Monica Molenaar of Alloy on the Life-Changing Magic of HRT and Why We All Should Be Estrogen Activists
Show Snapshot:
Going into surgical menopause overnight at 40 wreaked havoc with Monica Molenaar’s health, well-being, and marriage. Hormone replacement therapy (HRT) restored her equilibrium and overall wellness.
Now, Monica is an “estrogen activist” working to offer menopause solutions, resources, and community to women in peri, menopause, and beyond as a co-founder of women’s telehealth and pharmacy platform Alloy.
We talk hormones, breast cancer, why menopause is inevitable, but suffering is optional, and how to build a menopause support team.
Bonus! Monica shares snippets of her expat life, and how a lifelong New Yorker came to find herself launching a company (while tending a garden) in The Netherlands.
In This Episode We Cover:
Monica’s journey into surgical menopause at 40.
The swirl of misinformation around menopause, HRT, and breast cancer.
The life-changing magic of HRT.
Estradiol, progesterone, HRT, MHT, vaginal estrogen—what to ask your doctor and why.
How Alloy’s telehealth and pharmacy platform works.
Why we should all be estrogen activists.
Monica’s struggle with hormone-related urinary incontinence.
How HRT can help with depression, anxiety, and mood instability (aka toxic rage).
The taboo of menopause and the power of bringing “sunshine” to spotlight hidden (and embarrassing) symptoms.
Show Links:
Follow Monica:
Quotable:
I didn’t sleep through the night for 6 months, I gained 20 pounds, and I was kind of on the brink of divorce…Finally, one day, a neighbor across the hall caught sight of me, and said, ‘Monica, are you okay? What’s going on? You look terrible.’ And I just broke down I was like, ‘I’m in menopause,I don’t know what to do.’”
Transcript:
Katie Fogarty [0:04]:
Welcome to A Certain Age, a show for women who are unafraid to age out loud. For many of us, menopause is like midlife, something that sneaks up on you slowly, then all at once. Suddenly, you’re experiencing WTF symptoms like mood swings, dry vagina, low libido, brain fog, and more... Good times. Other women experience menopause suddenly when surgery or illness thrust them into it overnight.
My guest today, Monica Molenaar, went into surgical menopause at age 40 and very quickly realized that women get next to no support in tackling the roller coaster of menopause symptoms. Now, she is the co-founder of Alloy Health, which brings menopause solutions and healthcare resources to help women navigate menopause and beyond. She is a serial entrepreneur, a mother of two, and a recent transplant from New York to the Netherlands. She joins me today to talk about reinvention, women’s health, and why we all deserve better menopause solutions and care. Welcome, Monica.
Monica Molenaar [1:04]:
Thank you, it’s so great to be here.
Katie [1:06]:
I am very excited for this conversation. Regular listeners of the show know that A Certain Age is all about sharing stories the stories of women who are making the most of midlife, launching businesses, and creative projects, and pivoting their lives in new and exciting ways. But the show also features women helping other women thrive in midlife and you check all of those boxes. You’ve switched career lanes in midlife, you moved your family abroad, and these are major pivots. I’m dying to learn about your move and living abroad, and entrepreneurship but I really do want to have you kick off by sharing the story of the health crisis that put you on your current path as the cofounder of Alloy Health.
Monica [1:47]:
Sure. So, my mother had breast cancer twice and my grandmother had breast cancer twice. So, for my entire life, basically, since I was 25 because my mother’s first breast cancer incident was when she was 36, so the protocol when you have a mother who has had breast cancer so young is to generally start screening about 10 years prior to her age. So, I was 25 when I started getting screened twice a year; mammograms, sonograms, MRIs, everything that you could possibly do, I was doing. And I never really lived in fear of breast cancer it was just something that I kind of had to do and was part of my protocol. But I felt like I was screening really well, I live a pretty healthy lifestyle, I exercise and eat well, and all those things. So, I kind of was doing everything that I could do for myself. A lot of times, my doctors would encourage me to do something surgical, but I was so young, and I hadn’t had children yet and so I really wasn’t interested in that conversation, I just went through with all the screening that I possible could and figured I would deal with something else later on.
When I was 39, I had two kids, I had pretty much decided not to have another child, and actually, it was around the time that Angelina Jolie wrote her op-ed about her own journey being BRCA positive and the different things that she was doing. And what was interesting around that time was that there was just a lot of information and other tangential articles that were coming out around her big announcement. And one of them I read, there was a line that caught my attention which said that if you’re BRCA positive, and you have your ovaries removed by the time you’re 40, you further reduce your risk of breast cancer by 50%. And you know, that struck me. I thought, okay, I’m not having any more children, it’s a non-cosmetic surgery, it eliminates my risk of ovarian cancer which you really can’t screen for as well as you can breast cancer, so I’m going to go for that and take my chances on the breast cancer.
