Here’s why menopause is a $16 billion untapped market

There’s a common problem lurking in the shadows, that will affect every second person walking down the street at some point in time. Yet, it’s shockingly low in innovation, investment and startup activity. That’s right we’re talking about everyone’s favourite topic to avoid… menopause!

The natural process that makes everyone so uncomfortable and embarrassed they’d rather sweep it under the rug and pretend it doesn’t happen. When we say menopause is a big opportunity, we mean it. Globally, the market size is estimated to be worth $16 billion this year and growing fast. Remarkably, there is no market leader and no clear brand or business owning the category. It’s hard to name another issue where this dynamic prevails (actually, we wrote about the future of sex, the future of death and the future of sleep for these reasons).

Before we dive into the trends, tailwinds and pockets of excitement happening, let’s start with some statistics that highlight just how far-reaching this problem is. Around the world, there are approximately 1 billion women experiencing menopause or perimenopause at a given time. 80% of them are still working; that accounts for about 11% of the workforce. So, next time you’re at work, look around — more than one in 10 of your colleagues will be experiencing some pretty hectic symptoms during any given workday.

Yet the pain, both emotional and physical, remains unaddressed and overlooked. Overwhelmingly, menopause and its side effects are considered something that women should just suck up. This is a key thematic in the life of a woman; from period pain, to child birth, to menopause, pain is sold as part of the female experience. Fortunately, there are some startups fired up and ready to change that.

One of many examples of unhelpful stereotypes surrounding menopause.

What is menopause anyway and why is it so bad?

Menopause is the last day of your period and perimenopause is the phase leading up to this. While the last day of a period might seem like something to cheer, it’s accompanied by a host of complications.

Perimenopause normally lasts around 4-6 years and is the beginning of things going haywire. Most of the symptoms are pretty unpleasant; irregular periods, extra heavy or light periods, vaginal dryness, hot flashes, sleeplessness and the need to pee more often.

Then, during menopause, many of the symptoms persevere, punctuated by night sweats, muscle and joint aches, tender breasts, cognitive changes (like forgetting names and day to day details), weight gain, slow metabolism and decreased libido.

On top of this, post menopause women are at higher risk of heart disease, osteoporosis, bone density loss, dementia and incontinence. Understandably, this can have significant effects on a woman’s emotional state and confidence. Despite the intensity and severity of these changes, women are expected to just ‘deal with it’.

There are few diagnostic tests for perimenopause and most medical schools have no curriculum on this phase. Perhaps it’s no surprise that 40-59 year old women have the highest rate of depression among women. On top of that, according to research by menopause app Caria, women spent an average of $20,000 on trial-and-error treatments, doctor’s visits and product in the search for relief. Alright, enough doom and gloom, let’s turn our attention to some ideas and principles that new entrants are using to change the game.

What changes are afoot?

Positive ageing

There’s a lot of dread in the narrative around menopause. It represents the ultimate in ageing and as a result, women are trained to fear it. This fear of menopause is reinforced by a plethora of other products and services targeting women at this same time: from anti-aging cosmetics, to shapewear, to body shaming around what is and isn’t appropriate for a woman of a certain age to wear (for some serious inspo around this topic, check our sextech founder Cindy Gallop’s thoughts on the matter). All of which carry a message that reinforces to women that the journey they’re on is unsightly. The new menopause movement is less about shame or the sorrow around the vitality of youth ending, but about embracing the milestone with grace, positivity and a sense of triumph.

In it for the long haul

Rather than see menopause as a one-and-done event, startups are beginning to recognise and cater for the decade long journey that perimenopause can be. Similar to pregnancy apps and guides, where every day, week and month is carefully considered and mapped, startups are now helping women navigate the changes step by step, helping them to feel seen, supported and safe along the many ups and downs they will face.

Empathy on the rise

Just as other women’s issues are being recognised with the respect and gravity they deserve, (think period pain, infertility and miscarriage), menopause is starting to receive similar treatment. While there’s no paid time off for menopause just yet, we’re moving into a time where there is more empathy and understanding, and less of a need to suffer in silence.

