Under the Microscope: Midi Health
Why Avestria Invested in this Midlife Health-Focused Startup
In this series, we explain why we invested in our current portfolio companies. In the process, we hope to highlight the white spaces in women’s health and the life sciences — as well as the people, products, and companies working to fill those gaps. The name “Under the Microscope” refers both to our extensive due diligence process and our investment focus on healthcare and the life sciences.
If over one billion women in the world will have experienced menopause by 2025, why do only 20% of OB-GYNs feel comfortable discussing and treating menopause?
Nearly all women experience both menopause (which marks 12 months after a woman’s last period) and perimenopause (which marks the transition into menopause, can happen from several months to up to 14 years before menopause, and includes symptoms similar to those of menopause, such as irregular periods, depression, hot flashes, sleep disruption, and vaginal dryness). Despite their ubiquity, the overwhelming social standard around perimenopause, menopause, and post-menopause is still silence. As author Jessica Grose asked when researching perimenopause for a New York Times article, “If the experience of perimenopause is this universal, why did almost every single layperson interviewed for this article say something along the lines of: No one told me it would be like this?”
When it comes to seeking information and breaking this cycle of silence, the healthcare industry is not always a good resource. In fact, a 2013 study sent to U.S OB/GYN residencies found that only 20.8% of residents reported that their program had a formal menopause medicine learning curriculum, and only 16.3% had a defined menopause clinic as part of their residency. A 2017 study duplicated those results with 20.3% of responding residents reporting not receiving any lectures about menopause during their residency and only 6.8% reported feeling “adequately prepared” to manage women experiencing menopause. In 2018, a survey of 1,000 medical professionals (including doctors, physician assistants and nurse practitioners) found that only 57% were up to date on their knowledge of hormone replacement therapy (HRT): a common treatment to managing menopause symptoms. Most recently, in a 2021 interview, Dr. Stephanie S. Faubion, director of Mayo Clinic’s Center for Women’s Health and medical director for the North American Menopause Society, summarized that menopause training “might be covered in an hour in medical school” — even though women spent more than 1/3 of their life in perimenopause, menopause, and post-menopause all together
Even if the medical professionals in question do have adequate and up-to-date training and information, they have to be comfortable with talking about menopause to help their patients — yet nearly 80% of medical residents admit that they feel “barely comfortable” discussing or treating menopause. A study done by Female Founders Fund in 2020 found that the patients noticed their doctor’s hesitation: 32% of women who take part in FFF’s survey didn’t feel as though their doctor was comfortable talking about menopause. As a result, 60% of women ask for help in managing their symptoms, but 75% don’t receive it due to the lack of training, knowledge, and comfort on the healthcare provider’s end. In other words, if these trends hold, more one billion women in the world will be postmenopausal — meaning they’ve experienced both perimenopause and menopause — by 2025, and 450,000,000 of them will have asked for care but will not have received it.
The result is a major cost: both in terms of dollars and quality of life. Research also estimates that menopausal women experiencing Vasomotor Symptoms (VMS), which include hot flashes and night sweats, compared to women without symptoms had not only a 121% higher utilization of healthcare resources for a healthcare burden of $660 billion globally but also nearly 60% more work productivity loss days for a total lost productivity cost of $150 billion. And while 84% of women surveyed found that their menopause symptoms interfered with their life, menopause costs an average of $20k in often trial-and-error spending on prescriptions, devices, doctor visits, products, and other: a number that can put care out of reach for many.
To help these women, Midi Health is building an insurance-covered telehealth platform that focuses on providing care to all women in midlife and afterwards, especially for menopause.
Midi is partnering health systems and employers to offer personalized care to help mitigate the shortage of skilled and comfortable clinicians and the backlog of patients seeking care. By utilizing the expertise of national specialists in women’s midlife health — from Harvard, USC, USCF, and more — Midi aims to create protocols and treatment plans, help set up visits, and offer solutions to women over 40.
Midi’s platform provides curated content and suggest personalized products — including appropriate prescription medications and/or supplements and connections with trained nurse practitioners — to its users. With resources like the ones that Midi is offering, women may understand the reasons behind their symptoms, feel encouraged, guided, and supported as they seek treatment, and reap the benefits in their work productivity, quality of life, and healthcare costs. To democratize access, Midi’s concierge-level care will be covered by insurance — in soon to be 30 states — since cost can otherwise be a barrier to women seeking treatment.
As founder and CEO Joanna Strober wrote on LinkedIn about why she started Midi,
“When I shared what I was learning [about women’s midlife health] more broadly, I heard one thing over and over: ‘Someone needs to start a company to fix this!’ Fast forward to 2022: That company is Midi.
Our vision is ambitious, but we won’t stop until we’ve addressed what’s wrong for so many women.”
Through its focus on integrative solutions that are personalized, affordable and accessible to women, Midi aims to address a gap in the menopause market for both those giving and receiving care. We invested in Midi because of its ability to fix “what’s wrong”. We believe Midi can help millions of women who will experience midlife health changes and may not have otherwise received this high-level care and the healthcare professionals responsible for caring for these women, educating them, and allowing them to thrive through perimenopause, menopause, and beyond.
At Avestria Ventures, we look for early-stage women’s health and female-led life science companies with products or technologies that improve healthcare quality and/or access, lower costs, induce clinical or behavioral change, are evidence based, have scalable commercialization plans, and have a sustainable competitive advantage. Know one? Contact us via our website, LinkedIn, or Twitter.