So, I decided to do that, I had my surgery at Sloan Kettering, and I thought I was in pretty good shape, and then what I discovered the day after is that I was pretty much deleted from the system. The doctors kind of wiped their hands of me, because they had prevented the breast cancer, they prevented ovarian cancer. But literally, nobody talked to me about the menopause that I was now in that I was really unprepared for. And I had actually asked the surgeon at Sloan Kettering, should I take hormones? And he said, “Yes you should, you’re so young, you need it to protect your bones, your brain, and your heart. But you’ll still have some circulating estrogen in your system for a while and so, just get a prescription when you feel that you need it.” He didn’t send me packing with a prescription for estrogen and say, "Take it today. "
So, you know, I was just 40, I had two small children, and at the time I actually was home with them, not working, and who the hell knows when you need it, right? [Katie laughs] I didn’t have hot flashes, but I didn’t sleep through the night for 6 months, and I gained 20 pounds, and I was kind of on the brink of divorce. It was a rough time, but I was just living my life, I didn’t realize exactly what was going on and nobody was really talking to me about it. Until, finally, one day, a neighbor across the hall kind of caught sight of me, she’s 15 years older and she said, “Monica, are you okay? What’s going on? You look terrible.” And I just broke down. I was like, “I’m in menopause. I don’t know what to do.” My OB also had said you shouldn’t take it because you’re BRCA positive, you shouldn’t have hormones, blah blah blah. I just sort of entered this swirl of misinformation and kind of lack of information around menopause. So, this neighbor of mine-
Katie [6:03]:
And you know, menopause is so- It sounds like she stepped in. Tell me what she said next. Did she give you something besides, "Monica, you look terrible.” Was that followed by something helpful? [laughs]
Monica [6:14]:
Yeah, yeah. She put her arm around me and said, “I’ll take care of you, I have somebody who can help,” and she sent me to her menopause specialist who was a wonderful woman and sat down and listened to everything that I said and was like, “You need estrogen, you need hormone replacement therapy immediately. Don’t even go home before you go pick this up.” The problem was that this practitioner prescribed me compounded hormones which were very expensive, I had to send away for them, and I didn’t quite know what I was getting in terms of the dose. My OB and the doctors at Sloan Kettering said, don’t take compounded hormones, so I didn’t really know what I was doing, but it worked. I mean, the first night I took estrogen and progesterone, I slept through the night, literally, the first night in 6 months. I mean, I was hooked, I was like, obviously this is what I need.
Katie [7:09]:
That’s such a dramatic story, and you’re so fortunate that you had somebody that recognized that you were struggling and then put you into the care of a practitioner who was able to be helpful.
I’ve heard you, Monica, refer to yourself as an estrogen activist, which I absolutely love. Talk to me about the role of advocacy and solutions that you are now offering through your business and why it’s important to champion estrogen to a wider audience.
Monica [7:43]:
It’s so critical. So, basically, what my partner and I realized when we started... I mean, I reached out to my partner, I met her socially about 4 years ago, and at the time she was the editor and chief of Marie Claire magazine. We were on a summer vacation with our families, and when we got back to the city afterward, I reached out to her because I said, women just don’t have enough information about this whole menopause business. We need to educate women and get them to understand what’s going on and she, rightly so at the time, said that it’s very difficult to monetize, to create a business around content and she had a big job at a big publisher so we had to kind of figure out how we were going to move forward and actually create something that could support us.
So, we spent a few months really trying to figure it out. We actually, by sheer luck, got some investors before we even had an idea and we set about sort of researching...we really didn’t think we could go into Telehealth, or pharmacy, or do anything with pharmaceuticals because it just was such a heavy lift. So, we were trying to figure out, what are the supplements have been studied, that women could really benefit from? Even though of course, my life was literally turned around by HRT, and I would not have been able to start my last business, for example, or become an entrepreneur if I hadn’t been able to get a good night’s sleep or get my cognitive function back up to normal, et cetera. So, I was already an advocate for estrogen, but from a business perspective, really didn’t think that that was something that was manageable or would be manageable for us.
Katie [9:34]:
But you’ve done it. You offer prescription products like estradiol and progesterone, and if I’m mispronouncing any of these, please step in and help me out. So, talk to us about that. What is it that Alloy offers and why is it important to do it through telehealth versus having a woman ask just their local hometown doctor for this stuff?
