Perimenopause Is Hot . . . And So is the Profit Motive!

​Perimenopause and menopause are being featured in headlines and mainstream media coverage perhaps like never before. Every week, some health magazine, lifestyle publication or mainline news outlet is covering perimenopause and menopause, it seems. Reporters are tackling topics like hormonal mood swings, midlife weight gain and sex after the age of 40 week after week. In most of these cases, menopause is the centerpiece or, at the very least, it gets a passing mention.

Believe me, I believe it is better for perimenopause to be ushered out of the shadows, kicked out of the closet and the tape removed from its proverbial mouth of silence than the alternative. For far too long, women have felt ashamed of their symptoms, scared to speak to their friends about it and isolated, feeling absolutely crazy and about to lose the plot.

But as I examine this new heyday of perimenopause, part of me considers the profitable ecosystem surrounding all of this fanfare. As much as women need and deserve to be helped and heard, many businesses, companies and individuals are looking to get paid. The profit motive is real.

Perhaps the worst part of the profitability of perimenopause is that so many women still get bad advice or negligible help, sometimes after shelling out hundreds or thousands of dollars. So this made me think about the types of professionals and “experts” menopausal and perimenopausal women should consider avoiding – or proceeding with caution – when seeking and paying for their help.

Health Coaches. First of all, health coaching is a somewhat specious profession. There are various associations and organizational bodies that credential coaches, and sometimes such people have no experiential or high-level educational knowledge of anatomy, physiology, pharmacology, psychology, biology or chemistry.

Health coaching certifications can come from a range of providers, including personal training organizations, integrative health membership associations, holistic health societies and more. Most take only three to 12 months to complete. There are some programs at accredited colleges and universities, and many of those are actual associate, bachelor and master degree curricula, ending with an academic degree.
With health coaching being a field littered with ambiguity in how to get there, finding a veritable, trusted and knowledgeable health coach can be difficult. And even if you do find one, health coaches can only do so much. They can chat you up about nutrition, exercise and lifestyle, but they can’t prescribe medications or dispense medical information.

Health coaches usually charge $50-$500 per session, and insurance doesn’t cover their services. I believe the time and money women would spend on health coaches would better be used buying books, reading science journal studies and articles, and watching videos by experienced, established professionals and real women who share what’s worked for them (and are not selling anything).

Integrative or Holistic Health Providers. I previously explored this group in “Are Functional Medicine Doctors and Naturopaths Medical Quacks?” If I read more story, hear another anecdote or receive another email from a woman who’s been misguided and done wrong by a functional medicine or naturopathic “doctor,” I may scream.

More often than not, I hear about women paying hundreds or thousands of dollars on unnecessary – and possibly meaningless – lab tests. They are being coaxed into test after test after test, then being “prescribed” a growing list of expensive supplements and vitamins in the name of “balancing” every seen and unseen system in their bodies. Such tests may include measuring gut permeability, adrenal stress and heavy metals, among many, many others.

Some providers in this camp do provide perimenopausal and menopausal women with hormone replacement therapy (HRT), but often at microdoses (like 25mg of progesterone), inadequate delivery routes (progesterone creams, when progesterone is not well absorbed through the skin) and potentially dangerous options (like high-dose testosterone pellets that cannot be adjusted or removed once inserted).

The name of the game with naturopaths seems to be: “Let’s find a way to keep her coming back,” with the hopes of having a customer on the hook for life, test after test, imbalance after imbalance, lab after lab, and supplement after supplement.

I’ve literally communicated with dozens of women led astray by functional medicine and naturopathic providers that I no longer feel like I need to hold back on calling it like I see it.

Perimenopause and Menopause Tech Companies. Telemedicine has been a godsend for the delivery and access to medical care, replacing the needless commute, office wait time and total inconvenience of the typical doctor’s visit. And there are some virtual care providers in the perimenopause space who are bringing true value to their patients, including Evernow, which actually prescribes pharmaceutical, FDA-approved HRT along with non-hormonal options, such as SSRIs.

But some tech companies trying to cash in on the perimenopause gold rush aren’t providing much novel or new at all. More than anything, I believe women who are symptomatic with hot flashes, night sweats, insomnia, anxiety, depression, headaches and more want RELIEF. They want to be free from and rid of debilitating symptoms that compromise quality of life. They don’t need motivational speaking, more expensive supplements, beauty tips, exercise advice or creative recipes for cooking.

Let’s take a look at Phenology, which is offering “lucid lift refreshing mints” for $19, a “cooling mist” for $19 and a “fresh start skin roller” for, yes … you guessed it, $19! Wile is shilling “Hormonal” hats, sweatshirts and T-shirts, along with CBD oil and . . . more supplements!
Do we really need more of this?
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I don’t think so. What we do need are more clinicians – general medicine, adult medicine and internal medicine physicians – who understand perimenopause and menopause. We need more endocrinologists, psychiatrists and OB/GYNs who do more than dabble in diabetes, bipolar disorder and delivering babies, respectively. We need trained providers with a sincere interest in and commitment to patient health, including the health of half of the world’s population who are women, apt to begin perimenopause by their early 40s and likely to outlive their male counterparts by quite a few years.

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