In 1993, Jurassic Park came out in theaters and the World Wide Web was released into the public domain. That same year, the U.S. Food and Drug Administration finally let women of childbearing age be included in early-stage clinical trials. It had taken a whopping sixteen years to reverse that policy. In plain English: most of the people reading this are older than the requirement to include women in the studies that shape modern medicine.1
That fact tells you almost everything about why women’s health, as a category, looks the way it does today. The data is thinner, the diagnostic frameworks are coarser. The drug doses are largely calibrated to male physiology. And the commercial response (pink bottles, vague claims, retail-only distribution, products that cost more for less) has been called the pink tax for so long it almost sounds quaint.
By now we have specifics on the actual cost of that framing, and it’s not pretty. Today women’s health receives roughly 6% of all private healthcare investment.2 Only 1% of healthcare R&D outside oncology targets female-specific conditions.2 One percent! Yet McKinsey and the World Economic Forum estimate that closing the women’s health gap would add about $1 trillion to global GDP annually by 2040, and that every dollar invested in the category returns roughly three.3
That framing is finally collapsing. The wellness category isn’t expanding, but being replaced by something else: a clinical, evidence-driven, reimbursable category that operates inside healthcare rather than on a single pharmacy shelf. The companies and platforms being built into that gap are starting to gain traction, and the capital that was selectively curious five years ago is starting to move with intent. The opportunity is massive.
I — What changed
Several things, more or less at once.
The first is capital. Sequoia and StepStone are now in follow-on rounds for women’s health platforms, and the category is consolidating around a smaller number of operators with credible scale. The exit data tells the clearest version of the story: women’s health generated roughly $100 billion in cumulative exits between 2000 and 2024, and half of that value was created in the last five years. 27 of those exits were over $1 billion.4
The second is policy and regulation. In the UK, employers with 250 or more staff are now required to develop formal menopause plans.5 In the U.S., the FDA removed the black box warning on hormone replacement therapy earlier this year.6 Only about 5% of women in menopause currently take HRT, and that warning was one of the key reasons.7 Removing it will move adoption, and adoption will pull the entire companion ecosystem along with it.
The third is the wellness reset. The category that for years got away with vague claims and one-nutrient formulations is being squeezed by something harder to fake: biomarkers, published data, function-first outcomes. Consumers looking for evidence. Wellness in its old form is losing its grip, and what’s replacing it is measurable.
And the fourth is GLP-1. In the United States, the median GLP-1 patient is a woman; one in five women aged 50 to 64 has used one.8 With oral pills now approved and prices coming down, the patient population is expanding fast.9 What the drug has done, almost incidentally, is force a clinical conversation about women’s bodies, women’s metabolism, and women’s nutritional needs into mainstream medicine – something decades of public health messaging could not do.
"The drug has forced a clinical conversation about women's bodies, women's metabolism, and women's nutritional needs into mainstream medicine - something decades of public health messaging could not do."
II — The Perimenopause Blind Spot
If I asked a room full of healthcare investors to explain the difference between perimenopause and menopause clearly, even sophisticated rooms couldn’t do it. Women living through it understand the distinction perfectly well, and many feel the impact across every slice of their lives. The medical and commercial systems built around them, for the most part, do not.
Perimenopause symptoms begin at 35 to 40. The market wakes up at 50. An astounding 90% of women say they feel underinformed about what’s happening to their bodies during this transition, and only about 8% of symptomatic women aged 40 to 64 ever receive a formal perimenopause or menopause diagnosis.10 That is not a small gap; it’s a category-defining failure of clinical infrastructure.
On the consumer side, the conversation is exploding. Searches for perimenopause-related topics are up 50% year over year.11 Mary Claire Haver’s books The New Menopause and The New Perimenopause are New York Times bestsellers. Longtime actor and sex symbol Halle Berry founded and fronts Respin Health, billed as ‘Menopause care that works.’ This is not a niche demographic discovering a niche concern. It is one of the largest underserved patient populations in modern healthcare finally finding a vocabulary for what’s happening to them.
“This is not a niche demographic discovering a niche concern. It is one of the largest underserved patient populations in modern healthcare finally finding a vocabulary for what's happening to them.”
The companies filling that gap are the ones being valued at a billion dollars and more. Maven Clinic, at an enterprise value of roughly $1.7 billion. Midi Health at around $1 billion.12 Progyny on the public markets. Crucially, these platforms are operating as a clinical category, with provider networks, insurance coverage, employer contracts, and outcomes data. That distinction is the whole game.
III — The Collision Nobody Fully Priced
Now back to GLP-1, because it’s where the structural reframe becomes impossible to ignore. Increasingly, the drug is exposing what was never built around the female patient in the first place.
25-40% of the weight lost on GLP-1s comes from lean mass, not fat.13 For a 30-year-old man, that’s a clinical concern. For a 55-year-old woman, it’s something else entirely. At that point in life she is already losing bone density and muscle. Her estrogen is dropping, which compounds both. And she is now taking a drug that accelerates the lean mass loss further. Within twelve months on GLP-1 therapy, micronutrient deficiencies like iron, vitamin D and B-vitamins are widely reported.14 Roughly half of patients who stop taking these drugs regain the weight, and a meaningful proportion end up heavier than they started.15
There is no clinical infrastructure built for that woman. No nutritional protocol and no obvious off-ramp after the drugs. The default response (here’s a generic women’s multivitamin!) does not address the muscle loss, bone loss, or the hormonal transition she is simultaneously navigating. It’s a category in the market that does not yet fully exist. It’s also one of the most concrete signals we can point to that women’s health is no longer separable from clinical medicine. The drug is speeding up the inevitable, and the companies building for it well are going to be valuable.
