D for bone health — there are many more complicated, untested blends making big claims. Experts are emphatic that there are no nonprescription remedies for hot flashes. “Nothing over the counter works,” said Stephanie Faubion, the chief medical officer of the Menopause Society. “Not one thing.” But scores of products claim to alleviate them, like the Hot Flash & Night Sweat Relief tablets from Bonafide, a women’s-health company ($58 a bottle), and the Menopause Multi-Symptom Relief from Equelle, a specialty plant-based menopause-supplement company ($50 for 60 pills). Evernow, for its part, actually promises that its Femistry capsules can reduce moderate-to-severe hot flashes by 71 percent ($88 for a 60-day supply).
“I joke that this is one part of medicine where the rich white ladies are getting just as horrible advice and care as everyone else,” said Rubin. “Even the celebrities I’ve encountered” — the ones promoting these products — “are swept up in so much of the snake oil.”
The many unfounded claims of this boom have recently caught the attention of a nonprofit watchdog group called Truth in Advertising. In October, the group released a report warning buyers of what it called a widespread “menopause deception epidemic.” The organization, which spent a year investigating the market’s supplement sector in particular, pilloried two somewhat older companies — Equelle and Amberen — for what it described as more than a thousand instances of “unsubstantiated and unapproved health claims,” and its legal director sent letters to 100 other companies — including Stripes, Dr. Kellyann, Wile, Bonafide, and Womaness — urging them to review their language and comply with FDA and FTC regulations.
Unfounded claims are of course the lifeblood of the multitrillion-dollar wellness industry. And yet there was something particularly sinister about this slice of the business. It was leveraging a significant void in public knowledge, ratcheting up classic feminine anxieties and further entangling them with real issues, all while claiming to pull women from silent shame and into sisterhood. (See, among many others, Berry — “I want women to feel empowered to talk about their experiences and not feel shame” — and Perry, a community app for women in “Peri” — “Join the sisterhood!”)
As for me and my quest, it was perhaps a lost cause. Separating the helpful from the utter bullshit seemed to require nothing short of a medical degree.
About six months into my perimeno-supplement journey, I got in with a new doctor, a menopause specialist with a monthslong wait list who didn’t take insurance. (I was squeezed in after a cancellation — and some begging.) By the time I arrived, I was so anxious I was practically in tears. I didn’t exactly think she was going to solve my problems instantly, but I had high hopes. After a physical exam, we discussed my options: an estrogen cream and a progesterone pill; steroid creams for my rashes and itch; an oral antifungal, also for my rashes (just to see); and a supplement called Vitex, made from chaste tree (we meet again) that she thought might help with the painful breasts. She also advised me to cut out everything I’d been dosing myself with — thank God. But she warned we’d likely be trying out a few things: When it comes to perimenopause, she said, “modern medicine is, quite frankly, throwing shit against the wall.”
In the case of menopause, this seems to have been shit and piss: The first widely available hormonal menopause treatment was a mix of estrogens taken from the urine of pregnant horses. It was first commercially manufactured in the 1940s in the form of a drug called Premarin (short for “pregnant mares’ urine”), but it really took off in 1966, when a Brooklyn gynecologist named Robert Wilson touted its benefits in his book Feminine Forever. Wilson argued that menopause robbed women of their “feminine essence” and that hormone therapy could not only prevent cancer (not true) but also reignite a woman’s youthful vigor. The use of hormones, Wilson wrote — specifically those replacing the estrogen women’s bodies stopped producing as they aged — meant a woman’s “breasts and genital organs will not shrivel. She will be much more pleasant to live with and will not become dull and unattractive.”
It was later revealed that Wilson was being paid by the company that made Premarin. But hormone therapy did in fact effectively treat menopause symptoms, and by the turn of the last century, according to Faubion, about a quarter of all menopausal women in the country were receiving it in some form. “It was the most prescribed drug for women bar none,” Faubion said. “Even more than antidepressants.” In 2002, however, the National Institutes of Health announced it was halting a large-scale study of hormone therapy owing to concerns about increased likelihood of breast cancer, heart disease, and other health problems. The therapy is now considered generally safe — there is a small increased risk of breast cancer, but it also protects against osteoporosis and diabetes. But the NIH decision was widely publicized and the fallout was enormous. Between 2002 and 2009, use of hormone therapy fell by more than 70 percent, and the field never recovered. Today, less than 2 percent of symptomatic women 40 and older receive it.
