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After a full day of meetings at Julie, a startup that sells a morning-after pill, CEO Amanda E/J Morrison jumped a flight from New York to Boston and headed to a small, private college, where a trivia night awaited her. Dozens of students shuffled into a classroom with plates of chicken tenders, Texas toast, and bright blue boxes of the emergency contraceptive.Morrison had worked with the Planned Parenthood Generation Action club at Suffolk University to sponsor the event, part of Julie's efforts to win a new generation of consumers. However, she had another, more pressing reason for being there. Julie is doing more campus events to clear up some of the confusion about emergency contraception — namely, that it isn't medication abortion.Standing at the head of the classroom, Morrison read off a projector screen, "Emergency contraceptives like Julie are legal in how many states? 25, 48, 50, 37." Students tapped their answers into a quiz app. "It's 37," Lily, a spirited sophomore, whispered to her teammates.In a minute, the correct answer appeared on screen, and the quiet chatter rose to a clamor. Half the teams said 37 states."Fifty states, guys. It's everywhere," Morrison said.When asked why she said 37, Lily said, "Just the way things are going."In states that outlaw abortion, some patients and politicians worry that contraception could be in legal jeopardy, too. There's no federal law preserving access to birth control, rather, a patchwork of state laws and court decisions holding it in place. Another Trump term <a target="_blank" href="https://www.politico.com/news/2024/05/29/trump-birth-control-contraception-00159555">could change that</a>.For Julie, "that's the million dollar question of this election," Morrison said.<div type="image" title="TK" height="2000" width="2667" msid="114460252" hostid="261" sizebytes="193282"></div>"We're not worried about some big ban happening in the first hundred days. But how those decisions trickle down — what is presented in Congress as a bill, how the Supreme Court reacts, what trickles down to the states — becomes a real secondary concern," she said.Founders of women's health startups feel doubly invested in this election, one of the closest presidential races of the century. Half a dozen founders and investors of women's health companies, all women, told Business Insider that if Vice President Kamala Harris wins, it's business as usual. They said another Trump victory creates uncertainty for reproductive health startups, from period trackers to online abortion clinics to embryo banks.<div type="image" title="TK" height="1610" width="2147" msid="114460254" hostid="261" sizebytes="109206"></div>While Harris's presidential campaign has been marked by unrelenting support for reproductive healthcare, including contraception and abortions, Trump's position has been a moving target.The former president suggested <a target="_blank" href="https://www.politico.com/news/2024/05/29/trump-birth-control-contraception-00159555">in May</a> that he was "looking at" restrictions on birth control, then walked that position back in a social media post later that day. During the September presidential debate, he called himself a "leader" on IVF, a move that <a target="_blank" href="https://www.politico.com/news/2024/09/12/trump-ivf-gop-roe-abortion-00178760">angered</a> parts of his base that have sought to restrict fertility treatments. He said <a target="_blank" href="https://www.cbsnews.com/news/donald-trump-says-he-would-veto-federal-abortion-ban/">in October</a> that he'd veto a national abortion ban after deflecting the question for months but would support states ordaining their own abortion bans.Trump's waffling on reproductive rights has put founders of women's health startups on notice. "It is one of the major issues that we're discussing and that our CEOs are focused on — how to continue to provide care to women, especially women of childbearing age," said Trish Costello, founder of Portfolia, an investing platform that pools money from female accredited investors.The day after the presidential debate, Mika Eddy was vibrating with the weight of the election. The race's outcome could drastically change reproductive rights, foreign policy, gun safety, and climate law — all issues close to Eddy, a 35-year-old Californian and mother of two.But Eddy also has skin in the game as the chief executive officer of Malama Health, a startup helping women with gestational diabetes access better care. Its doula network assists patients on Medicaid with applying for benefits such as diabetes-friendly meals and medical transport.Eddy worries that if Trump wins, he would restrict access to the coverage and benefits that her users rely on, weakening one of Malama Health's key services."There is this common misperception that, 'we're in California, we're in a liberal state, and so we're safe.' And I don't think that's the case," Eddy said.For some founders of women's health startups, this election is more than a political contest; it has ramifications for their livelihoods. With so much at stake, they're planning how to handle a scenario where states or courts might impose more limits on reproductive rights.