Why midlife may be the most powerful time in a woman's career

Key Concepts

Menopause Care Accessibility: The core problem addressed by the company, stemming from the founder's personal experience of difficulty and expense in accessing adequate menopause treatment.
Telehealth and National Medical Practice: The enabling technology and business model shift that allows for nationwide healthcare delivery, overcoming previous geographical limitations.
Holistic Women's Health: The comprehensive approach to addressing a wide spectrum of symptoms and needs for women, particularly between the ages of 35 and 65, viewing menopause care as primary care.
Insurance-Based Model: The primary revenue stream and go-to-market strategy, focusing on commercial insurance coverage.
Care Protocols and Nurse Practitioners (NPs): The framework for delivering standardized, expert-led care across a large network of NPs, trained and supervised by specialists.
Consumer Brand Building: The strategy of establishing trust and recognition with women, leveraging celebrity endorsements and a focus on women's health.
Democratizing Access: The goal of making high-quality, specialized care available to a broader population regardless of location.
Normalizing Conversations: The effort to destigmatize discussions around menopause and other women's health issues.
Empowerment through Naming: The concept that acknowledging and naming symptoms (e.g., "hot flash," "menopause") allows women to reclaim power and credibility.
Impact of Menopause on Workforce Participation: The significant correlation between menopause symptoms and women leaving or not advancing in their careers.
Revolutionizing Women's Health: The overarching mission to fundamentally change how women's health is perceived and delivered.
FDA Policy Shift on HRT: The recent change in FDA stance on Hormone Replacement Therapy, moving away from previous warnings and potentially increasing acceptance.
Longevity vs. Healthspan: The focus on extending healthy years of life rather than simply living longer, emphasizing preventative care from an earlier age.
Founder as Brand Ambassador: The founder's role in embodying and promoting the company's values and mission, particularly on professional platforms like LinkedIn.
Fearlessness in Entrepreneurship: The necessity of bravery and conviction for founders, especially when facing initial skepticism.
Equity and Women in the Workforce: The historical and ongoing challenges women face in career progression and the importance of supporting their continued participation.
Women in Venture Capital: The critical role of female investors in funding women-led businesses and the positive impact of increased representation.
Purpose-Driven and Intentional Leadership: The focus on building a positive company culture, supporting employees (especially mothers and NPs), and enabling thriving careers.
Resilience and Rest, Not Quitting: The advice for navigating challenges in entrepreneurship and life.
Moderation and Grace: The approach to personal vices and overall well-being.
AI in Business Operations: The utilization of AI tools like ChatGPT for efficiency, strategic planning, and receiving feedback.
Cohort of Support: The importance of a network of peers, particularly other female leaders, for guidance and emotional support.

Personal Journey and Founding of the Company

The founder's entrepreneurial journey into women's health was catalyzed by a deeply personal and frustrating experience. After a difficult year, she was advised to see a hormone specialist. This led to a significant drive and financial outlay, but within two weeks of receiving the correct care, her life improved dramatically. This positive outcome was overshadowed by anger and frustration that such essential care was not readily accessible, required out-of-pocket payment despite feeling like insurance should cover it, and took so long to obtain. This experience ignited a desire to change the system and make this care available to more people.

Her background as an entrepreneur and venture capital investor, combined with a connection to her father, a doctor, provided a unique foundation for this venture. During the COVID-19 pandemic, her father, a bone expert, was advised to retire from his practice. The founder discussed her business idea with him, and he suggested leveraging his existing medical practice. This included utilizing his insurance contracts and his extensive efforts to become licensed in all 50 states, which involved hours of studying state-specific requirements. This allowed them to establish a national practice from the outset.

It's clarified that her father, an orthopedic specialist, did not directly provide menopause care. Instead, they hired established menopause experts, Dr. Kathleen Jordan and Dr. Mindy Goldman, to work within his practice. This structure enabled them to legally offer the services nationwide.

