Ro Launches Direct-To-Consumer Site To Treat Women’s Hot Flashes Other Menopause Symptoms - Forbes

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From left, Rory clinical director Dr. Melynda Barnes, Rory cofounder Rachel Blank and Ro CEO Zachariah Reitano. Courtesy of Ro

Direct-to-consumer telehealth startup Ro launched in 2017 selling erectile dysfunction pills to men. Now, it's launching a new brand for women in "midlife" with medications to treat some of the symptoms of menopause.

Called "Rory,"[1] the brand will be led by Rachel Blank, who met Ro's founders while working at one of the startup's investors, General Catalyst. (Forbes Media has an investment in Ro.) Despite growing up around a gynecologist—her father—Blank herself says she had been experiencing symptoms of a hormonal condition called polycystic ovary syndrome for years before she was ultimately diagnosed at age 22.

"When I first met the Ro founders when I was at General Catalyst and heard about what they were doing for stigmatized healthcare conditions, it really resonated with me," says Blank.

Rival direct-to-consumer site Hims launched its own platform for women called Hers[2] last year, though its product line, like acne creams and birth control pills, focuses more on the needs of younger women. Blank says that was the exact reason Ro wanted to focus on a different group. "If you look at every direct-to-consumer company, whether it's telemedicine or shoes, they almost all are addressing millennial women," says Blank. Instead, Rory is focused on the estimated 43 million women between 45 and 64 in the U.S. who are part of the group likely dealing with symptoms of menopause.

"Frankly, it felt like the biggest opportunity to really serve women," says Blank. To start Rory will sell products treating common symptoms of menopause, like hot flashes and vaginal dryness. They'll have over-the-counter products like water-based lubricant and supplements vitamin E and black cohosh for hot flashes. Prescription medications will include venlafaxine or paroxetine for hot flashes, Estradiol hormone cream for vaginal dryness, plus the prescription eyelash regrowth drug Latisse.

Like with Ro's other brands, Blank says potential patients will be screened by a Ro-employed physicianto determine if they qualify for any of the prescription medications. For example, to get prescriptions for medications treating hot flashes and vaginal dryness, women are required to have had an in-person vaginal exam within the last two years. A consultation costs $15 and OTC products range from $9-$25 per month, while prescription meds will be $20-$60 per month; Latisse costs over $100 per month.    

"I applaud the idea that we are increasing awareness and increasing availability of treatment options for women," says Dr. Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Health and Menopause. Many women who are experiencing menopause symptoms, Streicher says, don't necessarily seek treatment and choose instead to try to "tough it out." She added, stressing the benefits her patients get from the in-person appointments at Northwestern, that "we need to be cautious."

For example, director of the Midlife Women's Health Center at Massachusetts General Hospital Dr. Jan Shifrensays supplements like Vitamin E or black cohosh are fine for women to try for treating their hot flashes the way they could have cold drinks and wear lightweight clothing, but women shouldn't be told that they're going to be "really effective." (Though there have been reports[3] that black cohosh has caused liver issues.) Past studies have shown that both supplements have had an effect of treating hot flashes that is roughly on par with a placebo.  

One treatment area for moderate-to-severe hot flashes that Rory is leaving to the in-person doctor's visit is hormone therapy[4].While executive director of the North American Menopause Society Dr. Joann Pinkerton says that the low-dose venlafaxine and paroxetine that Rory will offer (higher doses are used in other settings as antidepressants) can help with hot flashes, she explained that hormone therapy has been shown most recently to have the "best benefit over risk ratio" for symptomatic menopausal women who are under 60 and within 10 years of menopause. Pinkerton also explained that there are several options beyond just the Estradiol hormone cream that women could use to treat vaginal dryness.

"Our treatment plans are 20-30 page documents that include most, if not all, of the information that a physician would discuss with their patient if they had 45 minutes to counsel them," wrote Rory's clinical director Dr. Melynda Barnes via email. "We pride ourselves on the thoroughness of our treatment plans in educating our members on all the different types of treatment options, as well as potential side effects and limitations of those options. Our blog also covers symptoms and conditions related to menopause that we do not specifically treat."

Blank says that Rory aims to be a "complement" and "not a substitute" for in-person healthcare, and that women using Rory will be encouraged to see in-person providers so they can address things like bone scans, pap smears and mammograms.

Ro last raised an $88 million Series A[5] from investors like General Catalyst and Reddit cofounder Alexis Ohanian's Initialized Capital in September 2018, bringing the company's total funding to $97 million, according to Pitchbook. In September Ro also launched a smoking cessation service called Zero that sells smokers kits containing nicotine gum, prescription drug bupropion and a behavioral therapy app.

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References

  1. ^Called "Rory," (www.hellorory.com)
  2. ^launched its own platform for women called Hers (www.forbes.com)
  3. ^reports (www.menopause.org)
  4. ^hormone therapy (www.menopause.org)
  5. ^last raised an $88 million Series A (www.forbes.com)
  6. ^here (forbes.us13.list-manage.com)

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