Monica [9:58]:
So, the more we researched the more we realized that not enough women are being talked to about estrogen and if you’re not talking to women in this phase in life about estrogen then you’re just really doing them a disservice. Basically, what happened was, 20 years ago... You know, estrogen was given to women since the ‘40s, and women who were taking estrogen replacement post-menopause were found to have a much lower risk of cardiovascular disease, much lower incidence of osteoporosis, much lower incidence of Alzheimer’s and dementia, and so they did this huge longitudinal study that I mean, to this day I still don’t understand exactly how the results were sort of, disseminated the way that they were because from the get-go, they were not only misunderstood, but they weren’t reported accurately at all. Even in that study, the women who took estrogen alone had a lower incidence of breast cancer.
So, you know, there’s really never been a problem with estrogen, it’s something that is like, it is the thing that makes our bodies function. There are estrogen receptors in pretty much every cell of our body, so when you go through menopause, and you lose the estrogen, it makes sense that your skin starts to age, your brain stops functioning properly, your joints start to ache because your body isn’t producing the collagen that lubricates the joints, and your cells, and everything. So, it all makes sense once you understand it.
So, we basically were like, we just aren’t going to be authentic if we are starting a business that isn’t actually just talking about estrogen first and getting women to access back to the super important, very inexpensive, widely available, generic hormone that’s out there that we all need. So, we set up this Telehealth and pharmacy platform to democratize access to this important healthcare. We’re national, so from day one we’ve been in 50 states plus DC, and we have a very simplified, easy medical intake that really just gets to the heart of the matter. If there are any contraindications or any reasons, and honestly there are very few, why you wouldn’t be a good candidate for estrogen, we suss that out very fast, and we make it convenient and inexpensive for women to get a prescription.
Katie [12:43]:
So important. Monica, we’re heading into a quick break, when we come back, I want you to explain to us exactly how that telehealth visit works and how much it costs and how women who are listening can access it. We’ll be back after this break.
[Ad Break]
Katie [14:14]:
Monica, we’re back. When we headed into it, you talked about democratizing access, making it easy and inexpensive for women across all 50 states to access telehealth that’s going to connect them to menopause resources. How do your visits work, and how much do they cost?
Monica [14:30]:
So, our visits are done asynchronously. It’s the way that we can actually scale the doctor expertise across a wide, giant group of women. That means that it’s all done through messaging and texting, so you don’t have to be sitting in front of a screen at a specific time to have a 10-minute visit with a provider. That works, I think, really well for women because they can really access this healthcare whenever it works for them, and it also works well for the providers because it’s the same, and they don’t have no-shows, and they can also do it on their own time. So, it’s a really efficient way to work. What we discovered is that about 80% of women have moderate to severe enough symptoms that drive them to go seek help, and only 6% of them actually get a prescription.
Katie [15:27]:
And that’s from their local doctors at home?
Monica [15:29]:
From their local doctor, yeah.
Katie [15:32]:
And why is that?
Monica [15:32]:
So, unfortunately, doctors aren’t educated about menopause in medical school and what they are educated about is, or they are taught in medical school that you should prescribe hormones, that estrogen gives you breast cancer. So, it’s a really, it’s a travesty, and the data, the research, the evidence is unequivocal that that is untrue. Anybody who knows, the North American Menopause Society, the American College of Obstetricians and Gynecologists, and the major medical institutions all have recognized that estrogen does not cause breast cancer and is really safe and effective for most women. There’s a lot more research about estrogen use in women who have even had breast cancer and how helpful it can be for them also to prevent osteoporosis and all the other symptoms that we all experience.
So, basically what happens is you come to Alloy, you do a very quick medical intake, and we’ve introduced a couple of other really cool products also for women, each of them has their own medical intake, which takes 3 to 5 minutes. The information then gets sent over to one of the doctors, and we have expert menopause practitioners, one of our doctors who I think you met at our event last night, has literally been in menopause three times, twice in surgical menopause and once in natural menopause. So, she’s really empathic, she understands, she’s an OB/GYN, and she had breast cancer.
Katie [17:12]:
And these are all board-certified doctors, I noticed on your website.
Monica [17:15]:
Yes, all board-certified OB/GYNs with years, decades of experience treating women with menopause, which is really important. So, this is something that most people don’t understand, but OB/GYNs are really trained in OB and surgery. So, they’re there to deliver babies, and menopause has been considered a phase of life and not a pathology, not something that needs to be treated. You need to listen to women and understand what their symptoms are and what they’re going through, the solutions, generally, are pretty simple. Still, it’s important to understand where a woman is in her symptomatology and just in her life. Is she most concerned about libido and sexual function? Is she having debilitating brain fog? Is she having vaginal dryness and painful sex and incontinence, like I had, actually?
