56 Comments
May 13Liked by Dr. Jen Gunter

I wrote the emails and made the phone calls to get the pricing information from a few supplement companies for this article. I cannot emphasize how easy this was. I have worked in business to business software for years, and while fortunes can be made there, it takes tens of software development years of effort to create software that has any real value. I have also worked for a software company that was bought by a major pharma company to do the analytics on genomic data. Once again, tens to hundreds of person years were needed to create something that we could validate actually worked. And we were extremely careful with what we were doing because as one of my colleagues once said, "we have to be careful because people could die."

The supplement business is an incredible low to no effort add-on if you are even a mid tier influencer. Obviously, you don't have to know anything. I don't! I am not a doctor and I am allergic to biology classes. Yet, in spite of my lack of knowledge, it would have taken less than 40 hours of my time to get a Dr Jen supplement business up and running, and you have seen the upside numbers in the article. It really doesn't take much to get that revenue and profit stream into the millions if you already have an audience and don't have a problem exploiting their trust.

I wish I could find the Bernie Madoff quote on this, but supposedly he said something about how the easiest people to fool are people who already trust you. That is why this grift works so well. You establish trust with some good information that is consistent with NAMS guidelines, and depart from those guidelines (e.g. supplements) when it is in your financial best interest.

So for the instagram commenter who thinks that writing an article shining a light on this grift is "shitting in people's cheerios for trying to make money" I would note that they are mistaken. What is actually happening is that Jen is just pointing out that what someone else said was Cheerios, was in fact shit. She doesn't need to shit in your Cheerios when it is already shit.

But as Mark Twain supposedly said (who knows if he actually said it, as a lot of clever things get attributed to him incorrectly), "It's easier to fool people than to convince them that they have been fooled.”

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That is really infuriating. I have pointed out to people that somethung is BS and boy did i get an earful…. The venom is really quite terrible. I guess people prefer to eat shit disguised as Cheerios….althiigh really it‘s the infkuencers who know better, but sell their soul for a quick buck. I hooe there is a special circle in Dante’s Inferno for these folks

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I go to Kaiser Oakland and use the Kaiser Northern California website. Kaiser still lists a Black Cohosh supplement on its website (called “Menopause Supplement”). The page says updated May 2024, but I doubt they still sell it since their “midlife and menopause guide book” says that black cohosh has shown to not be helpful in studies though another place on the website does recommend black cohosh). I’ve been communicating with Kaiser Oakland about some difficulties finding accurate information about menopause on their website. It’s really hard for big organizations to manage websites, but there’sa few things that it would be helpful to update on kp.org for No Cal.

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May 13Liked by Dr. Jen Gunter

Thank you so much. It’s so sad that at the moment when menopause is finally getting mainstream attention, the predators are so much louder than the truth (but I guess that’s usually the case with everything). We are so lucky that you have our backs.

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author

Yes, predators take advantage of gaps in care

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Wonderful article, as always, and amazing analysis you did. Thank you for it. I hope it gets read by as many people as possible.

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Ugh. I don’t even try to talk about this any more with the women I know, because it is like screaming into the void. And if you say the best “supplement” for menopause is exercise you don’t get invited back to book club. 😉

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May 13Liked by Dr. Jen Gunter

I may be dating myself, but am I the only one for whom this article conjures up the Monty Python Llap Goch advert?

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author

Ha!

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Had to look that up. LOL.

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May 13Liked by Dr. Jen Gunter

Thank you for all the time you spend on your content and research. You are correct... There is only so much time in a day to see patients and make content. I look forward to every article you write!

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May 13Liked by Dr. Jen Gunter

This really is a stroke of genius!

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Would "love" to know the ROI on estrogen and testosterone pellets.

