We’ve had some incredible conversations with menopause experts, but today’s guest brings a fresh perspective. 

Imagine having a reliable, go-to source for all your menopause questions—no more sifting through conflicting advice. That’s exactly what our guest, Monica Molenaar, co-founder of Alloy, has created. Alloy is transforming the landscape of women's health, providing accessible, trusted solutions for those navigating menopause.

We delve into the nuances of hormone therapy as a safe and effective solution for menopausal symptoms. We address the misinformation surrounding it and discuss ways to access accurate and reliable information.

Monica’s personal journey forms a vital background to the conversation.From navigating personal health challenges to developing innovative solutions for vaginal and skin care, Monica’s journey has fueled Alloy’s mission to empower women.

Alloy aims not to replace traditional medical examinations but to supplement them by providing guidance and treatment options like hormone therapy, topical sildenafil, and more. 

One recurring theme in our conversation is the importance of individual experiences. Different women will have different reactions to hormone therapy, but the key is having access to sound, evidence-based advice.

Highlights:

• Monica’s Journey: Discover why Monica founded Alloy, including her personal experience with surgical menopause and the drive to create solutions for menopausal symptoms.
• Hormone Therapy Insights: Explore the key steps in hormone therapy, its potential to protect against chronic diseases, and how Alloy addresses skepticism through research and trials.
• Access and Advocacy: Learn how Alloy helps women access proper menopause care, bridging gaps with personalized advice from experienced OB-GYNs.
• Overcoming Challenges: Hear about Monica’s balance between work and motherhood, and how she overcame misinformation to provide evidence-based care.
• Empowerment and Community: Understand the importance of support networks and personal advocacy in navigating menopause and perimenopause.

Join us for a deeply insightful discussion that's not just about menopause but about taking control of your health journey and living your best life through informed decisions.

Is there someone you'd love to hear from on the show? Remember, this podcast is here to help you become your own best advocate. If you enjoyed the episode, please like, share, and leave us a 5-star review on Apple!

Monica's bio:

Monica Molenaar is a serial entrepreneur and an advocate for frank talk and common sense solutions around women’s health and wellness.

At the age of 40, Monica tested positive for the BRCA gene and elected to remove her ovaries prophylactically to reduce her risk of breast and ovarian cancers, thereby ending her natural production of estrogen and sending her into surgical menopause overnight. This began a multi-year journey trying to make sense of all the misinformation and lack of clarity around this phase of life. It was only after starting to supplement with estrogen and progesterone that Monica found relief from the menopausal symptoms affecting her quality of life and was able to get back to work. She was inspired to start Alloy to make sure that other women entering menopause would have an easier time than she did accessing credible information, effective and safe solutions, and a supportive community.

Monica is a graduate of the Stanford University Graduate School of Business. A lifelong New Yorker, she now resides in Rotterdam, The Netherlands, with her husband and two teenage sons.

Get in touch with Monica:

Website

Instagram

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LinkedIn

Get in Touch with Dr. Rahman:

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Hey, y'all, it's doctor Samina Rahman. Gyno girl. I'm a board certified gynecologist, a clinical assistant professor of Ob GYN at Northwestern Feinberg School of Medicine, and owner of a private practice for almost a decade that specializes in menopause and sexual medicine. I'm a south asian american muslim woman who is here to empower, educate, and help you advocate for health issues that have been stigmatized, shamed, and perhaps even prevented you from living your best life. I'm better than your best girlfriend and more open than most of your doctors. I'm here to educate so you can advocate. Welcome to Gyno Girl presents sex, drugs and hormones. Let's go.

Hey y'all, it's me, doctor Samin Raman. Gyne girl. Welcome back to another episode of Gynegirl presents sex, drugs and hormones. I just recorded this episode. You guys are going to be very excited to hear Monica Moliner. She's a serial entrepreneur and advocate for frank talk and common sense solutions around women's health and wellness. At the age of 40, she tested positive for a BRCA gene and elected to remove her ovaries prophylactically to reduce her risk of breast and ovarian cancers, thereby ending her natural production of estrogen and sending her into surgical menopause overnight. Complete castration there.

This began a multi year journey trying to make sense of all the misinformation and lack of clarity around this phase of life. It was only after starting to supplement with estrogen and progesterone that Monica found relief from menopausal symptoms affecting her quality of life and was able to get back to work. She was inspired to start alloy to make sure that other women entering menopause could have easier time than she did. Access incredible information, effective and safe solutions in a supportive community. Monica is a graduate of Stanford University Business school, a lifelong New Yorker, and now resides in Rotterdam, the Netherlands with her husband and two teenage sons. So you guys are going to enjoy this a lot. A lot of these menopause platforms have popped up all over the country, you know, and this is a very good platform that I think has helped a lot of women access care that cannot. And so if you think about the fact that, you know, as of March of 2024, 75 million women have in the United States have entered perimenopause menopause and 6000 more are entering menopause every day.

So 75 million in the US, 6000 every day. That means that half of the us population will eventually experience menopause. Okay, so that's a lot of people, and there's only a few of us that, like myself, who are menopause specialists, who will take the time to talk to patients. We're not that much in terms of, you know, the number of people. I think it's less than 10% of women are actually getting menopausal hormone therapy. And again, if this is something that you're interested in and you can't get access to, it's very important that you know what's available. So today I have a conversation with Monica from alloy, and she tells us about her journey, why she is so passionate about midlife care, and what they offer on their platform. So stay tuned.

You're going to really love this one. Hi, everyone. Welcome back to Gyne Girl presents, sex, drugs, and hormones. I'm super excited today to share with you guys an amazing woman entrepreneur and really, life transformers. I mean, you guys heard my intro about Monica, and we're going to get into a great discussion about how she came to do all the great things that she's doing. So please welcome Monica Moliner. Hey, Monica. So thanks.

Thanks so much for being here today.

Thanks for having me. It's so great to be here.

Well, in my intro, I talked about, you know, your entrepreneurship and your journey into creating, really, one of the probably best, I think, menopause apps and access to menopause care out there, because we know how many women are going through menopause right now and how little access they have to good care. Like, you know, there's only so many doctors like myself who specialize in it, so. But I want to hear, and I'm sure the listeners want to hear, because you made a shift in early midlife. You're in early midlife. Not like I was looking that.

You're 50 now. Yeah.

