Founders and investors have jumped on the commercial opportunity in menopause. The midlife women’s health company Midi has reached a $1 billion valuation; the women’s health unicorn Maven has expanded into the stage of life; and celebrity-backed brands sell everything from supplements to moisturizers. Reports have estimated that menopause could be a $600 billion market.
This week, the category gained the endorsement of another major figure in women’s health: Melinda French Gates. The billionaire philanthropist announced a new $215 million commitment to women’s health, with menopause and midlife health one of three key pillars. French Gates has long funneled her philanthropy toward women’s health—especially contraceptive access and maternal health—through the Gates Foundation and her current firm Pivotal, but this is the first time she’s focusing on women’s midlife health. She has also given $100 million to Wellcome Leap, which works to catalyze women’s health research on under-funded and under-researched conditions. So far, that funding has been used to research women’s cardiovascular disease.
“As a world, we still really are not focused on these years that women go through called perimenopause and menopause. And yet those are women’s very productive years,” she told Fortune. “Their kids might be a little bit older. They might be in middle school. They might be in high school. The woman’s still working, but if she’s dealing with all these symptoms, and she goes and talks to her friends and all these providers and can’t get answers—she’s suffering and she’s losing days at work.”
Alongside the for-profit activity in the menopause space, French Gates’ latest philanthropic commitment gives the category a boost. Her initial partners include the Menopause Society, which trains frontline health care workers in how to provide care during this life stage.
At her firm Pivotal, French Gates blends philanthropy, investing, and policy advocacy with the idea that each can accomplish something different. Pivotal’s portfolio of 13 early-stage companies and 27 funds includes Haven, which treats migraines (a condition that often affects women in midlife); the women’s health clinic Tia; and the pregnancy care startup Millie. She looks for startups that are medically-backed, a crucial distinction in the midlife health category that encompasses everything from telehealth care to face cream.
On the policy side, Pivotal will support education requirements for providers; expanded insurance and Medicaid coverage; and workplace protections. Public education campaigns are another avenue for change, French Gates wrote in a New York Times op-ed.
French Gates is fascinated by a stat: that over the course of their lives women live in poor health for nine years longer than men—and half of those years come smack-dab in the middle, at peak productivity.
“Just as she’s right at what could be the pinnacle of her career, we’re seeing women step out of the workforce because of menopause,” she explains. “We won’t get women to positions of power if they’re stepping out of the workforce. That’s why this is so fundamentally important to me—as part of women’s power.”
French Gates will judge the success of this work by whether others follow with more funding for research and other needs. Her $215 million infusion is meant to be a testing phase, with more to come. “I’m trying to send a signal,” she says—that women’s health, and especially midlife health, are viable categories for philanthropists, even as the Trump administration has had a chilling effect on the sector.
“I try to say, what can philanthropy do? What can business do? What can policy do?” French Gates says. “But also, how do we crowd more people in these spaces?”
Read French Gates’ extended interview here.
