After years of being ignored, menopause is now a topic of public discussion.
Celebrities from Drew Barrymore to Naomi Watts have opened up about their symptoms and promoted the products. But despite the rise in chatter, there is a long way to go when it comes to treating the condition, and there are plenty of opportunities for companies to step in to fill the gap.
In fact, a recent McKinsey report found that menopause has the highest unmet need among women's health conditions, and that there is “huge potential for innovative treatments.”
The management consultant estimates that the global market potential for treating conditions ranges from $120 billion to as much as $350 billion worldwide.
Menopause occurs when a woman does not have a menstrual period for 12 consecutive months. While this phenomenon occurs, on average women are around 51 years old, and the symptoms known as perimenopause can begin years earlier. Symptoms may continue even after menopause.
These symptoms include hot flashes, anxiety, weight gain, vaginal dryness, mood changes, sleep disturbances, and changes in skin conditions. According to McKinsey, more than 450 million women around the world suffer from menopausal and perimenopausal symptoms.
Anna Pione, a partner at McKinsey who leads the firm's research into the future of wellness, said there is also significant unmet demand for menopausal products and services.
Menopause is “underserved, underfunded, and doesn't get enough attention,” she says. “That applies to women's health in general, but especially to menopause.”
“Exciting” development
Hormone therapy has been the typical treatment for menopause for decades. But it fell into disrepute in 2002 when a Women's Health Initiative study found that combined estrogen and progestin therapy increased women's risk of breast cancer and heart disease.
Dr. Stephanie Fabion, director of the Mayo Clinic Center for Women's Health and medical director of the nonprofit Menopause Association, says, “Many women stop taking hormone therapy because of their own fear, their doctor's fear, or a combination of both. “I did it,” he says. .
From 2002 to 2009, claims for hormone therapy decreased by more than 70%, a 2012 study showed.
“This leaves many women with no control at all,” Fabion said.
However, research now shows that for women under 60 or less than 10 years since menopause diagnosis, the benefits may outweigh the risks.
“Our knowledge has changed,” says Dr. Karen Adams, a professor at Stanford University and director of the university's Menopause and Healthy Aging Program. “It’s really, really exciting, but the women end up shaking trees trying to find someone to help them.”
invest in themes
There are not many publicly traded companies in this field. The largest company in the United States is Pfizer, which has a large number of products in its portfolio. These include Duaby and Premarin, hormone therapy treatments for hot flashes and prevention of osteoporosis.
Then there's Biote, a smaller company with a market capitalization of just over $400 million. The company, which went public in May 2022 through a SPAC deal, manufactures bioidentical hormone pellets customized to address hormonal imbalances.
Jefferies analyst Kaumil Gajrawala, who rates Biote a buy, said hormone therapy in general is an area of interest that is “very much coming to the fore.”
He said menopause accounts for the largest portion of the market. Biote uses blood tests to customize hormone pellets that are inserted into the body under the skin.
“This allows us to deliver a consistent volume, and we don't have to worry about compliance or remembering a day or forgetting a day,” he said. “What it ultimately means is that you feel better.”
Meanwhile, Dare Biosciences, a smaller company with a market capitalization of about $47 million, is developing hormone therapy. This clinical-stage biopharmaceutical company focused on women's health has an intravaginal ring hormone therapy and plans to advance to a single Phase 3 trial.
There is also a race to find non-hormonal treatments.
Last May, the Food and Drug Administration approved Tokyo-based Astellas Pharma's Veozah (also known as fezolinetant) to treat hot flashes.
Bayer also has a drug in its pipeline called elinzanetant. In January, the German company announced that in two late-stage trials, the treatment reduced the frequency and severity of hot flashes and improved sleep. Results from the third phase 3 trial are expected in the coming months, Bayer said. It will then be submitted for approval.
Additionally, Vistagen Therapeutics, a late-stage biopharmaceutical company with a market capitalization of about $100 million, is conducting trials of a hormone-free nasal spray to treat hot flashes.
In the non-drug space, fertility benefits administrator Progyny recently announced a partnership with private companies Genev and Midi Health to expand its menopause coverage.
Sasha Kelemen, Head of Women's Health Investment Banking at Leerink Partners It shows,” he said.
private innovation
Still, much of the innovation in menopause is happening in private spaces.
“Menopause is as inevitable as death and taxes, and every woman will experience it,” Kelemen said. “We still don't have many companies taking Women's Health public, but we hope that changes.”
In 2022, Kelemen finalized an agreement for Unified Women's Healthcare to acquire Genev, a partner in Progyny, a digital menopause care delivery platform. Kelemen did not disclose financial terms.
Another Progyny partner, Midi Health, a virtual care clinic specializing in menopause and menopause, is another company raising investor funding. In September, Google Ventures, Alphabet's venture capital arm, led the company's $25 million Series A funding round, bringing the total raised to $40 million.
Yet women's health has long been underfunded, and menopause is only a small piece of that pie.
“The dollar doesn't match the conversation that's happening right now,” Kelemen said. “Although it is growing, it is still too slow and completely out of proportion to the potential impacts to be addressed and the actual needs of the population.”
Still, Kelemen is optimistic that fundraising will continue to increase. He is also bullish about the potential for consolidation and new innovation in the sector.
“As hormonal changes occur over 10, 15, 20 years, women's needs will change,” she says. “There is an opportunity for multiple platforms to succeed.”