Ten years I was looking that Ann and, you know, doctor Malone got the Forbes 50 best. What was it? 50?

50, over 50.

And I was like, wait, where's mom? And I was like, oh, she's not 50.

Well, the funny thing is, I had turned 50 by the time it came out, but I wasn't 50 when they were doing. Yeah. So I was a little. I was a little jealous. I was a little jealous, I'm not gonna lie. When was the last time you ever were so sad not to be 50? But I. I do love being 50, and I'm glad that I turned it. Yeah.

Turned this corner.

I'll be there soon. So, anyway, let's talk about it. Tell us your journey. You went to Stanford. You're an entrepreneur, you know, a serial entrepreneur. Like, you've done so many things. What was it? And I know you met Anne. God, I'm blank.

2018. You methadore.

But tell us, tell the, tell the listeners and viewers, like, you know, what motivated you guys? I mean, this is a huge platform now, and really, and you can kind of go into what alloy is, but, you know, it's a great menopause platform, offering menopause care for patients all over the country. So tell us, you know, your story. What motivated you to do this? Like, you know, because we all have a trajectory of what, you know, like.

How we got here. Yeah. Well, so alloy, just to frame what alloy is, alloy is a telehealth platform for women in all stages of perimenopause and menopause, where we offer access to really credible, authoritative information, up to date science, access to affordable, convenient access to the expertise. As you mentioned, there are very few menopause specialists in the country, in the United States and, and around the world, to be frank. And this is not a unique or exclusive problem to the United States. I actually live sort of between the US and the Netherlands right now, and I can tell you that in Europe, it's a big problem as well.

Yeah.

So we offer access, really convenient, affordable access to really good expertise. Doctors, medical doctors who have generally decades of experience treating women in midlife and dealing with menopause, and also access to the prescription treatments that are going to not only make your symptoms go away today, but protect and protect you against chronic diseases. Prevent the chronic diseases like osteoporosis, like heart disease, very likely dementia, and other things that we disproportionately affect women as they age from the loss of estrogen, as you know.

Well, yeah, absolutely. We always talk about Mary Claire in the menopause. He always talks about the nursing home prevention program you're outlined.

Yeah, 100%. 100%. And I'm very much a part of that on that train.

Right. And I think it's very important to remember that, you know, we give these medications, you know, mainly for symptom relief, and the guidelines are all around that. But we know, we know that it's protective for the bones. We know that there's cardio protective benefits. And you're right, likely brain protective benefits are preventing dementia, although some of the data is ambiguous about it. But I think for those of us that do it, we see a difference.

In our own brain, even if it doesn't. I mean, it's certainly not going to make things worse. So all of the other things that it's protective of, to me, have really made me become an estrogen activist in the last six years.

Absolutely.

But I wasn't always in this place, obviously. As I said, I just turned 50 when I was 40. I had my ovaries removed prophylactically, really, because I was mainly more concerned about ovarian cancer. I was diagnosed with the BRCA gene. My mother and my grandmother both had breast cancer twice, very young. My mother was 36 the first time she had breast cancer. So I've been screened since I was 25, and my grandmother's breast cancer had metastasized to her ovaries. Neither of them died from it.

So I was lessen afraid, to be perfectly frank, of breast cancer. But I really, you know, I was young. I had two young children. I just knew that I didn't have any bandwidth to be dealing with ovarian cancer if I. If that happened to me. So that was kind of really my main motivation for getting my ovaries removed after having been encouraged by every doctor that I had been to, which, you know, were kind of myriad and many. I had my Ob gyn. I had a breast surgeon that was following me from the time that I was 25 who had been my mom's breast surgeon.

So everybody I met in the medical community was encouraging me to do something surgical. But until I knew that I was finished having children and I was really young, I just wasn't prepared for it up until that point, until I turned 40. And it was really around the time that Angelina Jolie came out with her op ed. And there was a lot of information all of a sudden that was coming out in the media about if you have the BRCA gene and you get your ovaries removed by the time you're 40, that you further reduce your risk of breast cancer. And that seemed to me like a good idea. It was a non cosmetic surgery. Nobody would know that I had done it, which at the time, felt important. Now, obviously, everybody knows everything that's going on with my health journey, and that's okay.

But I was in a different place, obviously, and the world was in a different place. But literally, nobody spoke to me. Not one doctor mentioned, like, you're gonna go into menopause the next day, and here's how you deal with it. And this is what it means, and this is what you should know about hormones and the loss of hormones and how it's going to affect your body. And so I basically went into, like, six months of crisis where I had, I don't even know how I knew about menopause. But I said to the doctor, like, do I, the surgeon who is at memorial Sloan Kettering, I said, do I need to take hormones after I have the surgery? And he said, well, you know, your body will still have some circulating estrogen, so just take them when you feel like you need it and get a prescription from your obstetrician.

Not that this is an immediate.

What does that mean?

Like castration the minute I wake up?

Yeah, exactly. So I didn't know what that meant, what that meant when I need it. And I. And I, funnily enough, I never had hot flashes. That wasn't my symptom. My symptoms were essentially that I stopped sleeping immediately. Like, didn't sleep through the night for six months, and I gained 20 pounds of pretty immediately and couldn't do anything to dislodge the weight. And so I was just kind of getting more and more depressed.

Like, I don't know what to do here. And my gynecologist said, well, you can't take hormones because your mom had breast cancer and you have the breast cancer gene. And so, you know, so I was sort of shit out of luck and kept going to different doctors and sort of figuring, trying, like, just getting going deeper and deeper into this sort of dark hole of, like, you know, it's affecting everything. All. Everything in my life, my relationships, my marriage, all the stuff. And finally, and we know the cognitive.

Effects that you have when you lose oxygen, too, and with emotional differences, irritability, all the things that we know about when people go into menopause. So it's like an avalanche of things at once.

Yeah, it was pretty awful.

And you lose your testosterone immediately, too.

Right?

Like, for some women entering menopause, it's more of a slow. You lose 50% of your testosterone like that. So I find people's libido and energy.

Go plummeting when they have, for sure. The interesting thing about testosterone, and I have used it multiple times over the years, and I now use it sort of again, but I. And I've used it in different ways, but the first time that I was offered testosterone was only for libido. And, you know, libido is a very complicated thing, especially when you have so many other things going on. And, you know, it has really a lot to do with not. Not just your testosterone, but your relationship you're feeling about yourself.

