Menopause is not a new experience for women, but the industry around it is nascent.

The U.S. market is sized at about 31 million women between 40 and 55 years old. Eighty percent of women exhibit symptoms, meaning there are 25 million women in the addressable market. Broadly, these are sophisticated consumers who have grown accustomed to digital solutions, but they’re not finding them when facing menopause. As we know, an educated consumer demanding new solutions is always a driver for change.

There’s growing attention in the media to the topic. The New York Times mentioned menopause about 43 times in 2015. In 2019, it went up to 77 times. According to my research, medical journal mentions of menopause seem similar. Over the course of the past five years, references to menopause have grown approximately 70%.

Investors are coming to understand that this cohort of women is a demographic with high discretionary spend that has been wildly underserved for many years. Indeed, the bar has been low in terms of solutions for menopausal women. With this confluence of events, menopause is having a moment. A lot of corporate and private innovation has come in and recognized that this is an opportunity, especially with telemedicine, precision medicine, and preventative care.

All of this is to say: the menopause space provides an incredibly tremendous opportunity for both companies and investors, with a lot of future growth potential.

Consultative Care

The COVID-19 pandemic has unearthed telemedicine as a viable form of care. Menopause requires a highly consultative experience, making it perfectly suited for telemedicine. There are tests for certain hormone levels, but because menopause typically lasts for 7 to 10 years and there are 34 different symptoms, doctors and providers are leaning on what women share about their experiences with their symptoms. With telemedicine, providers can not only meet women where they are, but also remotely monitor them.

Unfortunately, there was a lot of momentum around women’s health in terms of investment and innovation, but a lot got put on pause with the COVID-19 pandemic. Across the health care industry, preventative visits are down, which could have downstream effects on patients’ health in the coming months. Meanwhile, due to the high stress of the pandemic, women across the board, especially in menopause, are suffering even more with erratic periods and increased hot flashes. But as we discover what the new normal is, providers are back online or in offices, hopefully leading consumers and investors to return to menopause care. The momentum around this segment is starting to pick up again.

Still, challenges remain, with the top one being a lack of research and data. Women were left out of Food and Drug Administration clinical trials starting in the 1970s. There’s also social and cultural stigma. Menopause is not just a health care challenge, but also a marketing one. It’s a taboo topic. How do you reach women and get them to open up? Finally, there’s no one-size-fits-all solution.

Rising Interest

But there are plenty of reasons to be bullish on the space, due to the number of new companies coming into it. That number is large and growing. Bayer recently announced an $875 million deal to buy KaNDy Therapeutics, maker of an alternative to hormone replacement therapy. Allergan has been looking into this space, showing that after a decade of real dormancy on the pharma side, we’re seeing more interest from them.

In the startup world, we’re seeing exciting, venture-capital-backed businesses focused largely on consumer products, such as supplements and vaginal moisturizers. These companies are taking women’s symptoms and knocking them out one by one with products.

There are companies like Evernow or CurieMD. Within the playground that Elektra is in are Gennev and The Cusp, with somewhat different models and approaches to the space. There are CPG companies, for example L’Oreal, that are looking into solutions that can be marketed toward women of menopause age. Other companies are thinking about how to build out direct-to-consumer telemedicine and care. This is where a lot of change will happen, at least in the short term. Over the long term, look to employers and payers and how they can disrupt the industry more broadly.

Another reason to look forward to the menopause sector is money. Last year, Yankelovich Monitor reported that women control about 90% of household health care decisions. What’s more, women over the course of a lifetime tend to spend more money on health care than men, with the greatest disparity noted in the population aged 45 to 64 years, a period when women’s main health issues are often chronic conditions and menopausal symptoms. There is a market there, and more solutions will come out of it. As the health care industry continues to develop and meet these consumers’ current needs, women are willing to pay, especially as they’re looking for a higher quality of life.

But it shouldn’t be just on women to pay for menopause solutions — hopefully more employers and benefit managers will start to prioritize menopause.

A Problem Waiting for Solutions

There are insurance codes to track menopause, but they aren’t extensive. Because of how we’ve structured our health care system, it’s not as lucrative as procedures. So especially for OB/GYNs, delivering babies, hysterectomies, and other surgical expenses are more lucrative. Menopause often requires anywhere between two and five visits and upward, especially as women experience extreme symptoms. Unfortunately, health care doesn’t reward doctors who spend time talking through and educating patients. Women feel that on the back end, they’re not getting as much care as they would like.

Some studies, including one from Yale’s Dr. Philip Sarrel, show that women whose menopausal symptoms are untreated can cost insurers an additional $1,300 a year. It might not sound high in comparison with a high-risk pregnancy, but when it’s multiplied by the sheer market size, it adds up. Dr. Sarrel has also done studies that show women with untreated menopause symptoms can cost employers anywhere between $800 and $6,500 in productivity losses.

If women are provided with great care around their menopausal age, it can have real long-term benefits for heart, bone, and brain health. These are things that insurers would want to pay attention to save over the long term, but it does take about 5 to 10 years to see those benefits. Most women aren’t with the same insurers from menopause through geriatric care, so the incentives aren’t aligned on the insurer side to intervene at menopause, because they’ll anticipate women will turn by the time those longer-term diseases kick in down the road.

Fortunately, there has been some movement in women’s health. For example, New York now requires employers to cover IVF, which has had a positive impact for reproduction-related startups and companies. But one of the reasons there have been real strides with high-risk pregnancies or IVF is that employers and payers have perked their heads up because of potential cost savings.

With more studies, the savings around menopause care will be revealed. And given the willingness for women to spend on solutions, there’s tremendous opportunity in this space.

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About Alessandra Henderson

Alessandra Henderson is currently Chief Executive Officer and Cofounder of Elektra Health, a next-gen women’s health platform on a mission to smash the menopause taboo. Elektra empowers women with world-class education, community, and care. Alessandra has spent her career at the intersection of technology, entrepreneurship, and creative business design. She started her career in technology as the sixth employee at Artsy, where she built the content partner business from the ground up. From there, she went on to found and serve as Executive Director of the MIT NYC Startup Studio and Vice President of Network at Human Ventures. She holds a BA from Vanderbilt University (2007) and an MBA from Sloan MIT (2016), where she received the Martin Trust Community Fellow Award ’16 and the Patrick J. McGovern Jr. Entrepreneurship Award ’16. Beyond the office, Alessandra is passionate about taboo smashing, all things art, and supporting and elevating women.

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This article is adapted from the August 12, 2020, webcast “Women’s Health, Femtech, and Menopause Services: Private Equity Investing.” If you would like access to this teleconference or would like to speak with Alessandra Henderson, or any of our more than 700,000 experts, contact us.