Anne Fulenwider was Editor in Chief of Marie Claire magazine for eight years, and she thought she’d be in publishing for the rest of her life. But then the magazine published a series of stories about the state of women’s health research, and her future started to look different.
Fulenwider left publishing to become co-founder and co-CEO of Alloy, a company that helps women get prescription medications to treat menopause symptoms and provides reality-check information on midlife health.
At the recent Menopause CEO Conference in New York City, organized by Stacy London, CEO of State Of Menopause and held on World Menopause Day, Fulenwider joined 16 other menopause leaders on stage. It was the largest panel I’ve ever witnessed, and also the most interesting and provocative.
After the meeting, she spoke with me about the excitement around this relatively new industry, her midlife transition from publishing to the business of menopause, and the exorbitant cost of clinical trials.
Q: How did you transition from publishing to what you’re doing now?
A: “I was born in magazines, thought I was going be in magazines for the rest of my life. We did a whole bunch of coverage of women’s health and it was just alarming to me what we were uncovering about how, for example, women’s bodies were not even included in clinical trials until 1993—it’s the year I graduated from college.
“So I had that bubbling in the background, and then my mother died out of the blue of a heart attack at 73, which is not so young, but too young. I had a long conversation with a doctor and we talked about the fact that she’d had heart issues her whole life and was taken off her hormones. And I just realized through her experience and through my daughter’s—my daughter’s fine now—but how little is known about women’s bodies.
“So basically three things happened: We started covering women at Marie Claire, I had my own personal family health issues going on with my mother and my daughter, and then Monica (Monica Molenaar, Alloy’s co-founder and co-CEO) approached me and was like, ‘Hey, do let’s do a content set about menopause.’ And being a journalist and editor, I did the digging around why is there a stigma around menopause. Why is there so much misinformation?
“And I uncovered, as now everyone in the field knows, that study from 20 years ago, and how much damage it did. And that this was the root of all this fear around actual medical treatment of what is not a disease, but a medical phenomenon.
“I was totally motivated and happy to leave publishing, to be honest, to do this more mission-driven, impactful work. I loved my whole journalism career, but I really, really love being on the front lines and actually trying to fix policy and health.”
Q: I’m so glad your daughter is OK, what happened with her health?
A: “My daughter is 16 now but going through puberty she had really painful cysts, and we were in the emergency room with her because we thought it was appendicitis. And this lovely young doctor said to me, ‘Well, we’re just going to wait and do one more X-ray, and either we’re going to do surgery right now or send you home with Advil,’ because they didn’t know what was wrong yet.
“And I was like, ‘What?’ Those were my two options for my daughter. I was standing in the emergency room at the hospital and it brought me back to the lack of research on women’s bodies—how harmful it is to our own health and longevity.
“The other thing I’ll say is just that when you hit this age, I don’t know if you feel the same way, but I’m now 50, and with my mother dying, it was this pivotal moment of, wait, what am I going to do with the rest of my life? And it was a gift in many ways to have this moment of reflection of, okay, wait a minute, life is too short. I’ve done one thing for a long time and I really took advantage of that moment to stop and figure out what I wanted to do with my skills for the rest of my life.”
Q: Yes, I have felt the way too. One of the things during the panel that was remarkable to me was that distinction between menopause being a disease and being a stage in life, and ho that’s something you’ve come up against at Alloy as far as advertising on Facebook or anywhere else.
A: “So I really have a two-part answer to that, which is that menopause is definitely not a disease, but it is something that should be treated by the medical world. It is also a life stage, and there are lots of other things to do to improve the quality of your life.
“You have a moment at around 50 to set the course of your own longevity and your own aging. I mean, none of us can completely control our fate, but the choices you make around this time about changing your lifestyle and changing habits really set the stage for either a long, healthy life or even if it’s long, maybe not so healthy and active and enjoyable.
“Medical issue versus life stage—it’s just not the way I would phrase it. It’s both, and they’re not mutually exclusive.
“That, however, is completely different from the Facebook issue, which yes, we have come across. You can’t say hormones, you can’t say vagina.”
Q: You can’t say hormones?
A: “No. Because they think that you’re selling human growth hormones, which we’re not at all, of course, we’re selling FDA-approved treatments. There are so many things you can’t say. We have had many, many ads blocked.
“We spent a significant amount of our time dealing with Facebook and Google’s rejection of our ads. It’s insane. And it’s so unfair because of course, ED (erectile dysfunction) drugs are everywhere.”
Q: One last thing I’d like to ask you is regarding anecdotal, shared stories versus clinical trials to determine the effectiveness of treatments. In my mind, hard science is important, but at the same time, the bar is so high to start a clinical trial and it’s so expensive. What’s your take on how we can get treatments that are verifiably safe and work well but not spend $300 million? That’s kind of a giant question.
A: “It’s huge. Yeah, it’s huge. It’s funny, it’s what happens when you have a money-based health system, right? There are just so many things to unpack there. The fact that the clinical trials only apply to, I believe, new drugs that want to come into the market.
“So they’re sponsored by pharmaceutical companies. And by the way, I don’t know if you saw that article recently, the FDA is predominantly funded by pharmaceutical companies who are trying to get their drugs approved.
“Pharmaceutical companies have created life-saving, wonderful drugs including our vaccines, et cetera. I’m not against them, it’s just that they dominate the research field, which just seems really wrong. Those studies should be done, but other studies that are not based on incentives should really also be there.
“I think anecdotes are not strong enough. I believe in thousands and thousands of years of herbal remedies that are working. But I do think there may be a middle path. Now that I’ve been doing research on menopause for almost three years, I know there are tons and tons of studies out there that are pretty accessible.
“Currently, the burden is on the patient and the woman to do the research, which is ridiculous. But I think it might be on us and certainly on those of us from the media world and from storytelling in health.
“There are plenty of studies that may not meet the standards of double-blind clinical trials, but that are extremely informative and well done. And if you aggregate them and distill them into their truths and get them out there in digestible ways, it would be easier for women to make choices.”