All the things biopsychosocial, we always talk about multiple.

So it was not like a magic bullet. Like, whoo, got some testosterone and now I'm raring to go. No, no.

In fact, it's usually slow for libido, but some people find, I think their cognitive improvement comes right away, or maybe energy.

I guess I wasn't really looking for that. So it also really depends. I find that, or I have found, in my experience that the, let's say 95% of the benefits when you're mena, when you're in menopause, the really sort of marked change comes from replacing the estrogen or supplementing the estrogen, I believe it. And then the testosterone kind of helps to fine tune some of the things, like, you know, my arms, now that I'm working out and lifting weights and lifting heavy weights, like, I finally, you can tell that I'm working out, like, my arms look toned and cut, and I like that. So that I do believe that that comes from the. From the testosterone more than the estrogen.

I will say that in general, the guidelines from a clinical perspective are really around hypoactive sexual desire disorder. Although for those of us who treat and replace testosterone, and that's low libido with bother, if you're not bothered by your low libido, if it's not frustrating you or causing any issue in your life or with your partner, then you don't have to go that raw. But hypoactive sexual desire disorder is the primary reason we do replace it, per guidelines. But for those of us who, like, have been doing it for a while, know that it's, you know, libido is a mood. Right. And we know it acts on your brain. So obviously, there's other effects that we see in patients, and so it might not be the primary reason we give it, but we always, you know, caveat that by saying, you know, you might get improvement in your lean muscle mass and you might have improvement in cognitive function and all these things.

Yeah. And I've seen that. I mean, the part of the problem and with the whole testosterone discussion is that it's really difficult to get. It's difficult to have it prescribed, it's difficult to access.

There's no FDA approved female version of it.

Yeah. And so I think the, you know, for women to kind of get hung up on testosterone, like, really the biggest change and benefit will be using estrogen and obviously progesterone and then, which is much easier to access. That is what we offer at alloy. And, you know, when, as laws change, hopefully, or when we're able to kind of. And as we get more evidence and do more research about testosterone in women and sort of get a dose that, you know, I think we know a lot, but we. There's still that we need to find out. So, anyway, the interesting thing about this time of my life, when I had my ovaries removed, was that I, at that point, I was I washing a stay at home mom. So I wasn't yet an entrepreneur between 30 and 40.

I sort of was in and out of the workforce when I was. When I, my first son was born. When I was 30, and I was working full time, I went back to work, you know, right after my maternity leave. And about seven months later, I had a full time caregiver for him. I was traveling quite a lot for the job that I had, which was for a furniture manufacturing company doing marketing and product development. And this was right after I graduated from business school, and I had a. The caregiver that I had for him just really wasn't working out. And in lots of ways, I sort of was hearing from neighbors in my building, like, how terrible she was, and she was, oh, my God, that's very.

Traumatic, watching your child. Wow.

Not taking care of my baby. It was really a traumatic experience. It was awful. It was awful, and, oh, it was terrible. And not being there. And so, you know, I. But I. And it was December 23, I remember 2005, that I needed to basically, you know, let this woman go and figure out what to do next.

And so I was about to go visit my parents in law in the Netherlands, where my husband is from. And it was Christmas time, and then, you know, coming back, and I had. The world was a totally different place. I had two weeks of vacation for the year. I. There was no option for remote work. My employer was completely inflexible and literally told me that they had a policy against flexibility because it was a manufacturing company. And if they offered it to me in management, that they would have to offer it to all the women on the manufacturing floor.

And so I was allowed to take my two weeks of vacation for the year starting January 1 to find a new caregiver and then not have another day off for the rest of the year with a, yeah, you know, under one year old baby. And basically, I couldn't work part time. I couldn't work from home. Like, it was a completely different world that we were in. And so I really was left without a choice. And so I left that job, and then I spent the next couple of years. I had another baby two years later, and I stayed home with the kids for a while, and then I went back to work in 2008. Full time.

My husband was at Lehman Brothers, and it was either like, okay, we're gonna. I need to go back to work full time or be fully sedated, because I was so completely anxious about that. And then I kind of left that job. My family was always my priority. Then I worked part time for a while in pr, and I just was sort of in and out, depending on what the needs were of the family. And so I never really developed my career in a linear fashion. And I always felt also like, you know, I pretty educated. I went to Nivellead College.

I went to Stanford business school. Like, I kind of felt like I should be doing something with my life, but I just hadn't. I didn't know what that was. And, you know, and I had never found my work passion, and I. And so I. When I turned 40 and I had my ovaries removed, and it was clear I wasn't having more children. And, you know, I was having these discussions with my husband. Like, first of all, we needed the money, and I needed to support him also.

He was working really hard, and sort of I needed to contribute, and that was important for my marriage and important for myself and all the things. But what was I going to do? I wasn't, you know, I wanted to do something different. I had had this kind of traumatic break with, you know, the last corporate job that I had had. When it was completely inflexible, I didn't want to do that again. It was. Yeah, it was really hard. And in the ten years, I had kind of developed different interests, and I was really interested in food and nutrition and the different ways that, you know, Americans were starting to eat and kind of how. How the different.

The information that we were learning about, you know, whether it was veganism or gluten free or protein or, you know, just, like, having better options, essentially. And so I wanted to work in the food industry, and I literally could not get a job because I hadn't worked in food before. And also because I was too old.

It's always a catch 22, you know?

Yeah, I was too old to start way at the bottom, and I was too inexperienced to sort of do what I'm doing now or to run a business. So I really didn't fit in anywhere, and I was just getting rejected right and left and feeling worse and worse about myself, and also was dealing with this sort of trying to figure out how to get some hormones back and to feel like myself again. And so it was a really, really difficult time. And luckily, the first thing happened was that I did get a prescription for HRT, thanks to a neighbor of mine who saw me one day looking really bad. And she said, you know, are you okay? I think I. She was 15 years older than me, and she obviously had been through it before, had been, has. Was going through menopause herself and had worked it out. And she literally put her arm around me and she said, I'm going to help you.

Don't worry. I'm going to help. I'm going to get you help, and I'm going to connect you to the person I know. It's almost going to make me cry because it was so powerful and I meaningful to have an older woman who knew what she was talking about bring me along and you know, and say, like, this is something that you can deal with and you will feel better. So that was really important.

