Rebranding Midlife

Photo-Illustration: The Cut; Photos: Getty

On October 14, against an Instagrammable background of autumnal floral arrangements, Naomi Watts introduced the New Pause, the inaugural menopause symposium in New York. As founder and CCO of Stripes, a brand promising “menopause solutions from scalp to vag,” the actress conducted the event with Alisa Volkman, co-founder and CEO of the Swell, a “fast-growing community for the 40-plus that is hellbent on reimagining how we age.” Katie Couric, who is 66 and past menopause, introduced a series of doctors, scientists, writers, thinkers, a fitness expert. Humorist Jill Kargman took the stage to rev things up. For $150, participants could hear about the latest, greatest information about how menopause impacts women’s health while a fuck yeah! vibe permeated the room.

The menopause-wellness space is poised for its moment in the spotlight, with Watts’s symposium part of an ever-lengthening string of Gen-X-celeb-led business endeavors to help change “the change.” A few days after the New Pause, State of Menopause CEO and former What Not to Wear host Stacy London gathered a selection of thought leaders in a press-facing brain dump about the burgeoning industry for the CEO Menopause Summit. Burgeoning it certainly seems to be; according to a recent trend report from the Global Wellness Summit, the business of menopause is projected to be a $600 billion market by 2025.  

Gen-X celebrities are digging into a piece of the menopause pie behind the scenes, too. Gwyneth Paltrow, Drew Barrymore, Cameron Diaz, Glennon Doyle, and Abby Wambach have all chipped in to raise $28.5 million for Evernow, a telemedicine company that can help you text your way into a medical consultation for hormone replacement therapy (HRT), a.k.a. menopause replacement therapy (MRT), without an appointment or physical examination. Retired tennis superstar Serena Williams’s venture-capital firm Serena Ventures is a vocal investor in actor Judy Greer’s Wile, a plant-based supplement brand that offers powders and tinctures to ease perimenopause and menopause symptoms you can now find in Whole Foods. Both Greer and Williams appear on Instagram to endorse the products: “I’m all about game changers,” Williams says.

Though Julia Fox just proclaimed that “aging is fully in,” menopause can feel like a distant event so easy to underestimate when you’re preoccupied with a quarter-life crisis or Saturn return high jinks. Quite frankly, society makes ignoring this phase of our lives, and people without the means to physically defy the toll of it, really easy. Trust me, I’m in the throes of it right now.

If you’re a female, female-identifying, or nonbinary person who is lucky enough to make it to middle age, menopause will come for you. Your hair will thin, you will wake up drenched in sweat, and you’ll call your mental acumen into question. Even if the spirit is willing, sex won’t be the joyride it once was because your vagina will become an arid desert. Your joints will hurt, and you may fail to recognize your own body. Despite your level of wisdom, professional experience, accolades, or whatever superpower you might bring to the table, there is strong data supporting the likelihood you’ll be forced to reinvent yourself professionally, leading to a crisis of confidence. Add that to the rigors of caring for children and your parents (if you have them), and you’ll be more tired and over it all than you can ever imagine being at 28. After menopause ends, you’ll have a decent shot at developing cardiovascular disease (the leading cause of death for women) or a bone disease like osteoporosis, as menopause speeds up bone loss by 20 percent.

Unlike their parents, the Gen-Xer or elder millennial on your screen and in your life has zero interest in suffering silently through this often annoying and sometimes debilitating transition. It’s why telehealth companies like Evernow have recently emerged, as well as former Marie Claire editor-in-chief Anne Fulenwider’s My Alloy, a site that virtually connects women with menopause-trained doctors who prescribe and deliver various forms of HRT/MRT right to their door (like how Hims or Hers delivers mental-health, birth-control, and hair-loss meds to elder Gen Z-ers and millennials).

“Gen X is not interested in being middle-aged,” London tells me. “We have Botox, we have fillers, we go to the gym, we walk 10,000 steps, we’re going to live to be 90, so we are not making middle age a thing. We’re going to just extend our youth span.”

She’s right — my peers have no interest in feeling their age. So when someone credible like London, Greer, Williams, or Watts grabs a metaphorical megaphone and says they know of something that can help you stop sweating and get a good night’s sleep (or at least look as if you did), even the most jaded Gen-Xer could be convinced to buy in.