Katie [18:13]:
Wait, where’s D, all of the above? [laughs]
Monica [18:16]:
No, and most women actually do have all of these things. You don’t get to it in a 10-minute visit with an OB who has not focused on these symptoms anyway because he or she is generally trying to get you out the door but also doesn’t see menopause. It’s not a lucrative thing for them, it’s not a procedure-based phase of life or issue. So, doctors just...
Katie [18:44]:
Monica, you’ve really put your finger on something when you said that women don’t necessarily understand that the gynecologist that they’re seeing doesn’t always have training in menopause and really is more focused on the earlier phases of a woman’s reproductive cycle. I only learned that myself by launching this podcast. I was literally stunned to discover the percentage of gynecologists in the US that are trained in menopause care. It is minute. And so, for anyone who is listening to this who is thinking, I’m in the hands of a doctor that I really like, and they’re obviously taking care of me the way that I expect they might, it is an unwelcome surprise to learn that a lot of our doctors don’t know enough about how this complex interplay of estrogen across all of our systems gets impacted and we’re not really given the care that we deserve.
Monica [19:41]:
We hear day in and day out from women who are just getting dismissed by their doctors. And frankly, the North American Menopause Society has a certification program for practitioners and practitioners can include MDs. It can include nurse practitioners, pharmacists, and anyone who is licensed to deliver sort of medical care or information. So, it’s not only doctors who get the certification from the North American Menopause Society. Today, there are only 1,000 of these practitioners. Which again, includes pharmacists who aren’t going to be prescribing to you but at least there are some pharmacists that will understand. There are 55 million women in menopause in the United States today, so 1,000 practitioners, not all of whom can actually see you and prescribe, is not enough to care for 55 million women.
Katie [20:32]:
It’s astonishing and enraging. [laughs]
Monica [20:36]:
Yeah, that’s why I’ve become an activist.
Katie [20:38]:
Of course, when you said estrogen activist, I was like, "We need more of them,” because we should be clanging the bell and sounding the alarm.
Monica, when I was on your website, I jotted down something that you said that really jumped out at me. The website says, "Menopause is inevitable, but suffering is optional.” So, I would love it if you could walk through our listeners, what it is that gets offered after this telehealth, and what are some of the solutions that you’re bringing to the equation.
Monica [21:11]:
Okay, so we started out with menopausal hormone treatment which is estrogen and progesterone, it comes in different form factors and it’s all bioidentical, but they’re bioidentical FDA-approved.
Katie [21:27]:
And tell us what bioidentical is for people who are like, what the heck? [laughs]
Monica [21:31]:
Bioidentical means that the molecule of estrogen and the molecule of progesterone are exact to what your body makes naturally. There are three types of estrogen: estradiol, estriol, and estrone. The ovaries predominantly make estradiol, and that is what this bioidentical molecule is. It’s exact. Versus a synthetic... Since the ‘40s, I think there’s been a brand that was made by Wyeth and then purchased by Pfizer called Premarin. It stands for pregnant mare urine. It’s a conjugated equine estrogen, which means it’s horse estrogen. It was very popular. only Pfizer makes it because they actually have to maintain a farm of pregnant horses, but it’s–
Katie [22:25]:
This is like something out of a novel. I told this to my husband last night, and he instantly hit Google. He was like, “Pregnant horses?” And I’m like, yeah, that’s a thing. And he didn’t believe me until he googled it and learned. So, that does work, but not everyone...
Monica [22:43]:
It does work, but it’s not exactly what your body makes.
Katie [22:46]:
Sure, I’m not a pregnant horse.
Monica [22:48]:
I’ve tried everything. I’ve literally tried... I mean in the last eight years, let’s say the first five years, I tried everything. I tried compounded hormones. I tried the patch, the pill, pellets, I mean, I had literally pellets injected in my hip. At one point, I had so much testosterone accidentally from a pellet – don’t use pellets – that I was practically a man. The next doctor I went to because I was a little bit alarmed. I was like, I’m not sure what I’m doing here, but I’m just trying anything I can to feel better, and she, this new doctor, took my blood just to see where I was, and I was off the charts on testosterone. So, some testosterone is good, too much is terrible It can cause irreversible changes in your voice, the size of your clitoris, and your hair growth. So, you do have to be careful with testosterone, but estrogen is a different story.
You know, but still with the compounds, and the pellets, and stuff, you don’t know what you’re getting, it’s not safe, which is why we really, really, really recommend, as does the North American Menopause Society and others to use FDA approved generic or branded, but you know, we sell generic estrogen and progesterone. And it works like a charm. But everybody is a little different, so there are different doses, and there are different form factors, as I said. For me, I didn’t really like the patch because I was 40 years old, it was sort of a visual reminder, and I didn’t like the way that it felt on my skin. So, I took an oral estrogen, and that was great.
