Digital health and wellness entrepreneurs are taking on menopause
Jul 21, 2020
10 min read
Shining a spotlight on the long overlooked market
There’s one femtech segment that has notably flown under the radar in recent years despite the major increase in funding for women’s health products and services: Menopause. Though several new companies have formed to address the unique challenges and symptoms associated with perimenopause, menopause, and post-menopause, the space has not garnered the same attention in the women’s health or “femtech” moment as menstruation or fertility. But given the enormous audience, lack of consistent information, and dearth of medical specialists, there is no stage of life more apt for digital health transformation. This article explores:
- Why direct-to-consumer digital health is well suited for menopause
- Why innovation for the menopause life stage has happened so slowly
- What the menopause market looks like within the US
- How digital health platforms are supporting individuals in menopause
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The current state of DTC health
Following success stories in other industries, healthcare welcomed a wave of direct-to-consumer (DTC) digital health companies over the past several years. This influx of DTC entrants connects to a larger shift toward consumer-driven healthcare. Rising health insurance costs partnered with increased digital innovation in healthcare have led patients to become more involved in searching for, vetting, and selecting health products and solutions that meet their needs.
DTC digital health tools and platforms typically focus on education and personalized care resources. Many also provide access to services such as telehealth visits with a network of specialists or products such as supplements or home test kits. The benefit of these platforms is their ability to build a devoted community while bypassing traditional care pathways and making health services more transparent and accessible.
However, the DTC model also poses unique challenges. User acquisition can be incredibly expensive, and many DTC business models fail to sustain growth over time. For this reason, there are certain health conditions or situations for which DTC digital health is particularly well suited:
Health situations that are widespread and affect a large percentage of the population
Health situations whose symptoms interfere with daily life to the extent that patients seek out solutions
Health situations where reputable information and resources are not widely available for patients
Health situations that do not have clearly established care journeys and patient expectations
Half of the population will experience menopause in their lifetimes with as many as 85% of them enduring symptoms that range from uncomfortable to debilitating. The most common ailments during the perimenopause and menopause life stages are vasomotor symptoms—hot flashes or night sweats—but there are up to 34 symptoms that affect women in vastly different ways at different points throughout midlife.
Even with its widespread effects, there are surprisingly limited resources available to help women understand what to expect during this life stage, how to combat symptoms, and who to turn to for medical expertise. According to a survey of US obstetrics and gynecology residents by Johns Hopkins, fewer than one in five receive formal training in menopause medicine. So what has led to this phenomenon?
A slow turn to menopause
There are a few reasons why the menopause product space has been slow to innovate. For one, many of the entrepreneurs leading the charge in the digital health startup space have not personally experienced menopause—either because they are cis men or because they are younger women who have not yet reached the life stage. Though personal experience isn’t always a prerequisite for building a company, it is a key component in the origin story of many prominent digital health brands. And with an older affected population than many buzzy millennial-focused brands, menopause has seen less Silicon Valley tech attention.
The same lack of representation hinders menopause company founders navigating the VC landscape. “We pitch to men who just can’t get excited and passionate talking about vaginas,” explains Colette Courtion, CEO and founder of Joylux, which offers red-light devices designed to improve pelvic floor health and function for women. “Meanwhile, men’s health companies—the hims of the world—are getting hundred million dollar checks written for a platform promoting products that have been in the market for 30 years. Erectile dysfunction affects one in four men, while 50% of women experience symptoms like low sex drive, pain with intercourse, and vaginal dryness. But the money just isn’t flowing there yet. Where we have had success is raising from women angel investors who are in our target demographic because they really get the problem. They understand how big it is.”
Another reason is societal taboos. Despite menopause being just as prevalent in the population as the onset of periods, it has not benefited from the same taboo-smashing marketing campaigns in recent years. “As a society, we’ve been made to believe that reproduction is the pinnacle achievement in a woman’s life,” says Ann Garnier, founder and CEO of Lisa Health, a company that offers personalized insights and plans for each individual menopause journey. “When a woman gives birth it’s widely celebrated. When a woman transitions to menopause, in many cultures this event is barely acknowledged as an important beginning to a new life stage. Often, menopausal women describe feeling invisible and that their symptoms are dismissed. It’s no wonder women feel uncomfortable talking about menopause.” As one example, recent studies have pointed to the discomfort that women feel discussing menopause in the workplace, even when its symptoms directly impede professional performance.
Finally, like many other conditions or health situations that disproportionately (or solely) affect women, menopause has received little attention and study in the historically male-driven healthcare field. Jeanne Chung founded MIGHTY Menopause, a company modernizing menopause with specialized products, services, and data. “The underrepresentation of the menopause transition is one of the more extreme examples where women’s health issues are disregarded and considered unimportant due to the historic bias when it comes to medical research and literature.” Chung suggests that this underrepresentation is a combination of several factors:
- The patriarchy—or male dominance—in science and medicine.