Just when you, like, are losing faith in humanity, you hear stories this and you're like, wow, there's some still really good people out there.

Yeah, it was great. And so she and I became pretty tight after that also. She had just gotten a puppy and my eyed little kids, and Sarah was like, rent a dog. So, yeah, yeah, we were really close at that time. And this was in New York.

You were in New York?

This was in New York City? Yeah, I was in the middle of New York City. My father also is a doctor. He was on staff at Cornell Weill Cornell Medical, New York hospital. Like, I had access, and I still couldn't find the help that I was looking for.

It's amazing. Isn't that amazing? Like, you know, for someone who has access and, you know, privilege and everything, still, like, you can imagine people in the opposite position who are kind of like, even worse case. So, wow, this is.

Well, not only can I imagine, I know for a fact now that I've been working on alloy for the last five years, I've spoken to thousands of women across the country, all of whom have had a similar experience to mine and have gone to, you know, and really it has no. Who you are, how much access you have, how privileged you you are, has no bearing on whether or not you can find this care. Even Oprah went to five different doctors before, you know, about her heart palpitations before she, somebody said, you're in menopause, and gave her what she needed.

And if you're an xx and you live long enough, you'll go through menopause. So this is like, everybody will have this.

Everybody. Everybody.

And we don't want everyone to have these stories because I hear them every day, too, in my office. It's like I'm the 56 person, and they're like, where were you ten years ago when I went to pause?

And I'm like, it's awful.

It was here because you didn't find me.

It's crazy. So anyway, at that point, I was dealing, obviously, with a lot of things. I was 40 years old. I had two young children. I was out of work and looking for a job. I was dealing with my newfound menopause situation, etcetera. And so ultimately, I just kind of realize, like, okay, this looking for a job thing is not working. If I want to get a job, I need to create the experience that I need in order to get employed.

And so I'm going to start a business, and I'm just going to do it myself, and I'm going to figure it out, and I'm going to get going, and I'm going to do something that I'm interested in also, because I knew from those ten years of being in and out of the workforce, like, I've worked, I've been a stay at home mom. I've worked full time as a working mother. I've worked part time as a working mother. Like, I've done all the things, and I think that that's, that's one of the things. Also with alloy, like, I've. I've had compounded hormones. I've taken oral, I've used the patch, I've used the spray. I've had pellets.

I've, like, I literally try everything until I sort of land on a solution. And that's, I think part of the superpower that I have to give to other women is, like, I get it. Yeah, I understand the situation that you're in. I've been there before. I've worked through it to try and come out the other side. And I, and I understand the context and sort of what all of the different solutions are. And so I, you know, I love being now in a position where I can help other people get through this journey that's wonderful themselves.

I have to say, it takes a lot of intestinal fortitude to say, like, okay, I'm going to now, you know, totally shift and do something that's very scary. I mean, in September, it'll be ten years that I started a solo practice. So I get what you're talking about because it's really scary to go into. I mean, for me, a business that, like, I didn't learn business of medicine. So it was one of these things where, like, I was like, you know, people tell me I could, I'll probably fail because you don't know what you're doing and all the things, you know. But I feel like it takes a lot of, like, ovaries. I don't like to say balls because we know vaginas and ovaries take much more of it than balls.

Correct, correct.

So it takes a lot of that intestinal fluid, you know, so it's like, it does.

And that's also why having partners has been really important to me. Like, I need somebody. Yeah.

Tell me how you found Anna.

So I literally found Anne through my puppy. So after the neighbor Ann's in New York, too, and the neighbor with the puppy moved away, and so now we were dogless, and my kids were begging me to get a dog. And so basically, just to back up, before I met Anne, when I decided, okay, I'm going to start my own business, I found, I just started talking to everybody about that. I came across, like, what I'm interested in, what I'm trying to do, and just try to sort of drum up that, you know, like, what was that opportunity going to look like and what was going to stick? And the thing that stuck was that I met a woman. And then we quickly became three partners and started a business called Seed and Mill, which was a. We opened a shop in Chelsea market. And, I mean, all of this was like, we literally went and pitched Chelsea market with, we didn't. We didn't even have a business incorporated.

Like, we had a few samples and an idea and a deck, and we're like, this is what we're the shop that we're going to open. And we got a lease. It had tahini and halva. So basically sesame based products. And what was really interesting. Yeah, it was really, really niche, but what was really interesting about that business, and it's still going, it's, you know, it's always kind of been this little profitable business, which is. But. Little business, but really interesting case that we, at the time, we sort of hit this wave of millennials getting into, like, foodies becoming a thing which really hadn't.

Wasn't the. Wasn't a thing before. And I think it kind of started with millennials, with vegan. It was a vegan dessert that we were offering and gluten free, and also ethnic. Like an ethnic meaning. Like, it kind of, a lot of different ethnicities have both sesame products in their cuisine, but also, you know, a real nostalgia for whether you're jewish or Middle Eastern or like, it was kind of this peace food that, you know, like every argentine Argentinian has. They have a similar, I forget what it's called, but they have a similar food to this, I think, actually made from peanuts, but, like, it's halva is this really, it's a sweet confection that has sort of the consistency of, like, the inside of a butterfinger candy bar. And it's, we had different flavors, and it was really beautiful and visual and really nice.

And so it was kind of a great way for me to cut my teeth. It was a very different type of business from the one that I'm doing now, but I learned how to both learn start up a business and also how to work with partners and what the, you know, like, what to do and not to do, and, but I need accountability to other people in order to kind of get, you know, there are always other things, and having been a stay at home mom and having a family, like, they're always important things to do. So I can always make myself busy. And so to take myself away from the things that I was doing, you know, also, when you start up a business, you're, I wasn't making, I wasn't having a salary, so it, what, like, I needed to really kind of have that. I couldn't do it on my own, and, but one of the things that I learned in that business was that it's important to have clear lanes and expertise. What you're with, what you're doing in the business, the role that you're playing so that you're not stepping on each other's toes, which we were doing a bit in c to mill. And so at a certain point, it was kind of time for one of us to take that forward and the other two of us to kind of take a step back. And I didn't want to be the person to take it forward.

I I wanted to move forward to something else. And so it was around that time that my kind of out, not out of work, but not working as much anymore. I was, you know, I was sort of reflecting on what I wanted to do next. I was really thinking still more in the food, nutrition, like how, you know, dealing with my own weight gain, trying to lose the weight, et cetera. Like, how do you eat? Move. What's the right thing to do when you're in menopause? Which was a, obviously is a different time of life. And my kids then convinced me to get a puppy. And it was at that time, yeah, the best.

