Hot flash, p.14
Hot Flash, page 14
This chapter examines menopause using a market-focused lens. It surveys the landscape of menopause products and services, which range from skin-care products, creams, and nutritional supplements to clothing, personal devices, and digital products and services, all of which are marketed primarily to perimenopausal and menopausal cis women. Here, we apply a critical lens to what we call “menopause capitalism”—that is, the marketing and selling of menopause-related products or services by commercial entities, typically through messages that celebrate autonomy, community, or stereotypical femininity.12
The examination that follows illuminates two of the paradoxes that recur throughout this book. First is the need to avoid pathologizing menopause as a “condition” or “illness,” while simultaneously acknowledging that, for many people, the physical and psychological effects of menopause merit serious attention and treatment. Numerous businesses have now been founded on the premise that the treatment of menopause involves using a range of products, including but not limited to the creams, lotions, vitamins, clothing, devices, and digital services discussed in this chapter. Second is the importance of greater awareness and openness about menopause, on the one hand, and the imperative for more robust privacy protections for personal data, on the other. The growing number of menopause apps that prompt users to submit and log their menopausal symptoms, often in combination with receiving individualized health advice and/or connecting with other users, typify this tension. To illustrate and assess how these two paradoxes play out, this chapter takes a closer look at particular menopause-related companies as representative of larger trends or examples of salient issues.13
In one sense, menopause capitalism is long overdue. Diversity in both information resources and products not only increases consumer choice, but also allows for greater flexibility in addressing menopause. The proliferation of menopause-related offerings means that managing its symptoms need not be reduced simply to a decision about whether to take MHT or not. For customers who may be concerned about the possible side effects of MHT, nonprescription products that take the familiar form of topical applications and vitamins have tremendous appeal. Encouraging treatment free from stigma or shame is a salutary shift in both culture and commerce, too. At the same time, however, many aspects of menopause capitalism rely heavily on gendered and ageist stereotypes, tend to associate wellness and comfort with spending, and raise significant privacy concerns. This chapter explores those themes as well.
LOTIONS AND POTIONS
“A peri/menopause self-care kit we only dreamed about until we decided to get together and actually make it. Treat yourself to sweet relief and proactive daily support inside and out.”14 This is how Kindra, one of several menopause-oriented companies that offer products for aging skin and bodies impacted by the menopausal transition, advertises an “Essential Bundle” of vaginal lotion and a “body-balancing” daily supplement that it sells for $98.15 Kindra also sells treatments that target the face and other visible skin,16 creams that promise relief for vaginal or vulvar dryness,17 and nutritional supplement pills that allegedly address a range of menopausal symptoms including low libido, brain fog, fatigue, night sweats, difficulty sleeping, and depressed mood.18 With its tagline, “Feel Like You Again,” the company’s menopause topical products and supplements are advertised as “hormone-free relief that makes a difference on day one.”19
Kindra’s embrace of multiple products is, in some ways, typical of one segment of menopause-wellness companies. The company Stripes, which bills itself as a menopause brand of “scalp to vag products,” also sells an array of face creams (that promise to brighten, hydrate, and plump) for approximately $85,20 a “Vag of Honor” gel advertised for “dry vaginal skin” for $50,21 and vitamins that are “specially formulated for those experiencing (peri)menopause symptoms including hot flashes and brain fog” priced at $40 for 60 pills.22
Indeed, vitamins and other dietary supplements, which are largely unregulated by the Food and Drug Administration, are a notable segment of the menopause market. The company Wile, in which tennis star Serena Williams is one of the investors, is devoted entirely to vitamins for women over 40.23
Much of the advertising for lotions, creams, and dietary supplements aimed at menopause-aged consumers conveys a shame-free attitude toward aging generally and menopause specifically. For example, the tag line for the Stripes brand is “Welcome to a world where menopause isn’t a dirty word.”24 Kindra’s website features the prominent headline “Embracing the Change” and describes the company’s mission to “empower people who experience the hormonal changes of menopause to care for their bodies—naturally, safely, and holistically.”25
Many menopause-oriented companies also lean into personal messaging, even holding out the promise of finding community through the purchase of the company’s products. Kindra’s website features a picture of the company’s female CEO, next to which is a callout box saying that menopause “should not be like Fight Club. The first rule of menopause should be TALK about menopause.”26 Under the heading “Girlfriends and Guidance,” Kindra’s website includes a link to a members-only Facebook page billed as “Menopause Support & Straight-Talk.”27