- The disproportionate emphasis on acute problems (e.g., tumors, infections) versus chronic conditions.
- The persistent cultural emphasis on youth over experience or age, translating to clinical priorities like fertility and obstetrics over issues related to aging.
- The historical lack of interest by male doctors and researchers to understand the complexity of aging female reproductive endocrinology, resulting in its dismissal.
Many women feel uncomfortable discussing menopause symptoms and the built-in association with aging, which leads to even more shame or stigma around symptoms that they don’t understand. “There’s no roadmap for menopause,” explains Jill Angelo, co-founder and CEO of Gennev, a virtual clinic that matches women with telehealth-based OBGYNs and Registered Dietitians, supplements, and education based on the symptoms they’re experiencing. “There’s no first trimester or second trimester. As women, we know perimenopause and post-menopause based on the anniversary of no menstrual cycle, but understanding when and why a woman experiences a variety of symptoms is what we’re able to offer through the Gennev Menopause Assessment.”
As slow as the transition has been, attention is beginning to turn to menopause and the massive market opportunity to serve women in midlife who are actively seeking solutions.
The menopause market
The menopause market is poised for massive growth. By 2025 there will be 1 billion women experiencing menopause globally—12% of the population. And within the US, the age demographic typically entering perimenopause (ages 45-55) makes up the wealthiest households. “When I first started out, this discrepancy really puzzled me,” explains Garnier. “When you have a group of women who are economically the most powerful people in the world and are the chief healthcare decision-makers, why is this critical period of their life going largely ignored and underserved by the healthcare and research communities?”
The segment is also becoming increasingly tech savvy: Smartphone adoption and use of digital tools and services continue to increase across all age groups in the US. Plus, women in Generation X (and even the upper end of the Millennial generation) who have come to expect personalized digital experiences are in—or approaching—the perimenopause life stage. According to a 2019 survey, Gen X is leading the charge on digital health adoption: They are 37% more likely than Gen Z and 31% more likely than baby boomers to manage a medical condition with a mobile app. Having relied upon digital tools such as period trackers or digital fertility clinics for earlier life stages, women will increasingly expect a comparable set of digital tools and services to support them in the menopause stage of life.
An AARP survey found that nearly all women currently in the menopause life stage—93%—are interested in non-invasive tech solutions for menopause symptoms. This staggering number led the AARP to host the first menopause hackathon, which invited innovators to submit tech solutions and devices that help women experiencing menopause symptoms such as hot flashes, fatigue, and sleep disorders.
DTC digital health solutions
With a massive, largely untapped market, new digital health brands are offering novel solutions and services for those in perimenopause and menopause. Digital menopause companies offer a range of services:
- Education on perimenopause, menopause, and post-menopause life stages.
- Crowd-sourced data from digital users to inform broader expectations for each stage of perimenopause and menopause.
- Access to a network of medical professionals who specialize in menopause.
- Non-hormonal products that can be purchased through a digital e-commerce platform (e.g. supplements, sleep aids, devices).
Despite its ubiquitousness, menopause is not well understood in the medical field or across the population more broadly. As a result, digital health companies in the space center user education as a cornerstone of their offerings. “The number one question is: am I in menopause? And then the number two question is: is what I’m experiencing normal?” says Angelo. “There are a lot of changes in the body that you wouldn’t necessarily associate with menopause. You think of hot flashes or moodiness or weight gain, but you don’t think about joint pain and trouble sleeping. You don’t think about heart palpitations or tingling fingers. There’s a lot happening in a woman’s body as her hormones shift—there are 34 different symptoms associated with menopause.”
“Women aren’t uneducated about menopause, but they’re certainly undereducated. Like with any other medical decision, we should be empowering women by helping them understand what their options are and what questions they need to ask,” explains Alessandra Henderson, Co-founder and CEO of Elektra Health, a virtual menopause clinic that empowers women with access to menopause specialists, online education, and community support. “We recently launched a series of online workshops built and led by world-class experts. These workshops offer women a safe, welcoming space to better understand and manage their physical, mental and hormonal health alongside a supportive community of peers.”
“Women are searching for information and knowledge,” elaborates Garnier. “There are few physicians trained in menopausal care and when people turn to Dr. Google, they find it very complex and confusing. They don’t know what information to trust and there are a lot of myths and misinformation out there. At Lisa Health, technology is fundamental to our approach and as women are seeking information about their unique menopause journey, we’re providing data-driven personalized insights specific to them as well as our recommendations for non-hormonal, science-backed interventions.”
As explained by Garnier, much of this education has to do with breaking the myth that there is one singular menopause experience that all people will face. Instead, there are many factors that might influence how a person experiences menopause: “There are different phases, different hormonal profiles, and different symptom sets that occur through the multi-year transition,” explains Chung. “At MIGHTY Menopause, we started out focusing primarily on perimenopause, which is a distinction that doesn’t really exist in the market.”
