Nobody Dies From Menopause

How markets are learning to price women’s hormonal health

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Two weeks ago, Midi Health, a menopause-care company reached a billion-dollar valuation. That valuation came off the back of a financing round rather than an exit. Even so, the headline was significant because of what it suggested about how markets were beginning to see a category that had long been overlooked.

Last week, that headline became the starting point for an investor discussion at FemmeHealth Alliance’s event on women’s hormonal health and why investors are paying attention. Investors, founders, and clinicians logged in from different time zones for an evening conversation. It was the kind of conversation that rarely makes headlines but often reveals where markets are actually moving.

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Julia Monfrini-Peev of PACE Healthcare Capital and Afua Basoah of Fern Capital joined me on the panel, with Stella Ekogbulu moderating. There we were, three investors reflecting on how the language of risk and capital has begun to change around women’s health. Only a few years ago, the category itself was still being questioned as a serious area for investment.

The contrast between then and now kept resurfacing throughout the discussion. And at one point, a story emerged from an earlier diligence process. An investor had spoken to a large commercial insurer about menopause care and received a blunt response:

“Well, nobody dies from menopause.”

The sentence hung in the air and it explained more about the history of women’s health investing than any research report ever could.

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For decades, hormonal health sat in an awkward space inside healthcare. It affected millions of women and shaped decades of their lives, but it rarely appeared urgent enough to command sustained investment. Markets tend to price acute risk well; conditions with clear endpoints, measurable mortality, and defined treatment pathways. Hormonal health, by contrast, is long-duration and diffuse. Symptoms accumulate slowly. Effects show up in productivity, sleep, cognition, and long-term disease risk rather than immediate crisis. As a result, it rarely appeared urgent enough to command sustained investment.

Even the medical system reflected that logic. In the United States and Europe, menopause receives only minimal coverage in clinical training.

In the United States, menopause typically receives less than one hour of instruction across the entire medical curriculum, and fewer than 20% of OB-GYN residency programs offer structured menopause training. Many physicians simply were never taught how to manage it. The resulting gaps in care often look like individual failures, but the underlying issue is structural.

Where clinical frameworks remain underdeveloped, investment frameworks tend to follow in the same way. Investors struggled to model hormonal health in the same way they modelled other areas of healthcare. Without clear benchmarks or predictable economics, allocation remained tentative. The barrier was never biology. It was underwriting.

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What has begun to change is not awareness but structure. Investors are starting to treat women’s health like a normal healthcare investment category, and they are beginning to ask normal questions.

Instead of asking whether women’s health is “real” as a market, investors are asking how the businesses actually work.

They want to know whether patients return after the first consultation, whether employers renew contracts year after year, and whether care platforms retain women through multiple stages of midlife health. Retention is no longer an abstract idea but a measurable pattern.

They ask about reimbursement pathways; whether insurers cover menopause consultations, whether employers subsidize programs for their workforce, and how quickly a company can move from out-of-pocket payments to contracted coverage. These questions determine whether a company can scale beyond early adopters.

They look at unit economics; what it costs to acquire a patient, how many consultations follow the first visit, and whether the revenue from each patient exceeds the cost of delivering care. And they model lifetime value: whether a woman who enters a platform for menopause support remains engaged for years through cardiovascular monitoring, bone health screening, and preventive care. The conversation is shifting from belief to modelling and from narrative to underwriting.

At the same time, the scale of the underlying population has become harder to ignore. Millions of women are moving through midlife health transitions at the same time that female earning power and household financial influence have reached historic highs. Many women are willing to pay out of pocket for care that they cannot find through traditional channels, and employers are beginning to recognize the productivity and retention implications of untreated symptoms.

This was never a niche population. It was a population markets had not yet learned to see. As these signals build up, women’s health begins to look more investable because investors can now increasingly observe patterns (follow-on rounds, acquisitions, and scalable business models) that makes the sector possible to model inside a portfolio.

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What this shift ultimately reflects is not a sudden discovery of women’s health, but a change in how markets understand it. As the sector becomes easier to model, it also becomes easier to place within a portfolio. Once something can be modeled, it can be sized. And once it can be sized, it can be allocated.

Healthcare investors are familiar with the long development cycles that often precede successful exits. That reality is especially visible in women’s health, where regulatory pathways, clinical validation, and adoption curves often stretch across years. The companies that ultimately succeed are rarely overnight stories; they are built through patient capital and steady execution over time.

This Thursday I’m publishing a conversation on Blindspot Capital with Skip Baldino, the CEO who led Gynesonics to its successful exit to Hologic. His story offers a practical look at what building a durable women’s health company actually requires and why long-duration investing matters in this space. The episode drops on Thursday 26th February. It’s a conversation I would recommend for any founder or investor serious about building in this space.

Investors are also beginning to realize that even established healthcare markets can look different when viewed through a women’s health lens. Cardiovascular disease, for example, remains the leading cause of death in women worldwide, yet diagnostic pathways were historically built around male presentation patterns. That mismatch affects not only clinical outcomes but also healthcare economics.

Companies that design diagnostics and treatment pathways calibrated for female-specific presentation are not creating entirely new markets. They are improving detection rates, reducing unnecessary testing, and shortening time to treatment. Those improvements translate into clearer value for healthcare systems and more predictable revenue streams for companies — the kind of economics that ultimately translate into returns for investors and shareholders.

I explored this dynamic in more depth last month in a conversation with Professor Carolin Lerchenmüller, Chair of Gender Medicine at the University of Zurich, which you can listen to on Spotify or Substack. 👇

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What these examples point to is a broader shift. Women’s biology is not suddenly becoming important. It has always been important. What is changing is that markets are beginning to understand how to price it.

This is the central argument of my upcoming book, The Billion Dollar Blindspot: women’s health is not simply an overlooked issue but a mispriced market. If you want the full framework behind these ideas and how you can participate in this market, pre-orders are now open.

Conversations like the one we hosted rarely happen in public. They take shape in small rooms where investors compare notes long before the rest of the market catches up. That is exactly why we built FemmeHealth Alliance; to bring investors, clinicians, and founders into the same conversation around the future of women’s health capital. If you want to participate in discussions like this live, you can join as a member.

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If you want the broader lens behind this framework, my upcoming book The Billion Dollar Blindspot explores how capital actually flows and why women’s health remains one of the most mispriced areas of healthcare investing.

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Join Our Network

If you are building or backing credible, under-the-radar solutions in women’s health, we curate and occasionally review select opportunities with our investor community as part of our learning process. If your work would contribute meaningfully to that discussion, reach out privately.

I write weekly at The Billion Dollar Blindspot about capital, care, and the future of overlooked markets. If you are building, backing, or allocating in this space, I’d love to connect.

Disclaimer & Disclosure

This content is for informational and educational purposes only. It does not constitute financial, investment, legal, or medical advice, or an offer to buy or sell any securities. Opinions expressed are those of the author and may not reflect the views of affiliated organisations. Readers should seek professional advice tailored to their individual circumstances before making investment decisions. Investing involves risk, including potential loss of principal. Past performance does not guarantee future results.