Step up the science

By telling women to ‘deal with it’, we have avoided a conversation grounded in science and facts. A new wave of startups are now using data, telemetrics and the quantified-self movement to create services and products that lead with science; and then use that science to help make smarter decisions about how we age.

All of them are bound by their desire to stamp out pseudo-science and help validate women’s personal experiences with robust data sets.

As well as a commitment to science, there’s a broader mission to address the inequities in women’s health; and menopause is one of the clearest examples of this inequality. It’s no secret that the medical experience is designed with men in mind. Women often have to fight to have their medical problems taken seriously.

Armed with ever-growing data-sets, we are likely to see not only a chance in how we treat women around this time of their lives; but also a change in public policy. Ultimately, this will help provide some much needed relief to women’s neglected health needs in ways that support them in both their personal and professional lives.

Empowered consumers

Women in this age bracket are used to taking health matters into their own hands. On top of this, they have disposable income to spare and are notably tech forward when it comes to health. They are used to booking medical appointments online, cycle tracking and are rapid adopters of tele-health options. In fact, they are 75% more likely to use digital tools to help navigate their health issues than men. The next wave of startups entering this space are playing into women’s comfortability with tech and desire to take control of their health outcomes.

The menopause market is big, underserved and ripe for innovation.

Who will win?

Startups that work with employers

Menopause has consequences that reach far beyond the wellbeing of women. About 900,000 women are said to have left the workforce earlier than planned because of menopause — and that’s just in the UK. Losing women’s astute insight and experience (at arguably its height) comes at the detriment to companies; with a knock on effect for the gender pay gap, as well as superannuation and retirement planning. Smart startups will partner with employers, developing solutions to help them overcome this unnecessary loss in productivity.

Vision-led companies that take stereotype and taboo smashing seriously

As well as selling great products and services, winners will also build strong brands that help shift the narrative and break the taboo surrounding menopause. This means boldly doing away with harmful stereotypes and inviting women to speak more confidently about their experiences.  There is much shame and stigma involved in menopause, rather than a proud celebration of a lifestage that should come with wisdom, grace and empowerment. Top companies will lead this conversation, rallying an active community of empowered women in their wake.

Science-backed startups ready to elevate the gravitas of menopause

This is not just about uncomfortable symptoms. There are serious health risks at stake, like increased risk of heart disease, osteoporosis, type 2 diabetes and more. Winners in this space will campaign for menopause, and all its serious side effects, to be taken as the serious medical issue that it is. At a higher level, this also includes standing up for the inequalities and disparities between men and women’s health that have consistently plagued the medical profession.

Holistic approaches that offer solutions that work with everyday life

The answer to an improved menopause experience lies at the intersection of science-backed at-home diagnostics, smart devices, data-tracking wearables, CBT, pain management, hormone therapy and high-touch experiences like coaches and community. Startups taking a holistic approach, recognise each patients’ journey as individual and tailor programs accordingly will come out on top. As the field emerges, there will also be an invitation for a community to join and help shape solutions and offer support to those in the same boat. Ultimately, this approach will accelerate change and hasten global adoption of a better approach to menopause.

Who is currently making waves?

Thankfully, there are already some bold pioneers shaking up the world of menopause around the globe. While they are breaking taboos and making genuine inroads into women’s health, many seem to be going about it in a similar way; with telehealth apps. While this is clearly a very needed approach, we can’t help but feel that it demonstrates the need for even more innovation and entrepreneurial activity in the space.

Online menopause diagnosis, coaching and prescriptions

The Elektra platform offers education, community support and telehealth to help menopausal and peri-menopausal women stay on top of their game. They invite women to ‘smash the taboo’ and are dedicated to leading with science, as attested by their board-certified doctors and nurses. The experience kicks off with a menopause assessment, followed by a one-on-one meeting with a menopause guide, then ongoing and tailored education and community support.