<div type="image" title="US Vice President Kamala Harris taking pictures with some young teen girls." height="3000" width="4000" msid="114460257" hostid="261" sizebytes="755478"></div><a target="_blank" class="" href="https://www.businessinsider.com/abortion-telemedicine-startup-hey-jane-roe-v-wade-2022-10">Hey Jane</a> is a telehealth startup that connects patients to medical providers who offer online appointments and delivers abortion pills to their doorsteps. A year after the Supreme Court overruled Roe v. Wade, ending the constitutional right to abortion, Hey Jane started selling birth control and treatments for urinary tract infections, yeast infections, and herpes, both oral and genital. The new products cushion the business against a "plan E" scenario of a national abortion ban, said Carli Sapir, a Hey Jane investor and founding partner of Amboy Ventures."We're thinking about how to make sure those other verticals are in a good place to continue carrying the company forward," said Sapir.This time last year, one of Hey Jane's rivals, Choix, shut down <a target="_blank" class="" href="https://www.businessinsider.com/vcs-backing-online-abortion-sites-say-its-good-business-2021-9">after three years in service</a>. The company said in a <a target="_blank" class="" href="https://finance.yahoo.com/news/choix-closes-virtual-doors-launches-130300919.html">press release</a> that "the stigma and politics surrounding abortion care posed significant fundraising challenges." It raised a $1 million seed round in 2022.While direct providers of abortion, like Hey Jane, could see major restrictions or shutdowns to their core businesses if Trump returns to the White House, a wider range of companies expect to feel the ripple effects. Startups that seem removed from the front lines, such as those involved with period tracking and fertility treatments, are also preparing for potential challenges.<div type="image" title="Then-President Donald Trump addresses the anti-abortion &quot;March for Life&quot;" height="750" width="1000" msid="114460247" hostid="261" sizebytes="53678"></div>If a national abortion ban were to occur, apps like Flo Health or Clue might face increased scrutiny, according to <a target="_blank" href="https://www.businessinsider.com/why-lux-capital-deena-shakir-wrote-childrens-book-2024-9">Deena Shakir</a>, a general partner at Lux Capital. These apps track when women have their periods and when they miss them. In today's post-Roe America, privacy experts worry that such data could be used to suggest that someone has had or is thinking about having an abortion, potentially putting women at risk of prosecution in certain states.The stakes could be equally high for companies involved with fertility treatments.The demand for services like in vitro fertilization, or IVF, and surrogacy has been climbing for years as people have kids later in life and infertility rates increase. That's birthed a <a target="_blank" href="https://www.businessinsider.com/fertility-startups-booming-despite-market-downturn-2023-6">global fertility market</a> that includes companies that operate clinics to provide services like egg freezing and IVF, companies that run labs and tests, and firms that help people pay for the procedures.However, the industry's future is uncertain following attacks on abortion access. The end of Roe v. Wade opened up the legal terrain for states to interfere with access to other reproductive care, said Lauren Berson Sugarman, founder and chief executive officer of Conceive, a startup that offers personalized fertility guidance, including text support from nurses and peer groups.In Alabama, the state Supreme Court ruled that frozen embryos should be considered children. That put patients and fertility clinics on edge that they could be criminally charged for destroying extra embryos. A handful of Alabama clinics paused IVF treatments while patients throughout the South began moving their embryos to jurisdictions with more stable legal protections."We see a lot of patients come to us and say, should I move my embryos out of a red state? Because what happens if they come after IVF?" said Berson Sugarman.The push for "embryo rights" could have wide-reaching repercussions for startups like Maven Clinic or Carrot Fertility, which offer fertility benefits for employers, and TMRW Life Sciences, a biotech company creating robots for the safe storage of frozen sperm, eggs, and embryos.Moreover, it could influence the type of research that startups conduct and where. Alice Zheng, a principal at women's health investor RH Capital, explains how the shifting legal landscape might affect companies like Vitra Labs. As a biotech startup working on developing eggs from stem cells for IVF, "they're doing really cutting-edge research for fertility, but they need to think very carefully about where they set up shop," Zheng said. "Some of their research might involve certain types of tissue, which is more closely scrutinized in some areas than others."<div type="image" title="TK" height="2000" width="2667" msid="114460250" hostid="261" sizebytes="243576"></div>Two years ago, in the hours after the Supreme Court ended the constitutional right to an abortion, Morrison's phone started ringing and didn't stop. Investors wanted to know if the ruling would kill Julie's launch in Walmart stores that fall. Job candidates wondered if the company would still exist in six months. Morrison's mom called, concerned for her daughter's future."For probably two weeks straight, I was just doing reassurance calls," Morrison said.While emergency contraception is not the abortion bill and is currently legal in all 50 states, it is continuously confused with the abortion pill, which can have damaging consequences. In June, the medical journal JAMA Network Open published a <a target="_blank" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820370?