In the years following the NIH debacle, unproven treatments moved in to capitalize on public mistrust. Many were “bioidentical hormones,” a marketing term for compounded hormones made from plant material instead of animal sources. In 2004, the actress (and ThighMaster guru) Suzanne Somers published a book called The Sexy Years, in which she championed bioidenticals as a more natural and healthier alternative. Demand for the drugs took off, and experts now credit Somers for their rise. These hormones were untested, but they were also likely excessive, and in 2006, when Somers published her second book on the subject, several doctors called it “detrimental and dangerous.” In 2009, Somers detailed her own hormone regimen on Oprah: Every day she self-injected synthetic estrogen into her vagina and popped more than 60 pills.
Nanette Santoro, the chair of obstetrics and gynecology at the University of Colorado School of Medicine sees today’s boom as part of a pattern dating back to Somers. “It frustrates me to no end that women seem to fall for this nonsense over and over and over,” she said. “What about ‘buyer beware’ are we missing?”
Today, the best treatment for menopause is still FDA-approved hormone therapy, but most doctors, including OB/GYNs, receive little to no training on menopause. The best treatment for perimenopause is far less certain, and doctors receive no training on the condition whatsoever. “We’re not even taught menopause in medical school, so it’s fucking out to lunch on perimenopause,” said Rubin, the urologist. Until recently, according to Dunsmoor-Su, many doctors — and most medical literature — did not consider perimenopause to be a distinct condition that might require treatment.
As Faubion told me, and other experts confirmed, there has not been a single comprehensive medical study on perimenopausal women. (“Literally nothing?” I asked her, repeating her words back. “Nothing,” she said.) Only one study of any kind is known to have been published in a medical journal — in Menopause, in 2021. The paper was based on a survey helmed by a business consultant with no medical background, who at age 42 found herself so enraged by the lack of data that she decided to collect it herself.
In the spirit of throwing shit against the wall, I was willing to do almost anything, and in October, I found myself at a high-end hotel in Brooklyn Heights, among a crowd of menopausal women being led in a call-and-response: “I am strong!” “I am inspired!” “I am on fire!” After a few repetitions, the effort of the refrain triggered a hot flash in the woman sitting next to me.
This was “The New Pause,” a $295 per ticket conference hosted by The Swell in collaboration with Naomi Watts’s Stripes. (The VIP pass, which included private cocktails and a dinner with Watts, was $750.) The women in attendance didn’t particularly look menopausal, though certainly they looked middle-aged — tailored workwear, chunky loafers, light cosmetic work. The lineup of speakers was impressive: Lisa Mosconi, a neuroscientist and author of The Menopause Brain, spoke about the effects of estrogen loss on the neurological system; it influences everything from body temperature to memory and can pave the way for cognitive decline. Later, an NYU researcher brought out a preserved human brain to talk about the countereffects of aerobic exercise. Avrum Bluming, an oncologist who studies hormone therapy in women with histories of breast cancer, discussed the gender disparity in research and care. (“Just for a minute, imagine if I was talking to a group of men,” he said. “You’re having night sweats, you have brain fog, you don’t feel like having sex — and if you do it’s painful.”) In the afternoon, as a palette cleanser, the comedian Samantha Bee delivered a portion of her one-woman show, How to Survive Menopause: “Orcas go through menopause, too. Which is why I assume they’re attacking all the sailboats.” You may have thought you left acne behind, but acne has not left you behind.” In a keynote, Dr. Sharon Malone, the chief medical officer at Alloy (the OB/GYN praised by Michelle Obama), whose work has highlighted differences in how Black women experience menopause (often, more severely), issued something of a call to arms. “We have really underestimated women’s suffering and pain,” she said. “I’m here to tell you: No. Do not suffer.”