Personal storytelling and the presence of a discernible company story, or “face,” at least on the firm’s website, are central to many menopause companies’ marketing strategies. For example, the advertising for Stripes emphasizes that the company was founded by actress Naomi Watts to offer “holistic menopause solutions” like creams and vaginal lubricants. On social media, Stripes asks potential consumers, “Curious why @naomiwatts founded Stripes? She did it for YOU!”28 This question is followed by a link to personal video testimony from Watts herself, who recounts feeling “completely lost” when she entered menopause. She says that her goal is for any woman going through menopause to feel supported by both the company’s products and “a community to wrap their arms around her and feel like she is being seen and her specific needs are being addressed.”29
This empowerment and sisterhood rhetoric tends to downplay the fact that menopause-oriented companies like Stripes are profit-seeking ventures at their core. Indeed, menopause companies often seek to project an “indie” image through web presences and marketing that includes information about the company’s origins, pictures of the people in leadership positions at the company, and even humorous or irreverent product names or advertising.30 All of this does not necessarily present a full picture of what the company is, however. Kindra’s website, for instance, does not mention that Kindra actually is backed by Procter & Gamble, the international consumer goods company that also sells well-known products like Always and Tampax brands of menstrual products, Head & Shoulders shampoo, and Gillette razors and skin-care products.31
HIGH-TECH CLOTHING
For some people, “dressing for menopause” (with tongue-in-cheek) might mean novelty T-shirts with slogans such as “In menopause and hotter than ever,”32 or “When I asked for a smoking hot body, menopause wasn’t what I had in mind.”33 For others, dressing for menopause is a practical consideration that involves choosing lightweight fabrics or layers that can be removed easily during a hot flash or that will dry quickly after night sweats. Although people almost certainly have been dressing with menopause in mind for centuries, there are now entire companies devoted to selling menopause clothing lines (i.e., “cool clothing for hot moments”34), often touted as having the ability to “control hot flashes and night sweats.”35 This is, of course, a misleading promise. No clothing can control the symptoms of menopause. That said, certain garments may feel more (or less) comfortable or make it easier for the wearer to cope with the symptoms of menopause.
Advances in the development of synthetic fibers and moisture-wicking fabric have allowed menopause-oriented businesses to craft a message that customers need special clothing at this stage of life. Because the clothing is advertised as special—and even technologically advanced—companies feel entitled to charge a premium for it, which some people seem to have no problem paying.
As is true in the multibillion-dollar maternity clothing business, “menopause” clothing tends to be more expensive than nonspecialty garments. But unlike purchasers of pregnancy clothing, who may need specialty clothing only for a limited period with a fixed end point, those experiencing the menopause transition might have symptoms that last for years or indefinitely, as discussed in Chapter 1. That often translates into high prices for consumers over a much longer term. For example, on the website of Fifty One Apparel (so named for the average age of menopause in the United States),36 a basic pajama short set sells for more than $80.37 The company appears to justify its prices by reference to technology; the pajama short set, for instance, features “Thermocules Technology” and “Outlast Temperature Regulating Fabric.” Fifty One Apparel describes these technologies under the headline “The NASA Technology Behind 51 Apparel.”38
Another company, Become Clothing, sells moisture-wicking underwear (to “leave you feeling confident and fresh throughout the day”) for $17 a pair, presumably with the promise that the wearer will feel drier after a hot flash or night sweats.39 At a slightly higher price range, starting at $25, Become Clothing also sells absorbent underwear designed for those with irregular menstrual bleeding, bladder leakage, or urinary incontinence associated with the menopause transition.40
Once again, an examination of the marketing of menopause shirts, sleepwear, and undergarments reveals how companies craft messages of allyship and empowerment to encourage purchases. For example, the company Cucumber Clothing uses messages of solidarity: “Rampaging hormones can whip up a whirlwind of menopausal symptoms. . . . Well, Cucumber Clothing has your back.”41 Fifty One Apparel, the purveyor of “menopause day, lounge and nightwear,” proclaims on its website, “You should never be held back by your menopause symptoms.”42 Hazel, a company that sells menopause underwear, hygiene wipes, and an “Anti-Stick Stick” to reduce “rashes and irritation causes by leaks and sweat,” explicitly uses marketing language that rejects negative associations with menopause. “For far too long,” the company’s website reads, “the incontinence category has made women feel ashamed and alienated (hello adult diapers); our products are all about . . . making you feel like your marvelous self at every age.”43 The implicit promise is that by buying these products, one can be “marvelous” and free from shame that may have plagued past generations. Spending money is positioned as the pathway for “treating” menopause, controlling one’s body, and improving one’s sense of self.