%20utm_source=For_The_Media">study</a> that found retail pharmacy fills of Plan B, a leading morning-after pill brand, fell by 65% in states with near-total abortion bans the year after the Dobbs decision, partly due to clinic closures and confusion about its legal status.That confusion could threaten Julie's sales, and puts the onus of the company to better educate consumers. It sponsors events like trivia nights and sorority house brunches. It has enlisted TikTok influencers to share videos of their drugstore hauls showing how easy it is to buy Julie. In one video, a young woman going back-to-school shopping walks off with a two-count pack of the emergency contraceptive pill. The caption reads, "double majors, not double strollers."Other startups are urging consumers to fight for reproductive rights at the polls. Eddy's Malama Health has reminders to register to vote in its app and will tell users where their nearest polling station is closer to election day. The company asks for their ZIP codes during onboarding, Eddy explained."When you have a baby, you're like, 'I want to vote, but I don't know where to go,'" Eddy said. She hopes the emails will get more pregnant women and new moms to head to the polls. Eddy added that the emails won't support a candidate and are meant as a "nonpartisan resource."<div type="image" title="TK" height="2000" width="2667" msid="114460255" hostid="261" sizebytes="192114"></div>Julie's content isn't political, either. It's not trying to change any minds about abortion rights. The goal is simply to spread awareness among young adults that emergency contraception helps prevent pregnancy, not end it. This way, Morrison said, a woman who is anti-abortion and has unprotected sex can feel confident taking Julie knowing that she isn't compromising her abortion stance.It was past 9 o'clock on a weekday, and the competition at trivia night was heating up. Students in teams of two or three screamed with delight as they watched their names climb the leaderboard. They competed to win prizes like sex toys and T-shirts with the phrase, "A Better Morning After.""Morning-after pills end pregnancy. True or false," the club president called out.Thirty seconds later, the screen showed that every team had answered correctly.Morrison pumped both fists in the air, beaming her approval.<a target="_blank" rel="" href="https://www.businessinsider.com/author/melia-russell">Melia Russell</a> is a senior correspondent at Insider covering startups and venture capital. She can be reached via the encrypted messaging app Signal at +1 603-913-3085 and email at <a target="_blank" href="mailto:mrussell@businessinsider.com">mrussell@businessinsider.com</a>.<a target="_blank" class="" href="https://www.businessinsider.com/author/rebecca-torrence">Rebecca Torrence</a> is a correspondent at Business Insider writing about healthcare startups and venture capital. Send her an email at <a target="_blank" class="" href="mailto:rtorrence@businessinsider.com">rtorrence@businessinsider.com</a>.

'The million-dollar question of this election': Women's health startups are confronting a shifting legal landscape   

<ul class="summary-list"><li>Maven's chief financial officer has left the women's health unicorn one year after taking the role.</li><li>The startup plans to bring in a new CFO with public market experience, per a source with knowledge.</li></ul>Maven Clinic is swapping out its chief financial officers on the heels of a fresh funding round as the women's health startup inches closer to an IPO.Maven is bringing in a new finance head with experience leading a public company, according to a source with direct knowledge of the change.Kristina Campbell, Maven's former CFO, left the startup in October, according to her LinkedIn. She joined Maven a year prior, in October 2023.Earlier this month, Maven notched a $1.7 billion valuation with $125 million in new funding from the private equity firm StepStone Group. Business Insider <a target="_blank" href="https://www.businessinsider.com/womens-health-unicorn-maven-clinic-raising-new-funding-stepstone-2024-9">first reported</a> the round in September.The identity of Maven's incoming CFO isn't known. Maven declined to comment for this story. Campbell didn't respond to requests for comment.Maven launched 10 years ago to provide virtual care to women and families through employers and health plans, including for fertility, pregnancy, and menopause. It's since raised over $425 million from investors such as Sequoia Capital, General Catalyst, Lux Capital, and Oak HC/FT.As the highest-valued women's health startup, Maven is expected to be <a target="_blank" href="https://www.businessinsider.com/maven-ipo-chrissy-farr-womens-health-startup-prediction-2023-12">a candidate for the next wave of digital health IPOs</a>. The startup's hopeful future exit would be a boon for the women's health market, which remains a small fraction of all healthcare funding.Some of Maven's peers haven't fared as well in a tighter venture market. Fertility startup Kindbody is reportedly looking to raise more funding at a <a target="_blank" href="https://www.bloomberg.com/news/articles/2024-08-21/fertility-startup-kindbody-set-to-cut-valuation-letter-shows">$600 million</a> valuation, a massive markdown from the <a target="_blank" href="https://kindbody.com/kindbody-announces-100-million-in-new-funding-to-further-accelerate-growth/">$1.8 billion</a> valuation it landed in March 2023.Before Maven, Campbell spent over two years as the CFO of the cryptocurrency exchange Ripple. She left the company amid its <a target="_blank" class="" href="https://www.businessinsider.com/xrp-price-today-ripple-crypto-bitcoin-sec-gary-gensler-2024-3">legal battle with the SEC</a> after the agency accused Ripple of selling its XRP token as an unregistered security.Campbell has now joined entertainment payroll startup Wrapbook as its CFO, according to her LinkedIn profile. Wrapbook raised a <a target="_blank" href="https://www.hollywoodreporter.com/business/business-news/wrapbook-fund-bessemer-venture-partners-1236009642/">$20 million</a> funding round in September at a valuation of $750 million.

