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"A lot of cowboy stuff going on"? I thought this was a story about Menopause?

What the hell are these guys talking about. I need to retreat to my cave.

Menopause Apps and Telehealth Services Can Help Women Take Charge, but Proceed With Caution

New tech startups are marketing to women in their 40s and 50s, but there are right and wrong ways to approach new services; ‘a lot of cowboy stuff going on’

Julie Jargon hedcutBy Julie Jargon, WSJ

Apr. 9, 2022 9:00 am ET

New apps and telehealth services are providing women in middle age more access to health expertise, education and support to help them during menopause.

Many women are often confused about where they fall on the menopause continuum. It’s not as though you wake up one night in a sweat and suddenly you’re in menopause. Perimenopause begins a few years before actual menopause, which is defined as having had no menstrual cycle for a year. Perimenopausal symptoms, which range from insomnia to irritability, can be subtle and hard to distinguish from other conditions.

Menopause and the years leading up to it shouldn’t be a time to mourn. A good way to understand where you are is to track your cycle and your symptoms, with an app such as MenoLife.

Tech startups are now catering to the growing number of women in their 40s and 50s who want to take charge—and who haven’t always had doctors who understood menopause well enough to recognize and treat its many symptoms.

But women need to be cautious, especially when dealing with online services that sell supplements that promise to ease symptoms, or prescribe hormones and antidepressants without properly assessing patients.

“It’s kind of buyer beware out there. There’s a lot of cowboy stuff going on,” said Stephanie Faubion, director of Mayo Clinic Women’s Health and medical director of the North American Menopause Society. She said some companies pitching Mayo for partnerships lack substance and appear only to be trying to make money off women.

Here are several new apps and services that offer nonmedical approaches designed to help women navigate this life stage, as well as what doctors say about pursuing hormone therapy through telehealth services such as Evernow.

Nutrition and fitness

B-Untethered, founded by the nutrition entrepreneur Anissa Buckley, is developing the MyMeno app, expected to land in the Apple App Store and Google Play store later this month. (You can sign up for a launch alert.) The $10-a-month app will provide nutrition plans specific to women in midlife.

As women enter middle age, some find they are gaining weight as their estrogen levels decline. Ms. Buckley said women in their mid-40s and up should decrease the calories they get from carbs and increase their intake of protein. Independent experts agree with this advice. Ms. Buckley said the app will provide women with a personalized macronutrient plan so they can make these shifts in their diets.

Keeping fit is also a part of mitigating menopausal changes. Ms. Buckley said MyMeno will eventually include recommended exercises. (The Wall Street Journal has a list of six exercises to help people stay fit in their 50s.)

Behaviorial therapy

Caria is an app with a 40-day care protocol, using cognitive-behavioral therapy and goal-setting to help alleviate menopause symptoms. Each day, women can learn about different aspects of menopause, listen to guided meditations and follow stretching exercises.

There is evidence that cognitive-behavioral therapy—aimed to help patients identify and change destructive thought patterns—can be effective in alleviating hot flashes and heart palpitations. Caria has joined with the University of Illinois Chicago on a clinical trial to study the efficacy of the app’s protocol.

While the app is free, there is a $6-a-month premium version that gives users more programs for symptom management.

Community support

Social support is important for women going through menopause, doctors say. There are several apps that offer ways to communicate with other women, including Perry, an app specifically for women in perimenopause; the Balance app for menopausal women, and Peanut, a moms app that recently added a community for women in menopause.

“Menopause is part of life, and it’s important to talk about it,” said Mary Rosser, director of integrated women’s health at Columbia University’s department of obstetrics and gynecology. “My mother’s generation didn’t talk about it. They whispered about it. Menopause is a transition—it’s not the beginning of the end.”

Hormone-replacement therapy

For many women experiencing significant menopause symptoms, doctors say hormone-replacement therapy is safe and effective. But women who turn to telehealth platforms for it need to make sure there is proper screening to determine whether they are candidates.

Women with a history of breast cancer shouldn’t be prescribed hormones, for instance. And overweight women are at higher risk of heart disease and blood clots, and oral estrogen carries a higher blood-clot risk, said Mayo Clinic’s Dr. Faubion.

You also don’t want to feel as though a prescription was too easy to come by. Some telehealth startups, such as ones prescribing medication for attention-deficit/hyperactivity disorder, have been accused recently of pressuring clinicians to prescribe drugs to patients without conducting thorough assessments.

When approaching telehealth, Dr. Faubion recommends looking out for these key issues:

• Is there time to have all your questions answered?

• Is the clinician explaining the medication’s benefits and risks?

• Is there follow-up with doctors after medication is prescribed?

• How does the provider assess the treatment’s effectiveness?

• Can you access your prescription history to share with your primary-care physician?

The Mayo Clinic designed an algorithm for a new app from digital women’s health platform Lisa Health to determine eligibility for various menopause treatments. Through the app, women can request a telehealth appointment with a Mayo Clinic doctor before being prescribed medication.

The app, expected for the iPhone by summer (and later for Android), will have a subscription model, though pricing hasn’t been made final.

Telehealth startup Evernow, focused on menopause, just announced funding that included investment from the celebrities (and members of the target audience) Gwyneth Paltrow, Drew Barrymore and Cameron Diaz.

Women have to submit a photo ID for identity verification, complete a detailed online health profile and consult with a clinician before being prescribed hormones or antidepressants for menopause symptoms. Communication between doctors and patients is primarily by text message. The service, available in 33 states, costs $129 a month and isn’t covered by insurance.

Evernow founder Alicia Jackson said early tests showed patients preferred texting to video or phone calls, because it lets them communicate on their own time. (Phone calls are also an option.)

Evernow expects women to report accurate information about things such as their blood pressure and mammogram results. If there is no improvement in a patient’s symptoms, the service halts treatment and recommends an in-person doctor visit.

—For more Family & Tech columns, advice and answers to your most pressing family-related technology questions, sign up for my weekly newsletter.

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