Frequently Asked Questions

Your Health

What are menopause treatment options for breast cancer survivors?

Learn about menopause treatment options for breast cancer survivors here!

What is Perimenopause?

Perimenopause describes the years leading up to menopause, beginning in your forties, when the estrogen levels in your body start to fluctuate. Symptoms of perimenopause vary among women but can include irregular periods, prolonged and sometimes very heavy periods, sleep disruption, acne, mood swings, irritability, anxiety, depression, weight gain, and occasional hot flashes and night sweats.

What are hot flashes?

Hot flashes are one of the most common menopausal complaints. Night sweats are just the after-hours version of hot flashes. While science has not yet determined what causes hot flashes, we know that your brain is extremely sensitive to estrogen levels (yes, even your brain has estrogen receptors). Estrogen affects the area of the brain responsible for temperature regulation. So as estrogen declines at menopause, it affects the way our bodies react to temperature. A hot flash happens when your brain thinks that it needs to cool your body down, as if someone had turned on a furnace inside your body. They can happen anytime anywhere and can be quite distressing.

I only know about hot flashes. What are other symptoms of menopause?

By some counts, there are at least 34 symptoms of menopause, most caused by the declining level or lack of estrogen in your body. The most well-known are hot flashes (also called night sweats), but others are sleep disruption, mood swings, brain fog, weight gain, vaginal dryness, painful sex, libido decline, and urinary symptoms. For more information, explore our symptoms pages.

What is Menopause?

Menopause officially begins one year after the date of your last period. Prior to this, starting for most women around the age of 40, you are perimenopausal, and after one year of no periods you are forever and ever postmenopausal. (If menopause is your wedding date, perimenopause is like your engagement–some are short and some are long, very long! And being postmenopausal is like being married, except it’s always, definitely forever.) Menopausal symptoms, however, begin and end on a timetable all their own, starting well before the last period and continuing for months to even years after. It can be a fantastic, freeing time of life, but there are a host of symptoms that make it hard to enjoy. There are many symptoms of menopause, but some of the most common are hot flashes, night sweats, sleep disruption, vaginal dryness, mood swings, brain fog, and weight gain.

Our Products

What does “bioidentical” estrogen mean?

The term “bioidentical” simply means that the chemical structure of the estrogen (either in pill or patch) is the same as the estrogen that the ovaries make naturally. It has nothing to do with how the hormones are made. Estradiol pills are considered bioidentical.

What is Menopausal Hormone Treatment and is it safe for me?

Menopausal Hormone Treatment (MHT) is the newer term for what has commonly been known as Hormone Replacement Therapy (HRT). The name was changed to more accurately reflect what happens in your body when you take MHT. MHT is not intended to replace the hormones at the level that they were prior to menopause. The goal of treatment is simply to use the amount of hormone that adequately treats the symptoms of menopause. The amount of estrogen used after menopause is much less than the ovaries normally produce at ovulation and at least one half to one third the amount of estrogen in a low dose oral contraceptive. The Menopause Society published a position paper in 2017 stating that MHT is safe and effective for the overwhelming majority of healthy menopausal women. It’s important to speak to a doctor about what the right treatment is for you. Alloy provides access to doctors who specialize in menopause treatments.

What is the difference between estrogen and estradiol and why is estradiol prescribed?

Your body makes several different strains of estrogen, including estradiol, estriol, and estrone. Estrogens play a key role in the reproductive function of women’s bodies as well many functions outside of reproduction, including temperature regulation, mood stability, metabolism, maintenance of bone density and cardiovascular health. Estradiol is the most commonly prescribed estrogen for menopause.

Why do you recommend taking your daily synbiotic?

We formulated the Alloy Synbiotic to be exactly what we were looking for ourselves to help support our overall wellness and to cultivate a highly diverse microbiome. The ‘microbiome’ refers to the millions of microorganisms (good bacteria) in your intestines that affect your digestion, weight, immunity, and brain. Significant bodies of research have shown that the common thread among people who have lived to the oldest ages in the best condition all had a diverse and thriving microbiome. Within your microbiome is your estrobolome, a mini-microbiome devoted entirely to regulating your estrogen levels. As we age and our estrogen levels drop, our microbiome becomes less diverse, and our estrobolome function declines, exacerbating estrogen deficiency and increasing inflammation in the body. The Alloy Synbiotic is formulated specifically to boost the microbial diversity and estrobolome function of perimenopausal and menopausal women. Our custom blend of potent probiotic spores, gold kiwifruit prebiotic fiber, and citrus polyphenols balances your microbiome as estrogen declines.

What is a synbiotic? Why don’t you just call it a probiotic?

A synbiotic is a PRE-biotic plus a PRO-biotic. Why is that important? The good bacteria you need in your gut for a diverse microbiome need prebiotic fiber to thrive. Prebiotics are like food for all the good bacteria in your gut. Our synbiotic is a powerful spore-based probiotic combined with pre-biotic fiber made of golden kiwi fruits from New Zealand.

What is progesterone and why is it prescribed?

Progesterone is one of the hormones that the ovary produces after ovulation. Progesterone balances the estrogen produced in a normal cycle by limiting the growth of the uterine lining. Each menstrual cycle is delicate balance of these two hormones. The imbalance of these two hormones (more estrogen and less progesterone) can lead to unduly long and extremely heavy periods in perimenopause. Estrogen alone (unopposed) leads to unchecked thickening and possibly long term risks of endometrial cancer, and that is why after menopause women with a uterus need to take both estrogen and progesterone. Women with hysterectomies, women with hormonal IUDs, transgender women and women who have congenital absence of the uterus do not need to take progestins.

Customer Support

How do I get my prescription reimbursed through my insurance?

Unfortunately we do not accept insurance at this time. However, many women are able to get their Alloy prescriptions reimbursed through their PPO insurance provider, FSA, or HSA by submitting their itemized receipt. If you have any questions about how to do this, please email

What is Alloy's Return Policy?

We can’t accept any returns on medications–it’s a legal thing! Please reach out to if you have any questions or if there was an error in your prescription.

When will I receive my Alloy delivery?

Alloy orders are sent via US mail, so in most cases that means three to five days from the time of your order.

Where is Alloy available?

Alloy is available in all 50 states plus the District of Columbia.

Your Telehealth Visit

What are the qualifications of the doctors on the Alloy telehealth platform?

The board-certified medical doctors on the Alloy platform all have a passion for women’s health and are specifically trained in treating women in perimenopause and menopause. All of the doctors working with Alloy follow the protocols set by The Menopause Society and the American College of Obstetricians and Gynecologists.