Similarly, Vera, by My Modern Menopause, invites women to discover their hormone status with an online assessment; answers are then reviewed by a doctor who recommends the right hormone test to conduct. Then, a finger-prick test gets mailed to your home for you to complete and return. Finally, after reviewing your results, a doctor will create a hormone profile report with advice to help mitigate disruptive symptoms and manage the ongoing optimal balance. Vera was founded by Afsaneh Parvizi-Wayne, who believes menopause has a lot more in common with puberty and thus sees it as a valuable life transition.

Similar again is Caria, who have an AI powered app, with chatbot functionality. They are currently launching a clinical trial in the hopes of proving the efficacy of their approach. They are also working with large pharmaceutical companies like Bayer and Novartis, which could accelerate adoption. However, only a handful of these companies are venture backed. For example, Stella who offer diagnosis and tailored solutions ranging from sleep plans, to cognitive behavioural therapy to training like pelvic floor exercises, recently raised $2.5 million. Then there’s Alloy, who offer similar targeted menopause solutions and deliver them right to your door, who raised $3.3 million last year.

Connected devices

Joylux is creating wellness devices to help women improve some of the negative side effects of menopause, like sexual function, bladder control, vaginal atrophy and dryness.  The vSculpt, and vFit Gold use the power of red-light to help women take control of their menopause symptoms by tightening the vaginal canal and restoring the health of the vaginal tissue. The devices work in harmony with the Joylux app, which educates women on the science of what’s happening to their bodies and how improvements can be made. Founder Colette Courtion wanted to stop women spending exorbitant amounts of money on temporary solutions and instead find long-term solutions that have the potential to permanently improve outcomes. So far, Joylux has raised $23.2 million from angel investors and female-focused funds.

Taking a different approach, the Thermaband Zone is a connected device that helps menopausal women with thermoregulation. The band is placed on the inner wrist and gives heating or cooling sensations to help manage hot flushes. There are also hot-flush fighting pillows, temperature regulating clothing and herbal treatments to help overcome this infamous symptom.

Our predictions

10 years from now

As we head towards a future that’s more empathetic towards women during this pivotal time, and taken more seriously as a result of expanding scientific studies and data sets, we see a host of other positive knock-on effects coming too.

• Menopause will be science led and data-driven and there will be clear, proven approaches to augment quality of life and lessen symptoms throughout this phase. Solutions will combine at-home diagnostics, smart devices and wearables, CBT, pain management and hormone therapy; all underpinned by high-touch coaching and community services;
• As a result of more understanding and empathy, women will feel more confident to come forward to share their experiences and  get treatment they need to help empower them through this phase. There will be whole menopause sections at your local pharmacy!;
• Working women will have up to 20 days paid leave a year for adverse menopause symptoms;
• Menopause as a field of study will blossom; including entire courses and cross-functional curriculum dedicated to training doctors and exploring technology-driven solutions; and
• Just as there are period starter kits, there will be menopause starter kits that welcome women into perimenopause with an attitude that sets them up to thrive.

As we head towards a future that’s more empathetic towards women during this pivotal time, and taken more seriously as a result of expanding scientific studies and data sets, we see a host of other positive knock-on effects coming too.

50 years from now

Predictions about further futures are always part titillating, part dystopian, and entirely speculative. Here are some of ours:

• Menopause will be celebrated as a joyful transition, not seen as an embarrassing end to youth and vitality. There’ll be celebratory, empowering stereotypes a far cry from the hot flushed, emotional outbursts of women in the 50s;
• Employers and insurers will be sharing a large part of the health costs associated with menopause;
• There will be menopause camps and retreats that joyfully invite women to step into this phase of life on their terms;
• By being able to track hormone levels by the day, a host of other products will use this data to wrap services around it. For example, custom meal plans, medication that changes dosage day by day and coaches ready to call just when you need it most;
• Thanks to technological advancements, partners, children and colleagues will be able to don a headset and experience the burden of menopause in an instant; thereby creating empathy and understanding for the older women in their life; and
• By unlocking the science, we’ll be able to fast track the process; reducing the timeline of menopause from a decade to just a few years, at the patient’s discretion, with the advise of a medical professional.

This article was first published by AfterWork Ventures.