I mean, it was the best decision he literally changed my life. Literally changed my life because they do, for all the reasons. He also led me to Ann. So Ann also had gotten a puppy at that time. We were both on vacation with our families and sort of the only two, you know, as the moms, like the only two out on the street at 630 in the morning with these puppies. And we kind of ran into each other. The dogs liked each other, started playing, and we started talking about everything in our lives. We were both in our mid forties at that time.

You know, early morning walk and talks. Like, what are you going to do with the rest of your life? I don't know. What are you going to do with the rest of your life? What are you dealing with right now? And, you know, we just went deep.

Very fast because Ann at the time, was working with, Ann was with, she.

Was the editor in chief of Mary Claire magazine. Mary Claire magazine. So she was engaged in creating content and telling stories for women in our age group about kind of all these things or all kinds of topics. And basically, after getting to know her for a couple of weeks, we had some friends in common. We sort of really became friends. I reached out to her maybe a month or so later. I said, I have this idea. I think that you should quit your job and we should fix menopause, because all of our friends are about to go through this.

I have been struggling with this for five years. I'm not 100% sure. I mean, I know what the solution kind of is. I don't exactly know how we're going to fix this, but at the very least, we need to tell people that we want coming for them. Yeah. And that there are things that they can do. And so, long story short, she did just that. She quit her job, and.

And we have tried for the last five years to fix menopause. I think we're doing a pretty good job, which is nice.

How big is your platform now?

Pretty big. We have tens of thousands of women that we serve every month.

It's all states.

50 states. Yeah. We launched in 50 states to begin with. The way that we are able to really create this direct access to menopause experts directly to the doctor, make it convenient and affordable and not, you know, like, we're really solving the problem that we're experiencing ourselves. We're our alloy customers. We know how difficult it is to get an appointment with a doctor, how long it takes to wait for that appointment, and then, God forbid, you forget to ask, you know, your top three questions or the bottom five questions or whatever. Then you have to go back through the phone tree or, you know, you'll never get back to the doctor herself again. I mean, you know, it's really inconvenient.

So alloy is all done through secure messaging with the doctor, and you are connected directly to the doctor who answers your questions, who reads the intake. You list all of your symptoms. We go through an intake that's really guided and targeted around menopause, perimenopause. And we have a sort of formulary of solutions. We offer all of the different types of menopausal hormone treatment. We, when there is a commercially available option, that is what we offer. So FDA approved generic patch pill gel. We also have a branded estradiol spray.

So in different doses. We know that women are individuals. This care needs to be personalized. You know, there are lots of options. And not one size does not fit all, though it takes a bit of time.

Exactly. Precision medicine. I always talk about precision medicine and when it comes to mouth.

Yeah. And just, you know, like, we're living, breathing organisms that change. And so also, like, what may have worked for you yesterday may not work for you tomorrow. You know, it. Yeah. The interesting thing is that I never went through perimenopause. That's kind of the weird part, you know, so between Ann and me, also, like, we have really different experiences. She's still in perimenopause and, you know, and so that's another way that we're able to really relate to the women who come to alloyd, which is just.

Really nice in terms of covering the 50 states. Is it? I'm just asking for my own purpose. Do you have different doctors in different states that are licensed? We cover all 50 of them, yes.

Yeah. So we have multiple doctors, and most of our doctors have multiple state licenses so they can treat women who are, you know, you have to have a doctor who's licensed in your own personal state. Yeah. And so, you know, using technology, it's interesting. We were actually talking to Kelly Casperson recently, and she made a really good point, which is right now is kind of this really amazing time where the system is broken enough, the problem is big enough, and the technology is good enough to create what we've created, whereas, you know, in the past, like. Yeah, the timing wouldn't. The conversation is loud enough also that women are able to accept even the idea of being a menopause. And what we're trying to tell you is it's kind of great.

You know, you don't. You don't have to get your period anymore. You don't, you know, and deal with tampons and bleeding and all that stuff. But also, like, this time of life is really interesting because you have the decades of experience leading up to where you are right now, but you also have decades ahead of you to enjoy. And for most of us, either we've had children or we're beyond the point of wanting to have children or thinking that we're going to have children. So all of that stress and anxiety and just busyness is kind of abating, and it's a really great time to start thinking about yourself.

It's a me time. Like, what do I want to do with myself?

Yeah, exactly. Exactly. And take care of yourself. I was reflecting back in another conversation with somebody that, like, for so many years, I was definitely not the priority in my life. You know, like, my family was first, my kids were first, my husband, like, everybody else, came before I did. And there was a point in time, certainly now is it? But also as I needed to treat my own symptoms that I started to realize, like, I actually need to take care of myself or else I can't take care of everybody else because I don't have the space.

Yeah, absolutely. That's true self care. Right. I think getting yourself treated for your perimenopausal, menopausal symptoms is the first step to first care because I always say in midlife, we're juggling so much, right? Some people still have kids, they're kind of shuffling out the door. Some people have parents they're taking care of that are now in nursing homes because, hey, maybe or not a nurse, maybe they're actually taking care of them and they're the ones that, you know, didn't get the estrogen. Maybe I don't, you know, it's like a lot of stuff. And then you compound that with, like, people are going through divorces, people are having, you know, people that they love die in their life, you know, like, so much. And women bear that more than anyone else.

Right? Like, and we're supposed to keep everyone together. And how can we keep everyone together or manage all this when our life is in disarray because our hormones are in such flux and perimenopause, we've lost all of them in menopause. That it, you know, a head to, I always like estrogen receptors head to toe. Like, it's going to affect every human being. So, you know, I mean, there are the few people that slide through menopause and they're very lucky.

I know I ran into a friend last night. I ran into a friend last night who. Who I know is older than I am because I was a. We went to high school together, and I was a freshman when she was a senior. Her brother was in my class, and she said to me, she's like, wow, you look great. And how's the business going? Whatever. I said, it's great. She's like, God, it's really funny.

I'm not even in perimenopause yet. And I was like, Sarah, you are in perimenopause. I mean, you're 54 years old. Like, you may be still getting your period, but you are in perimenopause.

You're just not feeling.