While more than 1 million women in the United States experience menopause each year, this seemingly sudden market flood of menopause solutions stems from a glaring lack of research and support from the medical community. Unless you’re thrust into menopause early due to a medical condition, your body typically eases into perimenopause, the gateway to menopause, in your mid-40s, a party that lasts 7 to 14 years. Everyone is unique. Research on its long-term implications on our health is scant at best. For decades, women were denied HRT/MRT because a deeply flawed 2002 longitudinal study (with many white subjects past menopausal age) called the Women’s Health Initiative (WHI) linked HRT/MRT to an increased risk of breast cancer.

Why? According to Mary Jane Minkin, M.D., a renowned North American Menopause Society–certified specialist and clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale University School of Medicine for more than 41 years, many clinicians are not trained to manage menopausal patients. “I guess I probably shouldn’t say it sucks because that wouldn’t be professional,” Minkin tells me. “The WHI data came out in 2002 and around the same time, the Bell Commission cut hours of training for residents. You have to teach a resident how to deliver a baby. You have to teach a resident how to do a hysterectomy. They figured if nobody was going to be prescribing estrogen, maybe they didn’t have to teach residents about menopause, so menopause education went by the by. It was basically cut from curricula almost totally.”

Researchers now look to data from the 25-year, NIH-supported Study of Women’s Health Across the Nation (SWAN), which is age-appropriate and inclusive of more Black, Asian, and Latinx subjects. Though HRT/MRT is considered the gold standard of menopausal-symptom treatment for women without contraindications, many doctors still hesitate or refuse to prescribe systemic or low-dose vaginal dosages in its various hormonal combinations and forms. When so many doctors are hesitant to prescribe hormonal treatments, and so few even know how to address the onset of menopause in the first place, then this boom in celebrity-backed brands marketed directly toward women suddenly starts to make a lot more sense.

London says she became CEO of State Of because of the “horrible time” she had during her own experience with menopause. Initially, the reaction to her professional pivot from some of her colleagues was lukewarm at best. “Everyone’s like, You were in fashion! Why do something so unsexy?” she remembers. “‘Unsexy’ has no place in the judgment of this conversation. This was a massive personal crisis of confidence! I lost my sense of identity and agency. I did not know what to do. I was so desperate for help I would have bought, taken, or done anything.”

When Watts’s doctor told her she was going into early menopause at 36, she felt utterly alone.No one else in my age group was talking about it,” she told me during a press breakfast for her menopause-solutions brand Stripes. “I kind of tested the water with little jokes here and there about having estrogen dips and stuff and they weren’t really met with, Oh, yeah, let’s talk about that — I’ve got the same thing. It was isolating.”

Watts comes to Stripes with retail experience; she founded ONDA Beauty, a clean-beauty retail space, after developing a menopause-related skin condition in her 40s. During the pandemic, she composed the pitch deck and cold-called Amyris, a company that only manufactures products with clean ingredients, to set up a meeting. The call boosted her confidence to start Stripes, which currently holds a patent-pending formula of a moisturizer containing ectoine and squalane to plump skin and retain moisture, and sells a variety of ectoine-based moisturizing skin-care solutions for the face and body, lubricants, a cooling spray, and a vaginal probiotic.

Traditionally, showbiz and menopause don’t mix. Even with all the glitz and spritz, celebrities aren’t necessarily immune to ageism, especially if they are women. (See Amy Schumer’s “Last Fuckable Day” sketch from 2015 if you need a visual for what it’s like for women like Tina Fey, Patricia Arquette, and Julia Louis-Dreyfus as they enter middle age.) In 2022, Hollywood has eased up a bit on ageism, but if you ask London, that’s possibly just “because we have the means to look younger than we really are.” The impact menopause can have on a woman’s Hollywood career can still be quite negative.

Even an actor of Watts’s stature gave the potential impact of founding a menopause business careful consideration. “I’m not planning on giving up my day job,” she says. “While I still have fear about the stigma myself, even two years into doing a lot of work on this, so be it. I plan to just keep walking through it and hope that Hollywood is open to it as well.”

Greer’s team also voiced concerns before she co-founded Wile. “If you’re an actress in her mid-40s and you’re like, ‘Hey, I want to work with this brand about perimenopause,’ of course they’re going to be like, ‘How’s toothpaste instead?’” she says. Fresh off the Hulu comedy Reboot, Greer, at 47, says she now feels more empowered and beautiful than she ever has. “I’m just really proud to say I’m getting older but can still turn it out if I need to,” she explains, adding that this attitude places her in a good position to recommend products like Wile’s to her peers. “If I’ve always been looked at as America’s Best Friend, isn’t it your best friend you look to for help, advice, and guidance? I’ve got you guys! I take this seriously.”