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author

They are harmful and not recommended by actual experts

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Yes please! I recently had a very (otherwise) reputable OBGYN try to push pellets on me when I saw him for a completely different issue. He had me almost convinced but I did my own research after the appointment and then understood the grift he was trying to pull on me. He also sells supplements of course. Anger hardly begins to describe how I felt! I wish there was some way to report him but nothing he’s doing is illegal. Just money grubbing!

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Thank you! I so appreciate this. I Do buy a supplement—that supposedly prevents UTIs. I am prone and have spent a recent night in the hospital, so I’m very motivated to do anything to avoid them… but yeah ok this probably doesn’t help. (I hate cranberry juice and also it doesn’t seem to help either). If you have any interest, UTIS after menopause turn out to be both common and also to have wide ranging effects if undetected. I’d love an article on prevention and treatment at some point! Thank you for “supplementing” my knowledge.

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author

Cranberry supplements are one of those recommended products, but the research is so-so.

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It’s really not promising research. My doc suggested d-mannose (which is the supplement I was already taking, although I hadn’t told her that yet) so I’m sticking with it but it’s kind of like putting a deer whistle on your car: you never know if you would have hit any deer without it anyway.

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She talks about UTIs in the Vagina Bible.

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I am dubious of supplements in general but also take a cranberry supplement for UTI prevention (in addition to my vaginal estradiol which i highly recommend). There are two on the market that contain very high levels of cranberry extract unlike the ones that you can buy at the drugstore etc. My urogynecologist said the research is mixed but some people find them helpful so I take it.

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I'm so thankful not to deal with this...yet. but I have seen anecdotal info about vaginal estrogen. But... saw it on Twitter so no idea if it's good or bad info.

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author

vaginal estrogen does reduce UTIs, and I will be delving into how effective it is in another post

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I’m using it -for other things, mostly incontinence and lack of sexual interest—and I’m finding it really helpful.

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Thank you. The entire supplement industry is a con. I am thankful that my rheumatologist just flat out BANS them (see medication interactions). But some folks are so desperate to find the one magic pill to cure what is SERIOUSLY ailing them that they are vulnerable to outright manipulation. Again, thank you for marching us through the MATH on this stuff. It really is all about ripping off people for LOTS of $$$.

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Excellent article. I would love for you to discuss the probiotic messaging around menopause if that is on your radar.

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It's too bad you're not selling these for real, I could open up the gelcaps and sprinkle them on a nice curry.

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Super analysis and test run on "product to market" process; thank you. I can tell y'all that the cosmetics industry runs on the exact same formula. It's CRAZY that there are no regulations on supplements, cosmetics, etc. Absolutely wack-a-doodle.

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I bet you needed a long, hot shower to wash away the "ick" of that research endeavour!!!

It is very disheartening when trusted people such as physician specialists, dietitians, biomedical researchers start selling or promoting supplements. It's also scary how little regulatory oversight there is.

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The two products that are marketed as menopause "fixers" that I see often are for shampoo and collagen. What many women do not realize collagen by mouth goes in and out with no benefit to the skin or muscles. The commercial for the menopause specific shampoo is laughable to me, but I can see how a desperate women would open her wallet. Perhaps if more physicians had working knowledge about the use of hormones and did not rely completely on the WHI study (which I do realize had some valid findings) women would not be turning to supplements that will not help the problems associated with menopause and post menopause, The new studies that the Menopause Society (formally NAMS) has published and supports are what women of all ages need to pay attention to. Menopause/post menopause is not just about hot flashes (and some women as per the society can get them well into their 70's and beyond). Physicians need to listen to concerns, do the testing that is required and provide the most recent information. Educate patients and do not make assumptions. Women are prescribed a multitude of medications instead of addressing a hormone deficency. Fear mongering at its worst! Some physicians are selective on what information is provided as well as what patients they are willing to accept.

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With you right there. I love the commerials for „Nutrifol“: after 3 months i noticed thicker, longer hair…for real! That seems hard to believe since it takes more than 3 months to grow any appreciable amount or length of hair… unbelievable. But people will argue and insist that thus crap is it.