So, we offer all these different forms and different doses depending on... So, if you start out at one and it feels like it’s not enough and your symptoms aren’t resolving, we can go up and we have, as part of the service, unlimited free messaging with a doctor for the year duration of your prescription, so it’s sort of a subscription prescription. We ship three months at a time, and you can always access your doctor on your time, whenever you want, through your portal, through the dashboard, and send them a message, and they’ll get back to you within minutes
Katie [25:06]:
And how much does this initial doctor’s visit cost?
Monica [25:11]:
So, the initial doctor visit doesn’t cost anything, although we have introduced an option–
Katie [25:16]:
Free is good. We like free. [laughs]
Monica [25:17]:
Yeah, where you can. For $30 you can have an initial visit, and a text back and forth with a doctor for a few days before deciding on a prescription. So, if you have questions or you have specifics to you that you want to just iron out with the doctor, you can take advantage of that for a really low fee, and then they can, from there, write the correct prescription, and it gets sent to our pharmacy and then gets shipped directly to your door.
What we also know from being women in this life phase ourselves is that nobody needs another job, so we’re really trying to make it as easy, seamless, and painless as possible. For perimenopausal women, we also offer birth control, oral birth control, because what a lot of women don’t realize is when you’re perimenopausal, which is the 7 to 10 years leading up to the cessation of periods, so basically menopause is technically defined as probably most people know, or maybe they don’t, as 12 months since your last period. So, if you haven’t menstruated in 12 months, you are officially considered in menopause. But for the 10 to, you know, for some women, 15 years prior to that, their periods start to change, their moods start to change, their cognitive function might start to change, so you might feel more forgetful or have some brain fog, or your skin starts to...
Katie [26:45]:
Or angry, or very, very angry. [laughs]
Monica [26:48]:
Yeah. The rage is real.
Katie [26:51]:
The rage is very real. My very first show was on toxic rage, and I joked that that was my hot flash because I never had a physical hot flash, but I would have bouts of volcanic fury, and it was scary.
Monica [27:03]:
It is scary. A lot of women have this sense of doom also, like an impending sense of doom that all of a sudden, they feel so anxious, and it’s really new and very debilitating. We’ve spoken to women who have had to quit their jobs because they got too anxious to drive or to drive over bridges. One woman, her husband had to start driving her to work, and then she eventually quit, and it’s terrible.
Katie [27:28]:
It’s terrible. And I love that you brought this up because Monica alluded to it earlier, I got to attend a kind of an evening of conversation about taboo topics and to learn more about Alloy, and your very wonderful medical doctor shared that hormone replacement therapy or what’s now being called MHT, menopause...
Monica [27:50]:
Hormone treatment.
Katie [27:52]:
MHT, menopause hormone treatment, can help women who have a history of depression which gets exacerbated by menopause. It can help put a floor under them and support the antidepressants that they’re taking and to make them more effective. But for women who have onset anxiety and depression in menopause, who never experienced it earlier, sometimes simply taking MHT can be all that’s needed and that, you know, your doctor who might be interested in prescribing you an SSRI, that might not be needed. So, I thought that was fascinating. We have a rise in depression and anxiety, the last few years that we’ve all lived through probably haven’t helped, and you know, for women who are experiencing any of these symptoms that Monica just talked about, depression, this sense of doom, I think it’s absolutely worth having a conversation with either an Alloy doctor or your own to figure out, can hormone treatment make a difference?
Monica [28:52]:
Well, the interesting thing is that it’s so safe and it’s so effective that you can try it and see if it works as a first line of defense, and then if it doesn’t work, then at least you know that there’s something else that you need to treat. But it’s not given enough as a first-line defense the way actually that SSRIs are. Our age group, so between 45 and 55, we are the most prescribed demographic for antidepressants and anti-anxiety medications. There are millions of women in our age group who are using this who are not being given or even talked to about hormones, and it’s just, it’s an easier prescription, an easier fix for OBs to write. They understand it. But it doesn’t work for every woman, or certainly isn’t optimal because if you’re not dealing with the hormonal change and propping that up, then you’re not actually treating the root problem.
And the root problem, the only difference between being in menopause and not being in menopause is the production of estrogen. It’s the only difference between young and old skin is the loss of estrogen, so that’s actually something that I’m so excited about that we just introduced. I think I mentioned earlier that at one point, I became incontinent. I had never actually had vaginal symptoms, which are a big thing in menopause. 80% of women actually at some point in menopause actually will have vaginal symptoms, which means dryness, painful sex, tearing, burning, itching, frequent UTIs, and incontinence. So, when we started Alloy, I became a customer of course, but as you mentioned, I live in the Netherlands, so I have a local prescription there, but I also get my prescription from Alloy. So, I’m flooded with hormones, and I just take whatever is in front of me, essentially. And our starting dose, which was kind of adhering to an older protocol from NAMS, the North American Menopause Society, to take the lowest dose for the shortest amount of time necessary, which has thankfully changed, that’s not what’s recommended, you now can and should take the dose that solves your symptoms for as long as you want to. I will take this for the rest of my life because it’s so important to my overall health and well-being. So, that’s a really important point.
