Menopause is a billion-dollar business now. It should’ve been one long before now.

In February 2026, Midi Health closed a $100 million Series D at a valuation above $1 billion. That’s a company built on a stage of life that, not long ago, barely came up in doctors’ offices, workplaces, or investment meetings.

Now look at who’s supposed to deliver the care. In a national survey of U.S. OB-GYN residency directors, only 31% said their program had a menopause curriculum. The UK, with a national health system and years of public campaigning, isn’t far behind. In one survey of GPs, 52% said their training hadn’t equipped them to manage menopause.

The market has recognized the opportunity faster than our healthcare infrastructure has caught up.

Capital Moved Faster Than Care

For years, women were expected to push through menopause on their own. Hot flashes went to one doctor, sleep to another, bone density to a third. Brain fog, anxiety, and sexual health changes mostly went nowhere. Women learned to navigate the system themselves.

Capital is finally moving. Employers are paying attention. Digital health companies are opening access. Women are demanding better care. I’ll celebrate that every time, because this sector spent decades being told it was too niche, too small, and too hard to fund.

But investment isn’t infrastructure. A valuation measures what investors expect. Capacity is what a woman can actually book on a Tuesday afternoon. Right now those two numbers are far apart.

Mayo Clinic researchers put the U.S. cost of menopause symptoms at $1.8 billion a year in lost work time, and $26.6 billion once medical expenses are added. The demand was always there. What’s missing is trained clinicians, reimbursement, and reach.

Menopause Is the Entry Point

I’ve said for years that women’s health can’t be reduced to reproductive health. It’s whole-body health across the lifespan. We still fund and deliver it as disconnected events: menstruation, fertility, pregnancy, menopause.

Her heart sits in one specialty. Her metabolism, her bones, her cancer screening, and her mental health sit in four others. Her body never worked that way.

The cost of that fragmentation depends on where she lives. In India, the average age at menopause is 46.6, about five years earlier than in the U.S. That’s five more years of bone and cardiovascular risk landing on a public health system still organized largely around maternal care.

Midi clearly sees this. Alongside the raise, it repositioned toward what it calls lifelong care, adding cardiology, obesity management, and longevity. The company that proved the menopause category is already moving past it. 

Women don’t need another healthcare silo. They need preventative screening, heart and metabolic risk, bone health, sexual health, and mental health connected instead of assembling that care team themselves.

Move Menopause Into Workforce Planning

Employers are moving. In Business Group on Health’s 2026 survey, 58% said they’ll provide menopause support programs, up from 28% two years earlier. In Great Britain, employers with 250 or more staff will have to publish action plans that include menopause support from spring 2027, subject to legislation.

Most companies still treat menopause as the newest optional benefit to add on at open enrollment. It belongs in workforce infrastructure planning, next to succession and retention.

Menopause arrives in the years women reach senior leadership, manage teams, care for children and aging parents, and carry institutional knowledge a company can’t easily replace. In the Mayo study, 13% of working women reported an adverse work outcome tied to symptoms, from cutting hours to leaving the job. Benefits built around the reproductive years stop right where that risk starts.

Employer benefits only reach women with formal employers. In sub-Saharan Africa, ILO estimates put 89.5% of employed women in informal work, so care there has to run through primary care, pharmacies, and community health workers.

The Infrastructure Test

A billion-dollar valuation in women’s health deserves the celebration. It can’t become our proxy for progress. 

The real measure is whether a woman in a community without a menopause-trained clinician can get appropriate care. Whether insurance or the public system pays for it. Whether it works for a woman who can’t afford a premium subscription. Whether it catches heart, bone, and cancer risk early, before she becomes an expensive chronic patient.

Brazil shows how wide that gap can run. In its first national population study, 87.9% of midlife women reported symptoms, yet hormone therapy was recommended to just 22.3% of those in or approaching menopause.

I’ve watched the same pattern while placing equipment in 12 countries through HERhealthEQ. A device only delivers care when there’s a trained clinician, a referral path, and a way to pay for it. None of that gets built without data, and across 41 low- and middle-income countries, only 4% of 252 menopause studies were nationally representative.

The companies that define the next generation of women’s health won’t simply find an underserved category and build a product for it. They’ll connect that product to reimbursement, clinicians, employers, health systems, and patients at scale. 

Build the System Underneath

Menopause is the most visible test case women’s health has had. We finally have attention, consumer demand, serious companies, and investors willing to put meaningful capital behind them.

Now we need to build the system underneath it: trained clinicians, coverage that pays, data in the markets that have none, and care that follows a woman from her forties into her eighties.

The goal was never to create a billion-dollar menopause market. The goal is to create a healthcare system capable of taking care of women across their entire lifespan.