Pilot Program and Rapid Growth

The company began with a pilot program involving Dr. Goldman and Dr. Jordan, serving 150 patients in California for three months. This pilot was crucial for learning what resonated with women, the types of care they sought, and the symptoms they wanted addressed. The feedback was overwhelmingly positive; when the pilot concluded, 148 out of 150 patients expressed panic at the prospect of losing access to care, highlighting the critical need and impact of the service. This pilot took place in 2021, indicating the company's rapid growth in a short period.

Currently, the company is caring for 25,000 women weekly, offering holistic care for a wide range of symptoms including hot flashes, night sweats, joint pain, painful sex, and low libido. The founder views menopause care as essentially women's primary care, crucial for women aged 35 to 65.

Business Model and Go-to-Market Strategy

The business model is primarily driven by commercial insurance coverage, rather than being solely employer-based. The go-to-market strategy is direct-to-consumer, enabled by the widespread adoption and insurance coverage of telehealth, a shift accelerated by COVID-19. Previously, healthcare was localized, but telehealth allows for the creation of national medical practices.

The company develops comprehensive care protocols for various aspects of women's health, such as bone health and brain health, written by expert doctors. These protocols are then used to train a large team of nurse practitioners (NPs) who can deliver this care nationally. This approach democratizes access to top-tier care protocols, supervised by specialists like Dr. Goldman, a world-renowned expert in survivorship for women with breast cancer who experience severe menopause symptoms. Her expertise, previously accessible only to those who could travel globally, is now distributed to 500 NPs, benefiting women regardless of their location.

Fundraising and Brand Building

The company's fundraising journey began with professional angel investors, facing initial rejections due to the perceived niche nature of menopause care. Women's health was not a significant investment area a few years ago, making early funding challenging. As the company evolved into a consumer brand, they shifted their strategy to attract investors who recognized this potential.

They approached celebrities and influential women entrepreneurs, like Tory Burch, to join their mission. This led to significant investment from over 50 women, including celebrities and executives, who believed in the company's vision. The founder acknowledges receiving numerous "no's" during fundraising but emphasizes the importance of persistence.

Celebrity endorsements, such as Amy Schumer's social media posts, have helped raise the brand's profile. The founder views these women as ambassadors who are eager to share their positive experiences.

Normalizing Conversations and Empowering Women

A significant aspect of the company's mission is to normalize conversations around topics that have historically been taboo, such as menopause. The founder cites a Harvard study indicating that women experiencing menopause symptoms at work, if not addressed, can lose credibility and be taken less seriously. By naming these symptoms and seeking care, women can reclaim their power.

The founder highlights the substantial impact of menopause on women's careers, with studies showing that 50% of women do not apply for raises or promotions due to symptoms, and 10% leave the workforce entirely. The company aims to enable women to continue thriving in their careers by addressing these hormonal challenges, which can affect sleep, anxiety, and overall well-being. The founder believes that menopausal women, when properly treated, are highly capable and effective in the workplace.

Cultural Shift and FDA Policy Changes

The founder observes a cultural revolution in women's health, with increased open discussion about menopause, exemplified by celebrities like Naomi Watts and Halle Berry launching their own menopause-related companies. This shift is also reflected in advertising, moving away from outdated portrayals of older women to showcasing vibrant, active women in menopause.

The recent FDA policy change regarding hormone replacement therapy (HRT) is seen as a significant development. The founder believes the previous "black box warning," stemming from the Women's Health Initiative study, unnecessarily scared millions of women away from appropriate treatment. While HRT is medicine and requires professional guidance, the FDA's revised stance is expected to reduce fear and increase acceptance. Historically, 45% of women took HRT before the study; now, it's less than 4%. The founder emphasizes the proven benefits of HRT for bone health, cardiovascular disease prevention, and potential positive impacts on brain health, highlighting a generation of women who were deprived of a beneficial medication.

Diverse Treatment Options and Longevity Focus

While HRT is a crucial option, the company positions itself not solely as a hormone company but as offering a "toolkit" of options, including supplements. A study revealed that 85% of women preferred supplements over hormones for menopause, which the founder finds unfortunate, as she believes approximately 90% of women could benefit from hormones. This highlights a need for greater awareness and education.