“There is no clinical infrastructure built for that woman. No nutritional protocol and no obvious off-ramp after the drugs…It’s also one of the most concrete signals we can point to that women's health is no longer separable from clinical medicine.”
IV — Why Standalone Products are Losing and Platforms are Winning
A note on what’s working and what isn’t.
The old product playbook (a broad “women 50+” positioning, one nutrient per formulation, limited R&D, retail-only), is structurally squeezed. Direct-to-consumer acquisition costs in supplements are up roughly 60% over the last five years. Retention is pinned at around 28%.16 Sure you can spend more to acquire a customer, but you cannot make that customer stay. Without genuine IP, the moat shifts to brand and shelf space, a game the large incumbents most often win. And without a feedback loop measuring biomarkers, adherence, or outcomes, standalone products have no way to compound on their own data.
Platforms compound differently, and on every layer. They have direct access to engaged, diagnosed users. Their recommendations come from clinicians, not Instagram influencers. They generate longitudinal outcomes data that refines formulation and strengthens the moat over time. Their revenue is increasingly B2B2C – employer contracts, payer relationships, predictable and sticky – not subscription. And once they’re embedded in telehealth workflows, EHRs, and employer benefits, they stop being apps and start being infrastructure.
“This is the same pattern we see across nutrition and health categories more broadly; standalone products can work, but platforms compound.”
V — The Capital Map has Changed
If women’s health is becoming a serious category, then we should also have a serious conversation about the buyer universe. Pharmavite acquired Bonafide Health in 2023, pulling a major OTC player into the menopause category.17 LifeMD acquired Optimal Human Health MD last year, with a public telehealth company buying its way into women’s hormonal care.18 Prelude Growth Partners invested in Perelel in late 2025, validating women’s health supplements as a scalable PE category.19 Hindustan Unilever fully acquired OZiva in February.20 Maven acquired Naytal in the UK, expanding a virtual women’s health clinic through platform roll-up.21 Progyny is on the Nasdaq.
Strategic pharma, public telehealth, consumer PE, large FMCG, platform consolidators, and the public markets are all live buyers. The implication for company building is specific: focus commands premium. Doing one thing exceptionally well attracts more strategic appetite than doing everything adequately. The category is no longer waiting on a Nestlé to wake up. The exits are already happening, and they are increasingly diverse.
VI — Where the whitespace still sits
A few areas, in order of how strongly we see them.
- Perimenopause-specific systems, where the diagnostic and clinical infrastructure is still catching up to the consumer demand.
- Multi-system solutions: products and platforms that address bone and muscle, metabolic and cardiovascular, cognitive and mood together, rather than treating each in isolation.
- Puberty and cycle onset, where almost everything available is nothing more than a repositioned multivitamin.
- The post-GLP-1 ecosystem built specifically for women, addressing the muscle, bone, micronutrient, and rebound dynamics that the off-the-shelf response does not.
- The enabling layer: companies accelerating clinical evidence generation specifically for female biology, which is the prerequisite for almost everything else.
There is more, and the category is moving fast enough that any list written today will look incomplete in twelve months. That’s the point.
VII — A final thought
For thirty years, women’s health was the part of medicine you could safely undercount and still call yourself a serious investor. That window is closing. The biology is the same as it always was; what’s different is that consumer awareness, data, regulation, capital, and clinical infrastructure are finally catching up to it. The category being built on top of that convergence is one of the more consequential investment opportunities in healthcare right now, and it will be built by the people who saw it clearly first.
Endnotes:
- FDA “Guideline for the Study and Evaluation of Gender Differences in the Clinical Evaluation of Drugs,” July 1993; AAMC, “Why we know so little about women’s health,” 2024.
- World Economic Forum, “Women’s Health Investment Outlook,” January 2026.
- World Economic Forum and McKinsey Health Institute, “Closing the Women’s Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies,” January 2024.
- AOA Dx, “Follow the Exits: Why Women’s Health Is a Smart Bet in Healthcare,” released at the J.P. Morgan Healthcare Conference, Jan. 13, 2026. https://aoadx.com/exits-report-launch/
- UK Government guidance on menopause in the workplace.
- U.S. Department of Health and Human Services and FDA, announced Nov. 10, 2025; labeling changes effective February 2026.
- Manson JE, et al., JAMA, 2024, cited in Harvard Health Publishing, November 2025.
- RAND Corporation, “New Weight Loss Drugs: GLP-1 Agonist Use and Side Effects in the United States,” American Life Panel survey, April-May 2025.
- FDA approvals: oral semaglutide (December 2025) and orforglipron (April 2026).
- Evernorth Research Institute, analysis of 1.5 million commercially insured women ages 40–64.
- Spate, cited in BeautyMatter, “The Perimenopause Opportunity Beauty Can’t Ignore,” Jan. 27, 2026. https://beautymatter.com/articles/the-perimenopause-opportunity
- PitchBook, Crunchbase, and company press, April-May 2026. Private valuations stated as approximate.
- Mayo Clinic, “GLP-1 Medications and Muscle Loss,” 2026.
- Urbina et al., Clinical Obesity, February 2026.
- Clinical literature on GLP-1 discontinuation, e.g., Wilding et al., Diabetes, Obesity and Metabolism, 2022.
- Propel 2026 Retention Benchmarks, compiled from Statista; Metrilo DTC Metrics Report.
- Pharmavite LLC press release, Nov. 30, 2023.
- Fierce Healthcare, April 29, 2025.
- PR Newswire, Nov. 20, 2025.
- Nutralngredients, Feb. 16, 2026; HUL board announcement Feb. 12, 2026.
- Maven Clinic press release, March 21, 2023.