The pellets really make me mad, it is clearly just money-grubbing and profiteering…

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The marketing of products is due to the number of women in the world who have reached peri or meno/post meno for sure. What troubles me is there are too many health care professionals that have no idea about menopause nor thyroid issues (symptoms are the same) and are not listening to the women who are having more of a difficult time. Symptoms of menopause, all of them not just hot flashes, last a lifetime. It should be about quality of life for many of us.

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It is a new genetstion of women-baby boomers who are used to getting what they want and when they want it. They have worked hard to have the comforts they have and they cannot believe that money does not buy everything. I think it also has to do with the fear of growing old and irrelevant. I totally get it, i am there. I guess i have enough scepticism and actual understanding if science to just plunk some money down for dubious crap. It is also the world we live in where menopausal read older women are unattractive and irrelevant and youth is celebrated above all. It is really about exploitation of women, yet agaun. That is really what infuriates me.

And you are correct, not everything is menopause and not every symptom or ailment is solved by hormones, at least sex hormones…

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You and I are on the same page. Some women do have to take the risk of using estrogen due to menopause related issues at any age (and I did reach out to the meno society re the new study, starting and continuing estrogen over 65 they are supporting that statement). Too many women want to retain youth others need relief as the osteoathritis, moods etc. impact quality of life. Hip fractures are high on the list, it is not about wrinkles or hair colour. Products are just that, something that lines a bathroom shelf. Women's health has taken a back seat to men's since studies and treatment options were first designed. The WHI scared all of us into thinking using some (and I do not mean mega doses of estrogen and progesterone (and some take testesterone) would cause breast cancer and time in an ICU unit. All of the recent changes in women's health in the US should be opening the eyes of every woman in the world. It is time for us to speak up and get them (medical people) to smell the roses.

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May 16·edited May 16

There is a well known menopause social media influencer who sells a collagen powder. Posts a link to a PubMed article stating it is effective for increasing bone density in post-meno women. She shows before and after pictures of facial skin and cellulite showing how effective it is. This is in addition to her diet book and numerous other supplements. Makes me angry!

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Pictures can be manipulated like words or actions. If you ask a qualified dermatologist (I have done that) collagen by mouth has no impact on skin. You add it to a drink and it leaves your body, collagen can only come from the use of estrogen. We loose some during perimenopause and then the transition (menopause is literally one day) then post menopause for life. Some women ar eimpacted more from the loss which impacts muscles and skin, me included.

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My dermatologist said the same thing. She also said no proof that estrogen cream on the face improves wrinkles. People point to the benefits of estrogen cream for GUSM but that is estradiol and the face cream is estriol I believe. Regardless, definitely a big market out there to take advantage of women when they are not feeling well, concerned about aging and vulnerable.

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I have also been told facial use of estrogen is not effective ( I agree with you I think it is estriol) The need for estrogen in older women (post menopause) is for the bones, muscles, skin (elasticity) and vaginal tissue (definite). Using a low dose patch or gel will help with the stiffness and pain related to the "change" and vaginal estrogen as well. Not everyone can use estrogen of any kind and the risks of using it again over 65 should be a woman's choice based on medical history. Individualization when it comes to therapy as no two women are the same. We will not get the fountain of youth (to be honest I do not want it) I want relief. Grey hair and wrinkles I will accept the loss of mobility I will not. The symptoms of low or high thyroid are the same as menopause and post menopause, it is the interaction and need to increase my synthroid dose with medical supervision that is a factor. Vaginal estrogen has systemic properties, it has to if it will help with bone health. Thanks for responding.

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Very interesting. Not surprising, but I remember a Premarin rep saying that people were using it (successfully) for wrinkles. Certainly out of bounds for a rep. to be talking that way...

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A marketing tactic and not a good one for sure.

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Holy cow! I am so glad you wrote this and that I read it. Unbelievable!

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