Menopause care may be having a moment—but for decades, women were left to navigate it with little guidance and even less support. Anne Fulenwider and Monica Molenaar saw that gap early—and built Alloy to fix it.
Launched in 2021, Alloy delivers expert, evidence-based care for women in perimenopause and menopause—exclusively from board-certified physicians. The idea was deeply personal: both founders were navigating their own symptoms and searching for answers in a system that wasn’t built for them. They built Alloy before the conversation caught up. Now, as women demand faster access and better care, their approach feels less ahead of its time—and more essential.
We spoke with Anne and Monica about what they saw early, why menopause has been overlooked, and what needs to change.
When you launched Alloy in 2021, menopause care wasn’t nearly as widely discussed as it is today. What did you see early on that others were overlooking?
Monica: My journey to starting Alloy began with my own experience going through surgical menopause at 40. I was living in New York City, with access to some of the best doctors in the world. Yet I didn’t feel like myself, and no one was helping me understand why. My sudden experience of menopause exposed a much bigger problem. Like so many women, I did not have the language for what was happening in my body. It felt confusing and isolating. Eventually, I found relief through the right hormone therapy. But it should not have taken five years, multiple doctors, and that level of confusion to get there.
Anne: What Monica experienced was not unique. And yet, when we first started Alloy, menopause was barely part of the public conversation, even though it is something every woman will go through if she lives long enough. The scale of the gap was impossible to ignore: tens of millions of women navigating menopause, with fewer than two thousand doctors trained to treat them—and women left to figure it out on their own. I often say Monica was the canary in the coal mine. And it is true.
Why do you think this stage of life has historically been missing from mainstream health education?
Anne: The way that the healthcare system has served women historically has been narrowly defined around reproduction. Once you move beyond that phase, the system pretty much ignores you until you need geriatric, crisis-intervention care. Menopause was framed as something to endure quietly, not something to understand.
Monica: That lack of visibility shows up in real life too. So much of what women know about their bodies has historically been passed through conversations with other women, not through the healthcare system.
At what age should women realistically start learning about menopause and perimenopause and what are the most important things they should know early on?
Anne: Honestly? The same time we learn about our periods. If we are old enough to understand reproduction, we are old enough to understand the full biological continuum. Reproduction should be framed as having a beginning and an end, and while it's important, a woman's life is much larger than that. The earlier women understand that, the less confusing it becomes later.
How early can perimenopause start, and what are some of the first signs women should be aware of?
Anne: Perimenopause can start earlier than most people realize, sometimes as early as the mid to late 30s, and definitely in your mid-40s. And the first signs do not look the way people expect. It is not just hot flashes. Those often come later. Early on, it can be changes in mood, disrupted sleep, brain fog, weight fluctuations, or irregular periods. And I will be honest, I was in perimenopause while we were building Alloy and did not know! That is how big the awareness gap is.
Why do you think the cultural conversation is finally catching up now?
Anne: This is not happening by accident. Most women going through menopause right now are Gen X, and they are fundamentally different from the generations before them. They do not take life stage changes sitting down. They advocate for themselves and push for better solutions.
They also learned from younger generations. Millennial women, who are now entering perimenopause, have been much more vocal about their health, whether it is fertility, PCOS, or mental health, and that created a cultural shift. Gen X women picked up on that and applied it to menopause.