Digital health companies have the unique ability to educate a broad audience while simultaneously learning more about the menopause life stage from the experiences of their users.
Several companies are taking a data-driven approach to inform education and treatment options. Lisa Health’s assessment tool collects user data to inform predictive algorithms and evidence-based recommendations personalized to user needs.
Gennev created a menopause journey map based on proprietary assessment responses from over 50,000 women. “We’ve outlined five ‘types’ that define where you are in your journey with menopause,” explains Angelo. This can help women understand where they are within the broad population and what they might expect next. Over time, we’ll have enough of that credible data (through hundreds of thousands of responses) to start putting together predictive models that can help us provide more accurate, automated recommendations.”
MIGHTY Menopause is also leveraging data to analyze symptom sets and non-hormonal treatment outcomes. Chung explains: “We have developed a symptom tracking tool for our users that provides daily and weekly engagement as well as monthly progress reports tied to their use of our supplements. This is key for user engagement, but also informs our broader understanding of how to best meet user needs. We are building a data platform to aggregate behavioral data over time and integrate it with external data like research studies and clinical data to improve wellness decisions for individual women. As we collect more data, we will be able to derive new insights that will drive innovation such as continually improving products/services, improved clinical practices, and specialized research.”
Network of specialists
With a limited number of physicians who specialize in menopause, telemedicine has unlocked access to medical advice for many users—especially those living in remote areas. WellFemme, a telehealth menopause clinic based in Australia, is one example of a virtual clinic increasing access to menopause-related consultations. “We help women directly access the specialized menopause advice and treatment they need, regardless of where they live,” explains founder Dr. Kelly Teagle. “This service is absolutely essential for women in regional, rural, and remote communities. They often have a limited choice of general practitioner, many of whom may not have a good knowledge of menopause treatments, and they have to wait or travel a long time to see a specialist.”
The virtual clinic model also presents an opportunity to refine the standard of menopause care through a diverse network of specialized providers. “At Elektra Health, we’ve been working with our founding physician and several other amazing experts to build out a standard of care because right now the menopause field is very fragmented. There’s no one-size-fits-all solution, so we really need to be able to work directly with women to provide the type of care they need,” says Henderson.
Gennev also helps connect users with specialists to discuss a range of treatment options. Angelo explains: “Once someone takes our assessment, we provide some resources through content and community, but we try not to be too prescriptive beyond that. Instead, we say, ‘You told us this, so here is a doctor you can talk to if you want to pursue medication or here are some other specialists that can advise you if you want to consider nutrition, exercise, and behavioral approaches. And, better yet, those specialists are available via Gennev’s telehealth platform.’”
There are many brands offering products intended to combat menopause symptoms, especially with a large population of women choosing to avoid hormonal treatment options.
Joylux red-light devices repair vaginal tissue to improve pelvic floor health and combat common menopause symptoms such as vaginal dryness, pain during intercourse, and bladder leakage. And while the products are sold through physicians’ offices, the majority of the business is made up of online DTC sales. “I spent the majority of my career as an entrepreneur in medical aesthetics working with technologies—laser light and different energy sources—to rejuvenate the skin,” explains Courtion. “When I decided to become a mom, my girlfriend said, ‘be prepared to pee your pants every time you sneeze.’ And I was mortified by that. But it led me to this ‘aha!’ moment where I wondered why we aren’t using these energy-based technologies on the vagina.”
Chung describes MIGHTY Menopause’s plant-based supplement product offerings: “Products and services related to menopause need to be brought into the modern era. Menopause is a physiological and psychological change (not a medical disease) and women want to understand their bodies and their symptoms to maintain and/or improve their daily lives. Our first physical product is a plant-based supplement designed specifically for perimenopause-related symptoms which, surprisingly or not, doesn’t exist in the market currently. And we will continue to innovate in this area.”
Other broadly-focused digital health companies are recognizing the value in the menopause market. Rory, the digital women’s health brand from DTC giant Ro, offers a collection of products created to address menopause symptoms including hot flashes, vaginal dryness, and disrupted sleep. Even P&G launched Kindra, an online shop with products including supplements and skincare options intended to address menopause symptoms.
Digital health companies revolutionizing the menopause space are providing sought-after solutions for a long ignored lifestage. Not only are these brands improving the daily lives of an enormous segment of the population, but they are changing cultural perceptions and taboos around menopause. “There is so much to love about being older and more experienced!” says Teagle. “Women in midlife and beyond are sexy, empowered, and confident. They can be inspiring leaders, loving matriarchs, and have the financial and social freedom to explore the world. I think we really just need to hold up the mirror so they can see it for themselves.”
Elise is Director of Research at HTD. Coming from a background of social science and design, she specializes in user experience and behavior change.