- Online platforms reflect the growing demand for menopause-related care, such as hormone therapy.
- Further research is needed to better tailor treatment plans in virtual clinics.
- This article is part of our Healthcare Trends series, which highlights the innovations and industry leaders that are shaping patient care.
When Jodi Miller was 49, she began experiencing mood swings, hot flashes, weight gain, and adult acne — among the many symptoms of menopause.
When Miller, then a high school teacher in Rochester, New York, turned to her obstetrician-gynecologist for help, she felt disregarded.
“I was told to stop focusing on the negative and start focusing on the positive,” Miller, who turns 50 this month, told Business Insider.
Estradiol, the estrogen produced by the ovaries, typically falls below 20 picograms per milliliter, compared with the 40 to 300 pg/ml produced during a normal menstrual cycle, according to Dr. Mary Jane Minkin, an obstetrician-gynecologist and clinical professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine.
This hormonal shift can lead to hot flashes and night sweats, and negatively impact bone health, circulatory function, cognitive function and skin elasticity. It can also cause discomfort during sex because these hormonal changes contribute to a woman’s vaginal walls becoming thinner and drier, Minkin said.
Disappointed with the lack of support she was receiving for her menopausal symptoms, Miller turned to Midi Health, a virtual clinic that specializes in helping patients navigate perimenopause and menopause, the stages of midlife when a woman’s hormone levels fluctuate and then drop dramatically.
Since launching in September 2022, Midi Health says it has served more than 100,000 patients. It is one of dozens of menopause-care startups to emerge since 2010 and one of a handful of virtual and hybrid clinics that offer women support for menopause symptoms, such as hormone therapy.
It is estimated that approximately 1.3 million women reach menopause each year in the U.S. Now, as millennials — one of the largest generational groups in the country — enter their 40s and many begin to experience perimenopausal symptoms, some health care experts predict an increase in the number of patients seeking this specialized care.
Patients demand solutions to common and devastating menopausal symptoms
The menopause market — which includes supplements, medical devices, hormone replacement therapy (HRT) and telemedicine services — is valued at $5.3 billion in the U.S. and is expected to grow about 4.8% annually through 2030, according to analysis by Grand View Research, a U.S.- and India-based consulting firm that focuses on the energy, healthcare and technology industries, among others.
One reason menopause care initiatives are gaining traction is the growing presence of women in leadership roles in the workplace, said Dr. Neel Shah, medical director of Maven Clinic, a digital platform that employers and health plans use to provide care to women and families.
Shah said that as the number of women in decision-making and recruiting roles increases — many of them going through perimenopause or menopause — there is increasing awareness and empathy for employees seeking this type of midlife health support.
Companies need to retain talented employees, so preventing absenteeism and attrition due to severe perimenopausal or menopausal symptoms could motivate employers to look for solutions such as telemedicine clinics for their female employees, Shah said.
Miller, for example, said her hot flashes and heart palpitations made it difficult for her to attend classes. At the time, she was also transitioning into a career in higher education and becoming someone whose children had left home.
“I felt terrible and my energy levels were so low I couldn’t handle it all,” Miller said.
Shah added that millennials entering perimenopause and menopause may be more likely to seek the care they need than previous generations experiencing the same symptoms.
Luckily for Miller, a combination of therapies—including low-dose HRT for estrogen and progesterone, another sex hormone—helped her manage her difficult symptoms. After undergoing therapy, she said she experienced fewer hot flashes and an increased sex drive. Miller’s doctor also prescribed a low-dose antidepressant to help her manage her mood swings and a GLP-1 drug to help her lose about 60 pounds, which helped regulate her blood pressure.
Doctors can also prescribe supplements and lifestyle changes to patients who want to control their symptoms, according to Joanna Strober, CEO and co-founder of Midi Health.
Strengthening Menopause Research
With the growing need for healthcare for midlife women, research and education play a key role in improving treatments and support.
“We founded Midi on the premise that very few doctors and healthcare providers are trained to understand the issues facing women in this age group, particularly as they relate to their hormones,” Strober said.
Minkin said knowledge about perimenopause and menopause is still evolving, so more research into effective treatments and interventions is needed to refine and adapt treatments.
Researchers are collecting data as part of two long-term National Institutes of Health projects: “The Study of Women’s Health Across the Nation” and “Menopause Strategies: Finding Lasting Answers for Symptoms and Health.” The studies aim to better understand women’s menopause symptoms, such as depression, insomnia, and hot flashes, in order to develop more helpful treatments.
Another influential—but controversial—study was the Women’s Health Initiative. The study, published in 2002, described some types of HRT as increasing certain health risks, such as breast cancer and blood clots. In response, doctors balked at prescribing the therapy, Shah said.
But the interpretation of the data in the media and in clinical practice has been lacking in nuance, and secondary research has since shown benefits of HRT in most women, according to Shah. “The medical community is still catching up on the data, to be honest,” Shah said.
To further address the need for perimenopause and menopause research and care, Congress introduced the bipartisan Advancing Menopause Care and Midlife Women’s Health Act in May. The bill is pending in the Senate Health, Education, Labor, and Pensions Committee. If passed, the bill would strengthen federal research and public health promotion of menopause care. Additionally, in his 2024 State of the Union address, President Joe Biden called on Congress to invest $12 billion in research on women’s health, including menopause.
Bayer’s latest phase 3 study found that the non-hormonal drug elinzanetant can help reduce the severity and frequency of hot flashes, according to a Sept. 10 news release from the pharmaceutical company.
Expanding treatment options and providers to ensure patient satisfaction
Minkin said that overall, improving women’s health during perimenopause and menopause requires a comprehensive approach that combines technological innovations, such as online health platforms, with robust research and education initiatives.
An estimated 30% of U.S. residency programs offer a formal menopause curriculum, according to a 2023 report published in the journal Menopause. Minkin said that could be a long-term effect of the initial results from the Women’s Health Initiative. She added that increasing the emphasis on menopause at all levels of medical training is needed.
“Addressing the physiological, psychological and social needs of women at these stages of life requires a multi-faceted strategy,” Minkin said. “By integrating technological tools with a strong foundation in research and education, we can work to close this gap and improve menopause care for all women.”
After about a year of treating menopausal symptoms, Miller is thriving.
“I’m pursuing a doctorate in higher education administration, and I would never have been able to handle this enormous responsibility without menopause care,” Miller said. “I feel like anything is possible now.”