The hotel’s sun-drenched atrium had been set up as a “meno-marketplace” for the day. Attendees took turns trying out the Emsella Chair for urinary incontinence (a problem some women experience as menopause advances) which uses electromagnetic technology to stimulate the pelvic-floor muscles; others watched beauty tutorials from Jones Road, the “no makeup makeup” line from Bobbi Brown, marketed for “mature skin.” At a table in the center of the room were books by the day’s speakers. Thick-stock postcards replicated the cover of Watts’s upcoming book, Dare I Say It: Everything I Wish I’d Known About Menopause, which publishes next month, depicting the actress speaking into a bullhorn and flames erupting out the other side.
During lunch, as I milled around the hotel lobby, I chatted with Carol Tavris, a social psychologist who co-authored a book with Bluming on the benefits of estrogen therapy. She was resting on a bench. She’s 80 years old and spoke about how some feminists of her generation — in the 1970s and ’80s — had been critical of hormone therapy, convinced that doctors were medicalizing a natural part of aging. But she felt that the failed NIH study on the treatment had set the culture back decades by convincing women that all hormones were dangerous.
Waiting in a snaking line for pasta salad and sandwiches, I met the co-founder of Alloy, Monica Molenaar, who told me she’d gone through surgically induced menopause at age 40; she’d had her ovaries removed after learning she had an increased risk of cancer. At the time, not one of her doctors had talked her through what would happen. Soon she was experiencing brain fog, gaining weight, and crying often. “I really had no idea what was happening to me,” she said. Later, at happy hour, as I sipped a mandarin tequila cocktail, a woman dressed in fuchsia came up to introduce herself: “Are you in perimenopause or are you in the business of perimenopause?” she asked. (She herself ran a product-aggregator blog called The Fuchsia Tent.)
At a white-tablecloth dinner that night, on an upper floor of the hotel, I sat between two doctors, a physician who’d recently founded a women’s health clinic in New Jersey, and a gynecologic surgeon from Long Island who’d recently left a big hospital to open a menopause practice. Over beef filet and wine from a woman-owned winery (the winemaker was seated at our table), the two doctors got into a disagreement about testosterone pellets — another iteration of the unregulated compounded-hormone products that have recently become popular in private medical clinics, as well as medspas. The pellets, small waxy beads, surgically implanted under the skin (most commonly the upper buttocks), promise to treat symptoms like fatigue, weight gain, stress, and low sex drive in as little as a few hours.
The New Jersey doctor said she’d prescribed these pellets to one of her patients, whom she was closely monitoring, and she’d found them to be quite effective for the patient’s libido. The doctor from Long Island replied that she wouldn’t trust the treatment and would never prescribe it, noting that a lot of the pellets on the market are improperly dosed and hard to monitor. Later, out of earshot of the doctor from New Jersey, she told me the pellet manufacturers “should be shut down.”
As I would later learn, no testosterone product at all is approved by the FDA for use in women in the U.S., though some practitioners prescribe it off-label in small doses for low libido in postmenopausal women. The pellets were a prime indicator for just how messy, and potentially dangerous, this mixed-up medical ecosystem had become: They are explicitly cautioned against by the major medical societies, and at the same time, they are now frequently touted as a “miracle product” on social media, where women document their insertion, say they’ve eradicated their anxiety, and proclaim “Testosterone brought me back to life!” Dunsmoor-Su, who has written a paper warning against the pellets, told me that she understood the hype: “Testosterone is an anabolic steroid,” she said. “It makes you feel great until it doesn’t.”
In the past few years, Dunsmoor-Su has seen severe consequences of the trend. She’s treated patients who were previously prescribed dosages reaching far above the range that would be recommended for a person transitioning from female to male. “I have personally diagnosed endometrial cancers in women on pellets,” she said. More often, she went on, “I have had to tell women that the drop in their voice and the beard hairs are never going to go away — that their male pattern baldness is permanent — because they were on levels that are way too high.”