You're lucky. You're really. How lucky for you that you're, you know, nothing. But I was like, are you sleeping? Yeah. Are you sleeping? She's like, well, not that much. I was like, okay.

Are your muscles aching? Yeah, but that's not. It is everything.

I mean, so people, I think having this conversation and getting sort of the word out that of all of the different symptoms that you may not associate with menopause or want to associate with menopause are a part of that transition. And what we've really tried to do is create something that is available and flexible for anybody, any woman in the United States, to get the care. And what we started with in our first year was really addressing the pain. Like, okay, hot flashes, the acute symptoms of menopause, like, how do we get women what they need for that? And then the second year of our business. And so now, obviously, we offer all kinds of different things, but was like, once you've solved the pain, then you have space in your mind, in your life to spark some joy, right? So what are the other things that you want to do? And I know you recently started using our. The m four, which is like. And it's funny because I never went through perimenopause, so I didn't have the ups and downs of the ravage on my skin, luckily. But when, I mean, I kind of discovered vaginal estrogen a couple of years ago when I accidentally induced genitourinary syndrome of menopause in myself.

Truly by accident, it had never been one of my symptoms. Also, as I said, like, everybody's different. So there's, you know, a whole cocktail of, or, you know, host of symptoms, like, hundred plus symptoms, and everybody will have their own special cocktail, like, what's affecting them, and who knows how you. How it affects the universe decides which you're gonna get. But, like, you're gonna get something.

Yeah.

And so vaginal dryness and pain and incontinence had never really been my personal symptom until I accidentally started. Got a prescription purely by accident, for half my normal dose. I had been taking a milligram of estrogen orally for eight years. And all of a sudden I was taking half a milligram. And after three months, I started peeing in my pants. Literally lost control of my bladder. I had all of the painful vaginal symptoms, really uncomfortable. Luckily, I have access to vaginal, vaginal.

I knew what it was, but although it took me a minute as well, it really took peeing in my pants to be like, oh, I know what's happening here. But the interesting thing was I was in the Netherlands at the time, so I didn't have my own alloy prescription for vaginal estrogen at that point because I hadn't needed it or thought I hadn't needed it. And it was kind of actually also before the whole conversation about vaginal estrogen and how important it is for preventive reasons. And so I just hadn't used it. And it was so it took me three different doctors in the Netherlands to get a prescription for it to the point that I literally walked into the last office and I said, I'm here for vaginal estrogen. If you're not going to give it to me, if you won't prescribe, then I'm going to walk. I'm not even going to say I'm going to walk out and I'm going to go to the next doctor.

It's interesting because I always thought, like, Europe was so much more progressive. But I see, like, as I get DM's from patients all over the world, and they're always like, well, we don't have this here, and how do I get this?

And the whi did worldwide damage, global damage, worldwide damage. I mean, the, the information that they use, that they base their prescribing guidelines on is from the WHI. And that's it. And so, you know, I've now, like, given out copies. I have a box of estrogen matters that I have in my house there that I give out to every doctor I go to. I've given it to. I told you that I had a, I've now since had a prophylactic double mastectomy in the last several months, because after doing this now for so many years and speaking to so many women who are dealing with menopause after breast cancer, and, you know, that's a whole other discussion, of course, of whether or not estrogen after breast cancer. And whatever you believe about it, it still is.

I could not for the life of me fathom going sort of into surgical menopause again and going through breast cancer treatment. And given that my risk as a BRCA carrier was about 80%, you know, unnuanced, who knows? There's no way to really sort of tailor that yet to, like, well, if you eat more broccoli or if you do more exercise or if you breastfed or, like, is there anything that.

Right. And I think it's important just to say that, you know, BRCA one and two do confer higher, like, sometimes depending on which one, up to 85% risk of breast cancer, you know, depending on which one, like, you know, 70 plus percent risk of ovarian cancer. And these are mutations that you carry genetically, right? So you don't have any, you know, control over them. And so just as a public service announcement, like, if you have, usually the guidelines are if you have two or more family members on the same side with breast cancer, any breast cancer family member, first or second degree that's less than age 50, that got breast cancer. So pre menopausal, or any first or second degree relevant with ovarian cancer, if you have any of that on your family history, then you qualify for most insurances covering you to get tested for a host of genetic mutations. And BRCO one and two are some of them, but there's like a check mutation, which might be like 60%. I can't remember offhand now, but I use the lab called myriad genetics and I don't work for them, but they're just a lab I use. And so they actually do offer like a panel of, like 30 plus mutations to screen from, and then they actually give you a lifetime risk.

And so as a general rule, if your lifetime risk is over 20%, you can choose to do what you want in terms of, like, breasts and stuff. But you should start getting mammograms and mris every six months for, at, starting after age 30, or the earliest age is 30. But some people, like, if they're a, if their family member got it once they were 35, maybe they would start, you know, a little bit younger. But mostly we start around age 30. And so some people then battle the fact that, like, for the next, you know, 50 years, I'm going to be doing breast exams, mammograms and mris every six months, like, so that also pushes them in one direction, especially if their risk is like upwards of 60, 70, 80%. Then they have these discussions about, is it better for me to then avoid these risks altogether and be risk aversive and take care of my breasts and ovarian risks by having surgical removal.

Yeah. So that's what happened to me. And I had all of those risk factors. As I said, my mother was 36, so I started getting screened when I was 25 and was having every six months mamosano MRI for 25 years.

I mean, that's a lot.

Yeah, it was a lot.

You talk about being a busy. I mean, self care goes out the window.

It was a lot. It was a lot to manage. And also, as I said, like, because neither my mother nor my grandmother died from it, and it was, having a mastectomy is cosmetic. You know, it's a bigger surgery. And I've now had two surgeries. Like, I just, I didn't, I didn't want to do it. So it took ten years between my ovarian surgery and my breast surgery, but now I've done it, I'm happy that I've done it. And my risk was greater than 80% lifetime.

So there was, I was more likely to get it than not.

Right. But I think we're talking about just how, you know, all of this affected back up. We were talking about, you know, when you talked to Ann about it and how you guys decided to move forward with this.

Oh, I was talking about m four. I was talking about my vaginal, my vaginal symptoms. And so I used, I used vaginal cream. I finally got the prescription, and then I, of course, got some through alloy as well. So I have multiple tubes. Sometimes I give it out as a 50th birthday present to my friends. I'm like, here, this is what you need, because I have extra. But it was so effective so fast, and it cured my incontinence.