But in any case, our starting dose was half a milligram of estrogen, and for the last 8 years, I’ve been taking a milligram of estrogen every day. So accidentally, just because I was busy and I didn’t think about it, and I took what was in front of me, I starved myself of estrogen for three months and literally started peeing in my pants. Like, not just a tinkle, like empty bladder, pee in my shoes in the parking lot of the supermarket, and it was terrible. As soon as I felt like I had to pee, I peed. So, I didn’t even have to go to the bathroom anymore I was just like, okay, I’m going to drive home in my wet pants. Obviously not something I was willing to live with. I wasn’t going to get a diaper. I’m 48 years old; I have many more years to live, so I’m not going to start peeing in my pants now and keep it that way. So, I was in the Netherlands. I got a prescription for vaginal estrogen cream there. They use a form of estrogen called estriol. Here we have vaginal estradiol. It’s basically the same, well, does the same trick. I started using it, and within a few days, I felt much better, the painful sex and dryness and sort of lack of lubrication went away so I was kind of back to normal, and I stopped peeing in my pants which was awesome.
Katie [32:50]:
You know, I’m so happy that you’re sharing this story, and I’m so sorry that you went through that phase of suffering because the conversation around the changes that happen to women, the conversations that people are maybe embarrassed to have, need sunshine.
Monica [33:07]:
Yeah, who wants to talk about it?
Katie [33:08]:
Right. They need sunshine. It needs a spotlight, people need to know that these things happen, and there are fixes that are out there, full stop. We can and should be demanding more from our doctors and from our healthcare. I appreciate you sharing this very personal story with our listeners because if anyone is having that experience, know that Monica went through it and was able to find the solution that she needed, and solutions are out there.
Monica [33:36]:
Yeah. The solutions are out there. They’re cheap, they’re easy, and they’re safe. Everybody can and should use vaginal estrogen. In England, they’re way further ahead of us on the whole menopausal treatment conversation and just menopause in general, and they actually just, it’s now over the counter in the UK. You can get vaginal estrogen over the counter, you do not need a prescription, and that is because it’s a very low dose, it’s topically applied, and it’s non-systemic, so it only treats the skin that you put it on. What it does is it rehydrates the cells, produces collagen, it thickens the skin of your vaginal walls and of your bladder. The bladder is totally estrogen dependant, so that’s why we all start peeing. And now that I tell everybody that I had this bout with incontinence, the floodgates open, no pun intended, [Katie laughs] and everybody that I talk to has had something similar. They’re like, "Oh yeah, I can’t do jumping jacks anymore, I can't sneeze, or I can't whatever without peeing in my pants.” And that doesn’t need to be the case. That is all an estrogen problem.
Katie [34:45]:
It does not need to be the case, absolutely.
Monica [34:49]:
So, low and behold, after using this for a couple of weeks and realizing how effective it was, I thought, what if I put this on my face? What would that do? And the results have been amazing. So, I’m so excited to get this product out to more women. We formulated, we’re calling it the M4 face cream. It’s the mega miracle menopause moisturizer, and basically, it does the same thing, and it is as safe. It’s a very low dose. We’re using estriol, which is what I started using in Holland, it is a weaker form of estrogen, but once I started researching it and realized, actually, this isn’t a new idea. Estée Lauder, Elizabeth Arden, and a bunch of other companies actually started in the ‘40s putting estrogen in face cream because it’s such a forever-young product, and they stopped in the ‘90s when estrogen became a prescription drug. Prior to that, it wasn’t so it wasn’t regulated, which was a problem. Cosmetic companies shouldn’t necessarily be using things in an unregulated way because you don’t know what you’re getting, you don’t know what the dose is, you don’t know all this stuff but...
Katie [36:11]:
So Monica, is your face cream, is it FDA regulated? How does that work?
Monica [36:16]:
It’s not FDA regulated, or it’s not FDA approved because we have to make it in a compounding pharmacy because there is no commercial equivalent for it, and getting FDA approval for it would take years and millions of dollars. However, it is the exact same dosing, research, and evidence and sort of, the science behind the vaginal cream. And there has been a lot of research done on estriol and estradiol face creams. It’s just that because it’s a generic for a pharmaceutical company to put the money in to actually create it and get the FDA approval and get the years in, it just doesn’t happen, so nobody’s focused on it. There’s no commercial equivalent, and therefore we have to make it at a compounding pharmacy.