I got home the night of the conference feeling overwhelmed. But I was also somewhat comforted by the fact that everyone seemed to be as confused as I was. If even the doctors couldn’t agree, couldn’t I let myself off the hook a little for not knowing what to do?
I sat on my bed and dumped out the contents of my gift bag — a cooling and calming “face milk” from Stripes; a “MenoWell” granola bar formulated to help manage sugar cravings and “meno middle” (apparently fat that accumulates around the midsection); and a hair-loss supplement from Nutrafol. A rep for the company had appeared on a “Hair, Health, and Hormones” panel earlier that day; the moderator told a story about a woman who was so disturbed by her menopausal hair loss that she’d covered all the mirrors in her home.
But I also recognized the Nutrafol name and logo from a Truth in Advertising report. In 2023, the company, a subsidiary of the massive multinational Unilever, was accused of “widespread deceptive marketing” for claiming that its product was “clinically proven” to prevent hair loss. A case was referred to the Bureau of Consumer Protection at the FTC as well as the FDA. And yet here it was, the same product, still claiming to be clinically tested, in a sleek white bottle handed to me by The Swell. (In a comment, Nutrafol denied the assertions of the Truth in Advertising report and pointed to two studies to support its claims, one of which the watchdog group had cited and analyzed in its complaint.)
When I spoke to Laura Smith, the legal director for Truth in Advertising, she explained that terms like “clinical research” have essentially become meaningless. Much of the research cited on menopause products — and on wellness products in general — is faulty: sponsored by the companies themselves or even derived from online surveys and testimonials. In addition, Smith said, wellness companies are failing to disclose ethical conflicts. There are simply too many companies to monitor, she told me; the regulators are not keeping up.
I remembered that the Dr. Kellyann’s Daily Ritual capsules, praised by Barrymore, were promoted as “clinically proven,” and I searched for the fine print. I found it at the bottom of the product’s webpage: It was based on “self-reported survey answers.” Joylux, meanwhile, had advertised its vagina wand as “clinically validated.” The company sent me three studies to support its various claims, but two of these were co-authored by a member of the company’s executive team. They also denied that they were advertising the wand as a treatment for vaginal atrophy. (Stripes, Dr. Kellyann, Womaness, Equelle, and Ambren did not respond to my requests for comment. A representative for Wile said its products are developed in close collaboration with “food scientists” and naturopaths and offered to send me relevant studies. She did not reply to subsequent emails.)
Not long after “The New Pause” conference, and two years after I’d begun waking up in the middle of the night, I went back to my gynecologist. Since that first visit, we’d been ticking through treatment options. Some of my symptoms had resolved; others had been exacerbated. Sensing my frustration, she suggested we try a low-dose birth control to try to “even things out” — to essentially suppress some hormones and supply a steadier dose of others — and I immediately agreed. I practically ran to the pharmacy.
It’s been three months now and my symptoms are not entirely gone, but they do seem to have eased up. I can, at least, sleep through the night, and I’ve been able to start exercising again. For the most part, I’ve retired from my hobby as a perimenopause-product tester, which was necessary both for my health and my credit-card balance, though there are a few products I’m not ready to give up. (The hemp tank tops are solid; the Stripes cooling spray is really quite refreshing.)
Perspective is useful here. I was recently visiting with my mother, whose sheets I was sweating all over, and she told me she remembered the same thing happening to her around my age — though she’d had no idea it had anything to do with menopause. It would have been a relief to know, she said. Instead, she’d just endured it without having a clue.
There is something to be said for a generation that is unwilling to endure. Rubin, the urologist, told me that she believes the industry’s overblown claims were actually forcing doctors and researchers to ask new questions. In that sense, she said, the marketing chaos might end up contributing to advances in treatment. “Conflict is what makes science evolve,” she said. Despite all the mishegoss a perimenopausal person must sift through, at least we’re talking about it.
This article has been updated to reflect that Dr. Sharon Malone is Michelle Obama’s friend, not her former OB-GYN.
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