I never peed in my pants again. And it got rid of all of the sort of painful dryness and itchy burning symptoms that I was experiencing painful sex, that I was like, this is so amazing. I'm going to put it on my face and see what happens, because I understood the science also, like, what it's doing for your skin, it's hydrating your cells, it's creating collagen, it's improving elasticity, it's plumping, thickening the skin so that it doesn't tear and burn. So. And the results of using the vaginal cream on my face were so fantastic, although the vaginal cream wasn't a nice cream. And I thought, well, why don't women have access to this? Why do we not know that? And why is this not available? This is hiding in plain sight. We should actually be using topical estrogen on other areas besides our vaginas. And so we innovate the alloys m four cream, and we work with a compounding pharmacy to make it.

And we actually use estriol because that was the type of estrogen that was in the vaginal cream that I got in Europe. So things are different. But, you know, estriol isn't usually. So it is sort of thought to be less potent. There's not as much information about it, but it is the type of estrogen that soars when you're pregnant. And so you think about why women look amazing and vibrant and radiant when they're pregnant. Frequently, it has a lot to do with the estriol. So anyway, in the meantime, as you know, we launched it.

We've been selling it to great effect. It's been a huge seller for the last year and a half. But there were a lot of people who were like, estriol. What's that? Or why are you better than estradiol? Why are you using this? You know, are you sure it's safe? Are you sure it's non systemic?

Yeah. There was a lot of buzz on social media.

A lot of us. A lot of buzz.

A lot, actually, you know, last year, they actually had Ellen, Doctor Ellen Gentler, at the menopause society meeting. And so she spoke about it. And that's actually after that, I compounded estriol, you know, for myself until I realized was available. I didn't have an idea at that time.

So Ellen is actually now an alloy medical advisor, and we were in big contact with her before the NAMS meeting that she attended because we had reached out to her. Somebody had put us in contact with her because they were her patient and knew that she used her estrogen cream, her vaginal cream, like her primering cream, under her eyes for 25 years. And so we were like, let, you know, let's. We reached out to her and we have a great relationship with her and are happy that she's, you know, that she's sort of on the train of telling people that this is really good for your skin, you know, and something that can be helpful.

Yeah, she had some great before and afters that she shared with us in menopause.

Yeah. And so. But one of the things that we did, which I'm really excited about was, you know, in order to be able to really be confident about the information that we're imparting. We did a double blind, placebo controlled, three armed study comparing estradiol to estriol and how it works topically on the face. And the interesting thing is that they are broadly similar. Like, the effects of estradiol and estradiol topically are not that great in some, but both had really statistically significant improvements in hydration, in elasticity and collagen, and just general overall radiance. Overall skin health, like, 68% improvement in skin. Skin health versus a placebo, 88% improvement in hydration.

Like, this is an important tool for your face and. And something that. Or your skin generally. And, you know, instead of just being told the same way that women are frequently dismissed and told, like, oh, just use lube instead of actually using vaginal estrogen. Like, it's not going to solve the problem.

So actually treat the problem. This is not the band aid.

Yeah, right. And so, like, moisturizers are helpful, but they're not going to solve the issue that estrogen loss causes in your skin. And so we, you know, this is all sort of part of our, like, joy sparking move now that it's not just about, like, hoblashes.

We'll do our own. We'll do our own research.

Yeah, exactly. Like, we, you know, we're sort of tired of people saying, like, oh, there's not enough research, and so, therefore, we don't know, and we're not going to give you the help or the treatment that you deserve. That's hiding in plain sight. So we're doing a lot more research on things like that. We also. Yeah, we also offer topical sildenafil, which, you know, is the generic Niagara for women. Another thing that, like, why. Why shouldn't women get access to something that men have had for 25 years? The clitoris and the penis are basically the same organ.

Right. Like, every other medication that we take has been tested on men.

Exactly.

Why all of a sudden this one that, you know, that, like, is the. Is only really for pleasure enhancement. I mean, sensitivity enhancement. Like, there's nothing. It's only a sort of sex tool. But. But, oh, no, that's not something that we should have for women or offer, you know, so, like, all these things were really.

There's actually an sildenafil cream, actually, that's being tested by a pharmaceutical group. Yeah, as well.

Exactly.

Female arousal disorder. But it's true. Like, you know, bringing blood flow to the area, opening up, you know, that's what arousal is, is engorgement. So, you know, if applying sildenafil, which actually just vasodilates the area, you know, if applying that to the clitoris and the clitoris not just being what you see, but behind the labia, you know, the crua kind of sit right behind there. So a lot of erratic, you know, tissue that gets engorged. So why not apply it to that area and see? And a lot of patients get very good results from that.

Yeah. And there's. There are no contraindications. It's basically good for anybody. You know, it's. Or it may not help. Again, back to, like, libido is complicated, and, you know, it's not going to solve your relationship if you're having, you know, marital problems or whatever, but it may help you feel better. And.

And everybody has their own. Everybody's an individual. So, you know, it's. It's a tool. It may help. It may not work for you.

But, yeah, we can't extract to the husband or the partner from your situation, which is like, the biopsychosocial approach to. But, like, you know, if it's a biologic component, you know, and I always.

Tell women, like, try it yourself first. Don't try it first with, you know, in a situation with a partner where. And don't tell them, especially if it's the first time, because then there's all that added pressure of, like, this has to be perfect or that, you know, so, you know, I think.

Right.

The thing that we're having the most fun with is really being able to talk to women directly and have these types of conversations and use our experience and, you know, just sort of all the things that we've learned and from. From talking to people like you and other great doctors like Corinne, men and Mary Claire and, you know, Kelly and all. Everybody. Rachel Rubin, like, there's.

And Sharon Malone I had on my podcast is wonderful.

Sharon, of course, Sharon Malone, who, our chief medical advisor. How could I forget her? She's the best. You know, we've had such an amazing time having. I mean, Sharon really single handedly is the person who turned my life around and gave me the confidence to know what was going on with me, to, you know, feel confident in what I was doing to help parse, like, what are the important things about menopausal hormone treatment? Or what's the noise? You know, up until that point, I was really trying to start for five years, I was trying to figure it out for myself. And then when I met Anne, we were kind of, you know, what we knew was that also after having Ann actually went to go hear Avram blooming speak in 2020 before the pandemic, and she came back, and we had had this, a lot of discussions about estrogen up until that point. He's amazing. He is.