Our compounding pharmacy is FDA regulated, and the cream base that we put it in has been studied. We have safety studies, we have efficacy studies with these combinations, so you know, we feel very comfortable and confident. There is a place for a compounded product, you know, but you have to be careful about the pharmacy that you use and where you’re going, so we’ve done a lot of research and effort on the quality control to make sure that what we’re selling, we can stand behind what’s inside.
Katie [37:50]:
So, you have face creams, you have vaginal creams have prescriptions. Listeners who think they might need some of them should definitely head to your website to learn more about each one of these products and your studies, and the science behind it all. You have a wide range of offerings that can help alleviate what women suffer from.
I want to switch gears quickly because I want to hear a little bit more about the Netherlands and your pivot and your reinvention before we run out of time. I know you’re a lifelong New Yorker, and you are now living abroad. Why did you make this move? I’m super curious.
Monica [38:24]:
So, my husband is from the Netherlands, and we actually met there in 1997, and we traveled back and forth for two years, and then he moved to New York and we sort of, at the time, I didn’t speak Dutch, I was very young, and we felt like there was going to be more opportunity for both of us to work if we stayed in New York. So, he made the move, and we lived in New York for 22 years together. We also had a short stint in California where we both went to and were classmates and Stanford Business School, so we spent a couple of years in California, and then we came back to New York. And for all those 22 years, we were discussing where should we live. [Katie laughs] Should we live in New York? Should we move to the Netherlands? Where is it better? Where do we want to be?
And you know, we just never did it, and we ended up literally living on the same block that I grew up on. My kids were going to the school that I went to, and frankly, I was a little bit bored and just felt like I didn’t marry a Dutch guy to be living my life over again. And he was working in finance and traveling all the time, and it just was a really, really difficult kind of life. Our kids are now almost 18 and about to be 16, and it was kind of our last opportunity at a certain point to move where we could actually go with our kids.
Katie [39:48]:
To do it as a family.
Monica [39:50]:
Yeah, exactly. So, we just decided just to do it and blow up our life here a little bit. Although we’ve really been successful at maintaining sort of a double life. We still have our lives in New York. I still work in New York or in the United States essentially, so I have my daytime life in Holland, and then I have my nighttime work life, so I’m pretty busy these days.
Katie [40:19]:
I’m sure you’re on a lot of Zooms. But I’m curious, launching a company; I know you’ve launched two, we don’t have time to talk about your first one, but launching a company and becoming an entrepreneur is challenging; there are constantly new things that you’re having to face, and navigate, and learn, and I would imagine that some of the same qualities to succeed as an entrepreneur are needed to succeed in a completely new living environment, to be an ex-pat. Is there a commonality that’s helping you make this work in both of these spheres?
Monica [40:52]:
I think that’s a really interesting point. I think absolutely. I mean, to be an entrepreneur but also to make a move like this in your life, you have to really put yourself out there and talk to people and engage, and I’m pretty fluent in Dutch now, which I was not before, I just like, go for it. And in the meantime, also while we were... So, we moved in August of 2020, in spite of the pandemic, not because of it. So, we arrive in a new country in the middle of a global pandemic, we had a rental house for a year, and then we wanted to buy a house and create a home for our kids, who were going to have four to five years at home there, so we didn’t want them to feel displaced, we wanted them to feel like they had a home. So, in the meantime, while I’m also building this business, I bought a house in a new country, in a new language, and did my first renovation ever, so it was crazy.
Katie [41:45]:
Monica, I’m exhausted thinking about all the balls that you had in the air and the spinning plates. You’re like the emcee of your own circus. That’s a lot.
Monica [41:56]:
Kind of, kind of. But at the same time, it was really; I was really being deliberate about creating the life that I want to have and how I want to live. I have a garden now, I wanted something very different from what I had in New York, and I sort of manifested that, I guess.
Katie [42:17]:
I love the use of the word deliberate because I think that’s what happens when we get to midlife. We become much more intentional about how we want to spend our time because for many years, you’re like on this racetrack, and sometimes it’s the race to nowhere, and you get to a certain age, and you look and see that the runway ahead of you is a little bit shorter. And I don’t mean that to be negative; I mean it helps clarify how we want to spend our time.
Monica [42:41]:
Totally.
Katie [42:43]:
This is my last question before we head into the speed round, and I’m always curious about this. Do you feel that you could have been this deliberate... do you feel that you could have made this move abroad and launched this particular business when you were younger or did it take getting to midlife?
