Menopause is receiving more attention than it has in twenty years, which is good. It has also become a market, which is more complicated.
Menoprofiteering is the term for what happens when gaps in medical knowledge are monetized rather than closed: unregulated, expensive or unnecessary products sold to women who are uncomfortable, poorly informed and have often already been dismissed by the healthcare system. Any practice entering this space needs a position on it, because patients are actively watching for the difference.
In Summary:
| Commercial interest in menopause has grown faster than clinical training, and the gap is being filled by things that do not work. |
| The recurring pattern is the same: an unmet need, an untrained market, and a product sold as a personalized solution. |
| Four practices to avoid: routine hormone panels as a diagnostic, compounded hormones and pellets, subscription testing, and device-first sexual health care. |
| Credibility is the durable asset in this field. It is built slowly and lost in a single claim. |
Why this field is so exposed
The conditions are unusually favorable for it. There is a large population with real symptoms, a shortage of trained providers, two decades of misinformation about hormone therapy, and a patient group whose complaints have historically been minimized.
That combination produces motivated buyers with no reliable way to evaluate what they are being sold. When a patient has been told by three clinicians that nothing is wrong, a confident commercial voice offering a personalized protocol is persuasive.
Four things to keep out of your service
Routine hormone panels presented as diagnostic. In women over 45, perimenopause is identified from history and symptom pattern, because follicle-stimulating hormone and estradiol fluctuate too widely for single readings to be conclusive. Testing has a role in excluding other conditions and carries more weight under 45. Selling a hormone panel as the thing that will tell a patient where she is in the transition is not supportable.
Compounded hormones and hormone pellets. FDA-approved products exist across a range of doses and routes. Compounded preparations are not subject to the same manufacturing and consistency standards, and pellets deliver doses that cannot be adjusted or withdrawn once implanted. There are narrow circumstances where compounding is appropriate, and routine use is not one of them.
Subscription lab testing and repeat panels. Recurring testing generates revenue and rarely changes management in a patient whose diagnosis rests on history.
Device-first sexual health care. Where a patient with genitourinary syndrome of menopause is offered an energy-based device before local vaginal estrogen has been discussed, the evidence hierarchy has been inverted. Offer the treatment with the strongest evidence first, and describe adjuncts accurately.
The marketing lines that cause the most damage
Some of these appear in otherwise reputable practices.
Claims of a hormone imbalance requiring correction to a target level. Bioidentical framed as though it means safer or more natural rather than describing molecular structure. Optimization language applied to hormone levels. Any suggestion that hormone therapy prevents dementia, since the evidence does not establish it as a dementia-prevention strategy. Before-and-after framing borrowed from aesthetics and applied to a symptom that is reported rather than visible.
Fear-based framing is the other side of the same problem, and it is equally unhelpful. Neither hormones will save you nor hormones will harm you is an accurate account of the evidence.
What a defensible commercial model looks like
Charging properly for clinical time and expertise is entirely legitimate. The distinction is what the patient is paying for.
A defensible model charges for assessment, explanation, treatment and follow-up, and is transparent about what each costs. A problematic model charges for tests that do not change management, products with weak evidence, or subscriptions the patient cannot easily leave.
Retail is not automatically a problem either, provided recommendations come from a clinician as part of a plan, the evidence base is described accurately, and no member of staff is incentivized to sell a product to a patient who does not need it.
How to signal the difference to patients
Patients evaluating a menopause service cannot assess your clinical reasoning, so they use proxies. Give them good ones.
State your clinician’s training and certification. Explain your assessment pathway on your website, including that diagnosis rests on history rather than a test. Name what you refer out. Say what you do not offer and why. Publish accurate education rather than promotional content.
Pointing patients toward independent resources also builds trust rather than costing you anything. The Menopause Society publishes evidence-based position statements and maintains a directory of certified practitioners, and reputable nonprofits provide free education. A practice confident in its own standards has no reason to keep patients away from those sources.
The long view
This field is going to be scrutinized. Attention brings regulators, journalists and professional bodies, and practices that built on weak claims will be the case studies.
The alternative is not complicated: train properly, follow the evidence, charge for care rather than for products, and be honest about uncertainty. That is also, as it happens, what patients are looking for, because most of them have already encountered the alternative.
The commercialization of gaps in menopause knowledge, typically through unregulated, expensive or unnecessary products marketed to women with real symptoms and limited access to trained providers.
Yes, principally for excluding other conditions and in patients under 45, where testing carries more weight. They are not a reliable way to stage the transition in women over 45.
They are not subject to the same manufacturing and consistency standards as FDA-approved products. Pellets additionally deliver doses that cannot be adjusted or withdrawn once implanted.
No. It describes molecular structure, not safety. Several FDA-approved products are bioidentical, and the term is frequently used in marketing to imply something it does not.
es, where recommendations come from a clinician as part of a treatment plan, the evidence is described accurately, and staff are not incentivized to sell to patients who do not need it.
The evidence does not establish menopausal hormone therapy as a dementia-prevention strategy, and it should not be marketed as one. Treating symptoms that disrupt sleep and mood can improve how a patient functions, which is a different claim.