He's one of the authors of estrogen matters. For those of you who don't know him, but him and Carol aren't Tavros.

Tavris. Yeah. He's like a national treasure. And she came back from hearing him speak. And up until that point, she actually had thought that estrogen had given her mother breast cancer, and her mother actually ended up dying of heart disease after being taken off of her hormones. And Ann was like, well, the one thing we know is that the only thing that really works is estrogen. And up until that point, we had been thinking, like, how do we solve this without going into pharmaceuticals? And we realized if you're not talking to women about estrogen at this time of their lives, you're just doing them an absolute disservice. And that's what really back to your original question, like, what motivated us to start alloy and to do what we're doing? It was like we sort of started peeling away the onion.

I had my experience. I was patient zero. I understood the. The profound impact that taking estrogen had had on my own personal life. And luckily, we had investors who were supportive of us kind of going in this direction. But we realized, like, women are starved for good information. They have no access to this expertise. No matter where they live, how much money they have, what color their skin is, who they are, it doesn't matter.

They cannot access it. And the solution that is so safe and so protective and is really going to solve the problems that they're experiencing today has been incorrectly maligned and poisoned by the, you know, the medical community or the powers that be. And so all of that really just needs to change. And the conversation, the narrative arounds it.

Like Rachel Rubin says, it's like the worst pr in awful, worst awful.

And so that's where we were like, well, but we're, you know, we're good at PR. I actually had worked in PR and was the editor in chief of a national women's magazine. Like, we can change the story, and that's what we're going to do, and that is what we've, you know, I think, been instrumental in doing and what we're having such a good time at.

Yeah, and I think it's really the perfect storm of activities because I feel like, you know, pre pandemic, you know, televised telemedicine wasn't as an accepted platform because, you know, you just didn't know. Can you get. And obviously, like, you know, you still have to get your vulva examine and you still have to, you know, so it's not like alloy's trying to replace it. When I talked to Cory and she's always like, we know it's not like Aloe's trying to replace, but if you can't find someone and you want this, we can work with whoever you're working with at this juncture to try to make sure that you're getting the correct care that you need.

Exactly. Yeah, of course, there is still a need for a regular physical exam, and if something is acute, then you need to get that checked out. But, for example, when women have heart palpitations or start experiencing all these symptoms to tell them to go down the path of, like, well, before you start taking hormones, you should get a cardiac workup and you should get all this testing, which becomes really expensive, really time consuming, and very, very anxiety inducing. Whereas actually, if you're between 45 and 60 and you're experiencing these symptoms, the order of operations should be try hormone therapy. If you're still having palpitations and, you know, and these symptoms have not abated after also adjusting the dose or form factor within the first three to five months, then. Then at least you have that information, you know, that maybe it's not hormonally induced. It's not, you know, and so unless.

You have, like, a strong family history where people are dropping dead in their forties or fifties because of their cardiovascular disease.

Exactly.

But, like, I think that, you know, some of those things are nuanced.

Very nuanced. And also doesn't mean, therefore, that you shouldn't also start hormone therapy. Like, you could do both at the same time.

You could do both at the same time.

You could do both at the same time. Especially because you're probably going to have to wait about eight months to get that cardiac workup. And I keep saying workout. And also, like, if you have that kind of personal history, family history, the likelihood is that you're being followed. I mean, hopefully you're being followed by that, you know, if you have that point. Exactly. Exactly. So, always important to understand.

Well, I think what you guys have done is really wonderful. You know, given the amount of patients going through, women going through perimenopause and menopause in this country alone worldwide, obviously, you know, it's kind of crazy that we can't access more, but because I like I said, I get DM's all the time from people in other countries. Like, what do I do? And I've actually worked with some people in different countries. And she's like, I have a. I come there once a year. Can you? And I'm like, yeah, let's talk about it. So, you know, just trying to get it out there, but I feel like what you guys done is really remarkable. And, you know, there's a lot of platforms out there, but, you know, I think that when it comes to, like, evidence based medicine and really, you know, getting the word out of, you guys have done a wonderful.

We're the only ones also who only have doctors prescribing, and I think 99% of them are ob gyns who have decades of experience working with women in this life stage. So, you know, that is a differentiator and something that's important to us.

And you're very intentional about that, I think.

Yeah, yeah, for sure.

Yeah. Well, thank you so much, Monica. It's been a pleasure. I love what you guys are doing. I wish you all the best in a trajectory that'll affect more women across the country, because that's what we need. And, you know, as always, I'm here to educate so you could advocate for yourself. So now you know what's available. If you don't have a provider or clinician that is listening to you or that you feel like you possibly are a candidate for hormone therapy and you're not getting that help, you know, check out alloy's platform again.

You still, you know, if you need to get your exams done, all that stuff, probably need to see your clinician, but at least they can bridge a gap for you for sure, so that you can do that, because I feel like a lot of. From a clinical, I always feel like a lot of clinicians get a little, you know, they get a little, like, worried when they see all these, and I'm like, they're not substituting you. They're just, you know, giving people access.

Well, the other thing is, if you do have a great clinician who is providing you with hormone therapy, she most likely, or he is most likely not giving you access to topical estrogen for your face, to topical sildenafil for your. For your vulva, to oral low dose oral minoxidil dosed for women for your hair thinning. Like, there are other things also that women want and are looking for and just can't access that are there and are safe but are really hiding in plain sight. And I think we're trying to close that wonderful and give women what their I, what they're looking for and what's going to improve their quality of life and their sense of self and their, you know, prepare them for this for the next 50 years because there's a lot of life left to live. So let's do it. Let's make the rest of your life the best of your life is kind of what I like to say.

Absolutely. I love it. The rest of your life. The rest of your life. Great way to end. So again, I'm doctor Samirman. Gyno girl. Thank you for tuning into gyne girl presents sex, drugs and hormones.

As always, I'm here to educate so you could advocate. Please tune in next week for another episode. Thank you. If you have a second, please subscribe to this podcast. I'd love for you to be a follower and learn as much as you can about the things that we're going to talk about with all the people on our journey. Please review us on Apple or Spotify or wherever you listen to podcasts. These reviews really help review us comment tell me what else you want to hear to get more information. My practice website is www.cgccago.com.

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