The company also engages in the "longevity space," which the founder equates with preventative care. The focus is on encouraging women in their 30s, 40s, and 50s to adopt practices that promote healthier aging in their 70s, 80s, and 90s. This includes preventative measures for stronger bones, cardiovascular disease, and Alzheimer's, conditions disproportionately affecting women.

Founder's Role and Leadership Style

The founder acknowledges her close association with the company's brand, particularly on LinkedIn, where she shares her passion for women's health and hormones. She models the lifestyle she advocates for, such as weightlifting for bone health, even if it's not her personal preference. She describes herself as an introvert who is learning to be more vocal and even "louder" and "more controversial" in her public communications.

Her fearlessness is attributed to her children being grown, her commitment to this being her last career endeavor, and a desire to not impress anyone else. This allows her to focus on doing a good job and making a significant impact. She also draws inspiration from her children's social media savviness, learning from them about emerging platforms and trends.

She recounts an investor's memo that questioned her ability to be a "fearless" founder, which served as a wake-up call, motivating her to embrace bravery. Her advice to aspiring entrepreneurs is that bravery usually pays off, and in running one's own company, it's essential for success.

Equity, Women in the Workforce, and Venture Capital

The founder co-authored a book in 2008 titled "Getting to 50/50," which addressed why women were leaving the workforce and advocated for a mindset where both partners' careers and parental roles are equally important. While some aspects of the book may be dated, the core message of supporting women's continued participation in the workforce remains relevant.

Despite progress, she notes that challenges persist, including declining VC funding for women and a widening pay gap. However, she is optimistic due to the increasing number of women in venture capital who have capital to invest. She emphasizes the need for women in all stages of the capital infrastructure to fund women entrepreneurs, as female investors are twice as likely to invest in female founders.

Leadership Evolution and Company Culture

Reflecting on her leadership journey, the founder notes increased confidence, partly due to the company's success and her passion for its mission. She is proud of having a predominantly female workforce and is committed to supporting women, particularly through maternity leave and return-to-work programs. She also focuses on creating an attractive work environment for nurse practitioners, offering flexibility and career growth.

Her leadership is characterized by intentionality and purpose, focusing on building a culture where both men and women can thrive. She views this as a luxury that allows for proactive culture building.

Advice and Life Hacks

The best advice she has received is to focus on resilience, with the mantra "When things get hard, rest, don't quit." She also embraces moderation and grace for one's body, finding that contradictory dietary advice suggests moderation is key. She clarifies that there is no data showing Diet Coke is harmful.

Her life hacks include a daily Diet Coke, frequent walks (often with a weighted vest), listening to podcasts and audiobooks during these walks, and waking up early. She also relies on a strong network of female leaders in health tech for support during moments of panic.

AI and Mentorship

The founder actively uses AI tools like ChatGPT for efficiency, including preparing for board meetings by simulating harsh board member feedback. She also engaged in an eight-hour conversation with an AI persona of John Doerr, author of "Measure What Matters," to refine her company's OKRs (Objectives and Key Results). She even had her husband ask Susan Wojcicki, former CEO of YouTube and a close friend, to critique her OKRs, receiving valuable, emotional feedback.

She highlights the profound impact of watching Susan Wojcicki's success as a motivating factor and acknowledges the value of mentorship and having a cohort of successful women to look up to for inspiration and guidance.

Conclusion

The founder's personal experience with inadequate menopause care ignited a mission to revolutionize women's health. Through innovative use of telehealth, a robust insurance-based business model, and a commitment to holistic care, her company is rapidly expanding its reach. The narrative emphasizes the importance of normalizing conversations, empowering women, and leveraging technology and expert knowledge to democratize access to essential healthcare. The founder's journey also underscores the power of resilience, fearlessness, and building supportive networks in entrepreneurship, ultimately aiming to enable women to thrive throughout their lives and careers.