In the field of women’s health, much of the medical advancement until now has been focused on birth control and fertility treatments, but startups and venture capitalists are increasingly turning to menopause as an area ripe for innovation.
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By 2025, 1.1 billion women are expected to be postmenopausal. The space represents $600 billion of spending opportunity but is still largely untapped by startups and brands that could be creating new products and services for these women, according to data from early-stage investing firm Female Founders Fund.
“Only 5 percent of femtech startups address menopause, and overall the opportunity is huge,” Adrianna Samaniego, investor with Female Founders Fund, told Crunchbase News. “Fertility is nine months, typically, but menopause can last anywhere from four to 30 years.”
Difficult to reach women
Menopause is a complex area. Women can experience some 34 different symptoms depending on genetic factors and lifestyle factors, Samaniego said.
“Many women don’t understand menopause, when it happens and even if they are in menopause at all,” she added. “They end up spending an average of $20,000 in trial-and-error prescriptions, doctor visits, treatments, devices and products.”
A Female Founders Fund’s survey found that 32 percent of women say their doctor is not comfortable talking about menopause, so many women look to family and friends for guidance instead.
Shelley Kuipers, co-CEO and chief growth officer at Canada-based The 51 Ventures, is going through menopause and recalls phoning her mother and asking why she didn’t give her a heads-up about what was going to happen.
“She told me, ‘I just tried not to make a big deal about it,’” Kuipers said. “That is the challenge. I’m not diminishing her viewpoint, but people my age are not on their final act—we are just getting started. We have to have an open discussion about the process and the symptoms so that solutions can emerge.”
Complicating the matter is the fact that startups targeting this space often struggle to reach women experiencing menopause, according to Samaniego. Only one-third of respondents recall seeing advertisements for menopause-focused products on television or in magazines.
Certain types of products, like lubricants, have also been blocked on social media channels, such as Facebook, she said. Facebook’s advertising policy bans “adult products or services,” specifically ads that “promote the sale or use of adult products or services, except for ads for family planning and contraception,” according to a CNBC report. Companies claim Facebook is inconsistent with its advertisement policies, for example allowing ads for male libido-enhancing products, but not a link to a Q&A article with a doctor explaining menopause.
Kuipers refers to the menopause market as a “perfect storm” because the sector has capital, spending power and seems like an obvious place where innovation could flourish.
However, she continues to see a lack of support from traditional VC firms, and instead predicts backing to come from emerging funds targeting innovation. Her firm, The 51 Ventures, is one of those, currently raising its first fund. Kuipers intends to fund Canada-based companies in the menopause space.
“We are trying to move quickly to fund the innovation we want to see,” she added.
Innovation begets investment
Women’s health-focused startups, particularly those specializing in menopause, are beginning to see more investment, but while some VCs say the flood gates of funding should be opening up, investment into the sector is still a trickle.
Investors gave out $1.023 billion to U.S. women’s health technology startups in 2020, up from $625 million in 2019, according to Crunchbase data. Investment in this space has steadily risen since 2017, with total funding of $2.9 billion since 2016.
But since 2009, global startups focused on menopause have only raised $254 million, Samaniego said.
“Part of the problem is who is around the table controlling the dollars,” Deena Shakir, partner at Lux Capital, told Crunchbase News. “There is something much deeper there, like ageism and sexism, but if it was driven by market opportunity, hopefully that will mitigate biases.”
More male VCs are interested in having these conversations, but not nearly at the rate it should be, sources who spoke with Crunchbase News said.
Investment in the sector needs to start with clinical R&D and inclusion, Shakir said. For example, women, especially women of color, continue to be underrepresented in research, which leads to troubling outcomes and inaccurate dosing of medicine.
“This is indicative of a broader issue,” she added. “Women’s health is considered niche even though we are 50 percent of the population, and 80 percent of the health care dollars are controlled by women. It has to start with R&D.”
SteelSky Ventures is also raising a fund that will invest in the pipeline of companies focused on women’s health, a sector also known as “femtech,” Maria Velissaris, founding partner, said in an interview.
The firm kicked off fundraising last year and is targeting $50 million. SteelSky has already invested in six companies, including health and wellness startup Joylux, which focuses on menopause, and telemedicine startup Twentyeight Health.
“Anything that addresses gender-specific products or sexuality has a tough time,” Velissaris added. “I feel a majority of VCs don’t understand diverse populations because they don’t come from there or know how to invest in them.”
She predicts that many of the products and services not yet seen may come from unexpected entrepreneurs, such as nurses or midwives, rather than the startup standbys of Harvard and Stanford alumni.
Velissaris also doesn’t think the market can wait much longer: VCs need to take the risk now, have high conviction and be able to look beyond returns, she said.
“Women are suffering now, and we have the science, the math and the investor dollars,” she said. “People are so desperate that a startup with a $3.99 app could have $1 million of sales in three months. That’s why we are investing — we see the opportunity. Six-hundred billion dollars is not ‘niche.’”
Giving a voice to menopause
Gennev, an online clinic for women in menopause, is one of the 93 known women’s health startups that raised funding in 2019. The Seattle-based company raised $4 million in seed funding, led by BlueRun Ventures.
Jill Angelo, CEO, co-founded Gennev in 2016 after she surveyed 1,500 women about their menopause experiences and found that many were unprepared to start a conversation on the topic with their doctors, who often don’t receive training on menopause.
“We see menopause as the kick-off to the second half of life,” Angelo said in an interview. “How we manage menopause in our 40s and 50s will determine our long-term health: Alzheimer’s, bone health and osteoporosis. More women are getting educated and making necessary lifestyle changes so their second half is as healthy as it can possibly be.”
Natalie Waltz is a new entrepreneur chasing those potential dollars. She founded sex and menopause startup Tabu in March 2020 after a conversation with a friend about sexual pain affecting some 90 percent of women during menopause, which causes them to stop being active, she said.
Waltz, CEO, previously worked for TCG Capital and would see startups in the sexual space, but not at the nexus of sex and menopause. She rolled out her first product last October, a sexual wellness kit containing a vibrator and lubricant, and a platform of curated educational content for women from peri- to post-menopause.
Tabu raised a friends and family funding round, and Waltz is considering more funding, but says her company is still in a controversial area.
“We also saw that with sex, investors will make one investment in the category and then say, ‘that was my one investment,’” she said. “They are treating it as a narrow area. Now we are working to get Tabu in front of the right people who can give capital to scale.”
Meanwhile, Elektra Health, co-founded by Alessandra Henderson and Jannine Versi in 2019, raised pre-seed funding last fall. The New York-based startup is developing a menopause platform to help women navigate their health care journey.
From Day One, the company’s mission has been to “smash the menopause taboo, empower women with education and provide virtual care and a community,” Henderson said in an interview.
Like Kuipers in her conversation with her mother, Elektra Health’s community is full of women who asked the same question: “Why didn’t anyone tell me?” Versi said.
“There is an interesting inflection point in health care as consumers become increasingly educated, digitally savvy and are advocating for themselves,” Versi said in an interview. “Women like Michelle Obama are speaking up and encouraging women to take up space. I hope that it won’t take five years for this to happen, but that we are well on the way.”
Illustration: Dom Guzman
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