CHEMICAL CONCERNS
Given the positive messaging that dominates menopause clothing advertisements, consumers may not be aware that potentially harmful chemicals may be present in these products. Like exercise clothing, menopause clothing is advertised as having antimicrobial and odor control features. These qualities likely depend on the use of silver nanoparticles, which are small microscopic particles that have been identified as chemicals of possible concern for human health and are commonly referred to as “nanosilver.”44 Nanosilver can be absorbed through the skin, lungs, and mouth. In animal studies, nanosilver exposure has been shown to have a negative impact on organs such as the brain, liver, kidneys, spleen, and heart.45
Furthermore, given recent disclosures about the presence of per-and polyfluoroalkyl substances (PFAS) in so-called “period underwear,” it is quite possible that menopause underwear contains them as well. PFAS have been linked to a variety of health concerns, including cancer, thyroid disease, liver damage, and hypertension.46 In February 2023, European regulators proposed a gradual phaseout of all PFAS in all chemicals, mixtures, and products ranging from contact lenses to food packaging.47 In the United States, some PFAS are no longer produced because of their potential hazard to human health.48 Maine, Washington, and California, for example, have enacted strict rules on PFAS; several other states are considering legislation that would ban or sharply or limit them.49
In response to concerns about the dangers of PFAS, researchers at Emory University and the Chemical Insights Research Institute announced in 2023 the launch of a first-of-its-kind comprehensive study designed to precisely identify which PFAS are in certain clothing and furniture, whether and how PFAS are absorbed by the human body from consumer goods, and the impact of PFAS on human health.50 The results of that study, combined with negative publicity around chemicals in menstrual underwear, may impact the future shape of the market not only for menopause clothing, but also for garments and textiles more generally. Perhaps in anticipation of these developments, Become Clothing’s absorbent underwear are now advertised as PFAS-free.51
Although there are no publicized consumer tests for the presence of PFAS and nanosilver in menopause underwear specifically, there have been tests of menstrual underwear that show the presence of these chemicals.52 In 2023, the underwear company Thinx, which markets absorbent period underwear primarily as an alternative to tampons and pads, settled a class action lawsuit that alleged deceptive marketing practices concerning its menstrual underwear. The company previously advertised its underwear as “organic, sustainable, and nontoxic.”53 In connection with the 2023 settlement, Thinx claimed that PFAS were not part of the underwear’s “product design” but agreed to ensure that PFAS are not intentionally added to the underwear.54 Relatedly, the company also agreed that it will “not refer to the anti-microbial components of Agion,” which uses nanosilver and other particles for odor control, as “non-migratory,” or staying entirely on the clothing.55 In other words, the underwear does contain nanosilver; the company will simply limit its claims about the nanosilver’s staying in place.
Neither the complaint nor the settlement in the PFAS class action litigation made any mention of the company’s Speax product line of incontinence underwear (now known as Thinx for All Leaks), which can be useful to people suffering with menopause-related bladder issues, even though Speax was advertised as having the same absorbent and odor-reducing properties as the company’s menstrual underwear.56 Furthermore, Thinx is not under any obligation, either by statute or terms of the settlement, to make an affirmative showing of the absence of PFAS or nanosilver in its absorbent underwear.57
Thus, despite claims by Thinx and other companies that their absorbent underwear is “ecofriendly,”58 consumers have every reason to take a more cautious approach. Indeed, it is notable that a significant portion of the customer base for menopausal products has already expressed concerns about the possible side effects of MHT, which suggests that they may well be concerned about the prospect of chemicals in menopause underwear as well.59
MENOPAUSE-RELATED DEVICES
The market’s selection of technology-related products to “treat” menopause goes beyond creams, supplements, and clothing, and increasingly includes special devices as well. One such product is the “Cube Sleep System,” formerly called the “Chilipad,” a mattress topper that promises to “reduce hot flashes’ symptoms in both severity and duration by regulating your bed’s temperature” for about $700.60 Another device is the Embr Wave 2 wristband, which—also “at the touch of a button”—generates “precisely calibrated cooling or warming sensations to [provide] more control over your hot flashes and related menopause symptoms,” at the cost of $299.61 A different “smart” wristband (not yet available for sale to customers) is supposedly able to itself detect the onset of a hot flash and preemptively apply coolness to the wearer’s arms.62
In 2021, the Food and Drug Administration even approved an at-home ultrasound device to treat menopause-related vaginal dryness, without the use of hormones.63 The small handheld device is designed to stimulate blood flow to the vaginal canal to treat vulvovaginal atrophy64—a condition characterized by a shortening and tightening of the vaginal canal, vaginal soreness, vaginal dryness, and painful intercourse, and caused by low estrogen levels in the body.65
The promotional materials for these devices echo some of the same themes discernible in advertising for menopause clothing, skin-care products, and vitamins. Madorra, the maker of the ultrasound device, proclaims that its corporate goal is “to empower people to live fuller, healthier lives,” adding that its device is the first to provide a nonhormonal alternative to MHT for “post-menopausal people and breast cancer survivors.” In this way, Madorra embraces the familiar trope of empowerment, saying that “[a]ll people have the right to choose” how to address their symptoms of menopause.66 Relatedly, Embr Wave touts its “exclusive technology” that is “grounded in thermal science,” mirroring the language used to market high-tech menopause clothes that use “NASA” technology.67
CURING THROUGH SPENDING?
Menopause capitalism is propelled by creating a perceived need for expensive products to cope with inevitable bodily functions. Indeed, what all these menopause products—from skin care, creams, and vitamins to clothing, pillows, and devices—have in common is marketing that relies on the notion that menopause is a “problem” with a “solution” that can be achieved through spending. The notion that exclusive, NASA-level technology is necessary here is striking. No doubt, many of these products do provide relief to their customers, and it is certainly positive that menopausal symptoms are being recognized and taken seriously by the market. However, fans, ice packs, or other inexpensive options may also be effective in addressing many menopausal symptoms (although not necessarily vaginal atrophy).