Not every menopause-related brand has a celebrity at the helm, but Colette Courtion, founder and CEO of ten-year-old Joylux, a company that sells cooling sprays, beauty products, supplements, and an at-home pelvic-floor-tightening device, says she welcomes them into the menopause space because they bring attention to the cause. “It normalizes the conversation,” she explained via email. “We need all of us to work together to improve women’s health for the future. This isn’t anything to be embarrassed about or ashamed of. It is reality for 50 percent of the population and solutions are now FINALLY starting to exist.”

Of course it helps to have a famous face attached to a business, but part of the reason some of these new menopause brands, like Stripes and State Of, seem to have popped up suddenly with all these product offerings can be attributed to the fact that they offer topical solutions, which are usually made with FDA-approved ingredients. But there are still some challenges around menopause branding and market definition. “Menopause is a huge market in theory, but you need a willing consumer, and so far, that willingness is kind of lukewarm. Either they don’t feel like talking about it, or there’s deep shame around the entire topic,” London explains. “This customer is no dummy. A celebrity alone isn’t going to make them care about menopause.”

The general confusion around the medical effects of this midlife change has even trickled all the way up to the FDA, and then back down to the general public. “Part of the issue is that the FDA is confused whether this is a medical issue or a life transition,” London says. “You have a consumer that is reluctant because she doesn’t understand if she’s getting a moisturizer or hormone cream.”

Fulenwider has found that consumers crave science-backed facts to be convinced that sites like MyAlloy, and products sold by brands like Stripes and Wile, are the real deal. “The places we’re getting the most engagement, both in social media and on our website, is scientific information. Women are starving for the unvarnished scientific information because no one’s been educating her about this.” Social media has proven to be highly effective at spreading information and fostering community, and menopause-telehealth brands are a booming business. “I would not wish the pandemic on anyone, but it did really significantly change behavior — and getting your health-care answers and solutions online became much more normal,” Fulenwider adds. But she cautions against finding all of your menopause solutions on an app like TikTok: “There are some people there to cash out and marketing stuff to women that doesn’t work, and some who are really invested in improving women’s health care.”

Adding further to consumer confusion is the overlap in what these menopause solutions brands offer. “At my end of the spectrum — over-the-counter, nonprescription, nonhormonal product that is not contraindicated in any way with hormones — there is a lot of duplicative product offering,” London explains, noting that education, clarity, and curation will help solve that problem. “I want to work with other brands as much as I want to work with the consumer. Nobody wears the same designer head-to-toe. Eventually, we’re going to see a lot of brand partnerships.” Collaboration can also be a win-win for these brands because product development and clinical and third-party testing can be really costly, London adds.

There can be a stigma against using supplements or naturopathic solutions, which are not regulated by the FDA, but some can be effective. Depending on the brand and its reputation, Dr. Minkin says she isn’t entirely opposed. “There is so much in how you extract it from the roots or get leaves, how you purify it, how you process it,” she explains. “In Germany, they have the equivalent of an FDA for herbal products, but here, there’s no one watching to make sure these ingredients actually make it into the products.” But beware of hot-flash products, Minkin warns, as they can have quite the placebo effect. “You basically have to see prospective randomized double-blind trials to say if something’s working,” she says. “With hot-flash products, there is about a 30–35 percent placebo response.”

Ultimately, celebrities like London and Watts see these business ventures as their own way of sticking it to our culture’s rampant ageism. “We see aging through the lens of the patriarchy. We see aging as being put out to pasture. You don’t matter. You’re not attractive. What if we shifted our perspective?” London asks. “I might not be on television anymore, but you think that’s going to stop me from making people feel better about themselves? Fuck you! That is the attitude I want us all to have because then that power over what an aging person looks like becomes ours to own, and not theirs.”

“We’re supposed to be invisible and disappear into the corner,” Watts echoes. “I’m not done! I hate — I reject — that women should feel that it’s over.”

Between press coverage, consumer confusion, and venture capitalists waiting to consider when and where to invest, London feels that “it’s going to take more time to hone our skills and products to create this vertical in a way that makes it part and parcel of our everyday life, the same way that period hygiene is.” But she remains enthusiastic about a menopause aisle at Sephora — eventually. “We’re not ready for that aisle because I guarantee you, the menopausal population isn’t ready to ask where the vaginal-dryness products are,” she says. “But if I’m screaming, if Naomi’s screaming, if Judy’s screaming, if all of these CEOs are screaming, we’re screaming so you don’t have to.” Placebo or not, if what they say can make the sweating stop, I’m tempted to listen.

A medical advisory put in place to establish residency guidelines in response to the death of an overworked New York City medical resident.
Rebranding Midlife