Monica [42:58]:
It took getting to midlife. I think the thing that I’ve realized, and you asked a question prior to the podcast, you know, sort of one word to define or describe how you’re feeling, something that you’ve realized, and I came up with the word “competent.” I’ve never felt competent. Or I knew that I was competent, but I always felt like, I’m not sure if I’m doing it... I’m a little bit perfectionistic. I’ve engaged in all the self-loathing that I think probably all of us have; never good enough, never feeling that I had arrived or that I knew exactly what I was doing.
I think part of the question you just asked before about, you know, what are the qualities of being an entrepreneur. I’m a really big relationship person. I have friends, and a lot of the people that you saw at my event last night, were people that I’ve been friends with since high school, since college, since my first job, my second job, and my third job. I always make friends, I love listening to people’s stories, I’m really curious, I really enjoy being in the company of other people, even though I’m actually, in a funny way, quite introverted, I really love talking to people, and I’m authentically interested. And I think that that is a really important quality both for being an entrepreneur and also in this phase of life; I have so many people in my network that I have developed over a period of years. I know what I’ve done well, I know what I need to learn more about, I’m not afraid to show up and ask questions and not be an expert in something, and I think that that’s really important both for being an entrepreneur, but also just something at this phase of life, you get to the point where you know who you are in a different way than how it was earlier.
Katie [44:57]:
I love that. I love that. that is the perfect note to end on, and I agree. We get to a phase of life where we really know ourselves more, what makes us tick, what we’re good at, and where we still have the opportunity to grow. I think you captured it so beautifully.
All right, Monica, this is our speed round. It’s the high-energy way we end every show. It’s just one-to-two-word answers to these questions. So, let’s do this thing.
Okay, launching Alloy Health was _____.
Monica [45:28]:
Exciting.
Katie [45:29]:
This Alloy product is always in my medicine cabinet: _____.
Monica [45:34]:
M4 face cream.
Katie [45:35]:
Ooh, nice. My number one piece of advice for women in peri or menopause is to find a doctor who gets it. What’s your number one piece of advice?
Monica [45:46]:
Take estrogen.
Katie [45:47]:
Nice. This is a lifestyle or fitness hack that helps make menopause more manageable: _____.
Monica [45:54]:
Weight training.
Katie [45:55]:
I love it. I just took that on myself.
Monica [45:59]:
Me too. I’ve been doing it now for the last, let’s say, a year and a half, pretty consistently. I’ve never been consistent with it before, and I’ve totally changed my body for the better.
Katie [46:08]:
I love it. I’m not there yet, but I’m getting there. Launching a business is hard work. What’s a hack that helps keep your entrepreneurial trains on the tracks?
Monica [46:22]:
Oh, that’s a tough one. I’d say, first of all, I like having a partner, so open communication with a partner is really important. But also taking some time for yourself, exercise, walk the dog, take a bath, that’s something I’ve started recently. Just have some downtime.
Katie [46:44]:
Love it. Makes so much sense. Okay, Monica, we are still in the first month of 2023. What’s one thing you want to try or take on this year?
Monica [46:56]:
I’d like to relax a little bit. [both laugh]
Katie [46:59]:
You and me both, sister. I think we might have already covered this, but I always ask, what is your one-word answer to complete this sentence: As I age, I feel _____.
Monica [47:10]:
Competent.
Katie [47:10]:
Competent. Love it love it, love it. Thank you, Monica. This has been so much fun. Before we say goodbye, how can our listeners find you and learn more about Alloy?
Monica [47:22]:
So, come to our website at MyAlloy.com. It’s also on Instagram as @MyAlloy. My email is monica@myalloy.com. I love hearing from people and talking to people; I talk to customers and women day in and day out who are struggling with things. I’ve become, in addition to a menopause activist, I feel like I’m a little bit of a menopause doula as well. I really benefitted from my friend, my neighbor putting her arm around me and pulling me along, and I love doing the same for other women. That is honestly my mission more than anything else is just for women to feel informed, not to feel afraid, and to be able to, you know, age gorgeously and wonderfully, and do the things that they want to do because they’re not fracturing their wrists or their hips or having such debilitating brain fog or pain that they can't get along. So, I just want women to know what their actual risks are, usually much lower than they think, and get out there and do their thing.
Katie [48:35]:
Fantastic. I love it. I love, I love it, I love it. I’m putting all of that in the show notes. Please reach out to Monica with any questions. Thank you for that generous offer.
This wraps A Certain Age, a show for women who are aging without apology. Thank you for tuning in, spending time, and being a friend of the show. If you learned something new, nodded along, took mental notes, or feel smarter, energized or more inspired after tuning in, I would so appreciate a review or a rating over on Apple Podcasts. Reviews matter. They help other women find the show and help the show grow.
Special thanks to Michael Mancini, who composed and produced our theme music. See you next time, and until then: age boldly, beauties.