Dr. Jen Gunter

Gwyneth Paltrow wants to monetize menopause

Gwyneth Paltrow is out to monetize menopause.

She’s telling everyone about her pre menopausal journey and COINCIDENTALLY has a  supplement called Madame Ovary.

Ha ha. Get it? A play on Flaubert’s Madame Bovary.

The name did make me wonder if anyone at GOOP has actually read the book, because as much as I enjoyed it I certainly don’t want to emulate Madame Bovary. In any way. Like at all. Especially as I age, or not in her case. It doesn’t end well.

If you haven’t read Madame Bovary or you did but have forgotten most of it allow me to summarize (I’m reaching back to 1st year university, so English majors and my beloved librarians be kind):

Madame Bovary is about a farm girl who marries a doctor. She quickly becomes bored with her middle-class life. She has an affair with a man who does not love her and then has another affair. She becomes obsessed with aspirational living. Her debts mount, so she turns to prostitution. Her double life about to be exposed, she kills herself with arsenic.

There are a lot of themes in the book and I am but a simple gynecologist, but aspirational living gone wrong, a major plot point, seems like how I would snidely describe GOOP not how they should be advertising themselves.

Anyway…

No one needs the kind of supplements they sell on GOOP. There are many unresolved safety issues with supplements and multivitamins, but a good summary is no study has shown that they are beneficial for an otherwise healthy person living in a developed country. Many of these products have also been adulterated or do not contain what they claim. I have an idea about raising money to have GOOP products tested to see what is even in them. If you are such an Angel investor, let me know!

Back to aspirational living gone wrong.

No woman needs Madame Ovary. There is a lot of vitamin A (8,000 IU) and if you don’t live in developing country or don’t have cystic fibrosis you probably don’t need any additional vitamin A. Here are the NIH guidelines on Vitamin A.  There are lots of unresolved issues regarding vitamin A and cancer risk, so additional vitamin A is always a big nope for me.

You also don’t need that green tea leaf extract in Madame Ovary, unless risking liver injury is your thing. Currently there is insufficient evidence to recommend Black Cohosh for menopausal symptoms.

Given Paltrow’s propensity for making clams why she needs that much vitamin B12 is clearly unknown. Four ounces of cooked clams gives you as much vitamin B12 as Madame Ovary.

The only type of supplements an otherwise healthy pre or menopausal women may need are calcium and vitamin D. Ask your doctor if you need those and double-check the recommendations on the NIH Office of Dietary Supplements Site. You can buy those for a lot less than Madame Ovary at any drug store, Target, or Costco. I am pretty strict with my diet so I get all my calcium that way (maybe I should send Paltrow some of my recipes?), but I appreciate it is hard to do.

But the worst advice from Paltrow is the bullshit she is spouting about hormone levels. She brags about getting her “hormones” checked twice a year. That is, quite frankly, bad medicine. Neither ACOG nor the North American Menopause Society (NAMS) recommend hormone levels. They vary not only day-to-day but throughout the day. We also don’t do anything with the levels.

This is what NAMS has to say:

Testing hormone levels is not required to determine whether a woman has the “right amount” of hormones. The optimal hormone levels in postmenopausal women have not been established. How symptoms respond to a particular dose of hormones or nonhormonal menopause medication is the only reliable guide. 

Saliva testing is often a part of custom-compounded “bioidentical hormone therapy” with hormones. But saliva testing is not only unnecessary; it has also has also not been proven to be accurate or reliable. Because hormone levels vary day-to-day as well as throughout the day, even a blood test cannot accurately reflect the body’s hormone levels.

The common hormone test that may be appropriate is for the level of follicle-stimulating hormone (FSH) to help determine if a woman is in menopause, especially for women who do not have a uterus and thus cannot tell by their menstrual pattern that they are menopausal. 

NAMS does not recommend saliva testing to determine hormone levels and does not recommend custom-compounded products over well-tested, government-approved products for the majority of women.

We might check the FSH level for a woman over 40 if she hasn’t had a period for a while and wants to know if she is at risk for getting pregnant. A common situation might be a 47-year-old with no period for a year who wants to be super sure before she pulls her copper IUD.

We do not manage symptoms or prescribe hormones or offer any medical care at all based on hormone levels. Anyone who says otherwise is wrong.

While Paltrow is free to get all the wrong medical advice that she wants, women see recommendations from celebrities like Paltrow and then ask their own providers why they can’t get their hormone levels done? To those women I say, your doctor is up to date and following good guidelines!

And I have yet to see a celebrity who gives menopausal advice that is even vaguely accurate.

While we are on the subject of hormones, shame on you Vogue for publishing this utter bullshit recommending hormone testing for 20-year-old women last week. So much for Anna Wintour’s commitment to fact checking. That article is medical drivel.

So give the GOOPy Madame Ovary a big pass as well as Paltrow’s terrible hormone advice. It is truly apirational living gone wrong.

(BTW, I’m not linking to GOOP anymore, if you want to read up on Madame Ovary with your own eyeballs have at it!)

Madame Ovary’s “proprietary” blend