Exclusive: Maven Clinic is swapping out its finance chiefs as the women's health unicorn looks ahead to an IPO

It’s not every day that a beloved doll-turned-movie star leaves an audience with questions that have them Googling <keyword id="20071779" type="General" weightage="20" keywordseo="medical-specialists" source="keywords">medical specialists</keyword>. But that’s exactly what happened after the <keyword id="20068788" type="General" weightage="100" keywordseo="Barbie-movie" source="keywords">Barbie movie</keyword> hit theatres. Let’s dive into the curious case of why Barbie, of all things, sent the internet into a frenzy of <keyword id="22061992" type="General" weightage="20" keywordseo="gynaecologist" source="keywords">gynaecologist</keyword> searches. But be warned, there might be some mild spoilers ahead. It all started with a cheeky line delivered right at the end of the Barbie <keyword id="6356021" type="General" weightage="20" keywordseo="movie" source="Orion">movie</keyword>. The film, which had already packed a punch with its social commentary and humour, closed on a note that caught everyone off guard. As Barbie herself stepped into a real-world scenario, the movie’s creators dropped a final joke: Barbie, with her classic pink flair and forever-young appearance, was off to see a gynaecologist. Cue the laughter, a few raised eyebrows, and then — wait, what? That was it. No more context, just the credits rolling and audiences left in a state of amused confusion. <h2>Spike in gynaecology-related searches</h2>That single line sparked a curious chain reaction. Within days of the movie’s release, Google saw a noticeable spike in searches for the term "gynaecologist." According to data from <keyword id="20126148" type="General" weightage="20" keywordseo="Google-Trends" source="keywords">Google Trends</keyword>, searches for "gynaecologist" and related queries such as "what does a gynaecologist do?" spiked by over 500% globally in the week following the film’s release. This surge was particularly notable in regions where the Barbie movie saw the most viewership, including the United States, the United Kingdom, and Australia. In the United States, the spike in searches was particularly dramatic, with a 400% increase in searches for "first time gynaecologist visit." In the United Kingdom and Australia, similar spikes were recorded. Notably, the search for "first time gynaecologist visit" saw a significant increase, suggesting that the film may have prompted people to consider aspects of their health they had previously overlooked. <div type="Article" hostid="261" msid="112474200" title="Susan Wojcicki, YouTube CEO, died at 56 from a type of lung cancer that is often diagnosed late" mstype="2" mssubtype="0"></div>Interestingly, the spike in searches wasn’t just limited to general terms. Specific queries like "importance of regular gynaecologist visits" and "why women should see a gynaecologist" also saw significant increases. The movie had, in its quirky and comedic way, made the topic of women’s health more accessible and less taboo. <h2>Social and actual realities</h2>For many, the joke was a nudge toward an overlooked truth: Barbie, despite being an icon for decades, never had the anatomy to warrant a trip to a gynaecologist. This paradox was both hilarious and thought-provoking, prompting viewers to question their understanding of the doll’s physicality and, by extension, what it means to grow up with certain expectations about bodies and adulthood. Despite the noticeable spike in <keyword id="22539296" type="General" weightage="20" keywordseo="online-searches" source="keywords">online searches</keyword> for gynaecology-related information however, translating this curiosity into real-life healthcare actions appears more nuanced. According to insights from a study that examined these trends, while the movie successfully sparked interest and raised awareness about gynaecological health, there isn't conclusive evidence that this surge in searches led to an increase in actual appointments or visits to gynaecologists. The study’s authors noted that their research didn't track whether people who Googled these terms ultimately followed up with healthcare providers. Additionally, trends in other related search terms suggest that while many viewers were interested in learning more, this didn't necessarily translate into scheduling appointments or seeking medical consultations. This highlights a common phenomenon where increased awareness or interest, especially prompted by media, doesn't always result in immediate real-world actions. <div type="Article" hostid="261" msid="112410033" title="&amp;#39;It Ends With Us&amp;#39; screenwriter on why Blake Lively&amp;#39;s character&amp;#39;s obsession with Ellen DeGeneres is left out of the movie" mstype="2" mssubtype="0"></div>However, the real-life healthcare effect of the Barbie movie might still be unfolding. Even if immediate actions weren't taken, the film may have planted a seed of awareness that could influence future decisions. Sometimes, it takes repeated exposure to a health-related topic before individuals take concrete steps, and Barbie's joke might be just one of many influences that eventually lead people to prioritise their gynaecological health. But it is certainly irrefutable that the Barbie movie did more than entertain — it got people thinking, talking, and, yes, Googling. It’s not every day that a <keyword id="22805725" type="General" weightage="20" keywordseo="cultural-icon" source="keywords">cultural icon</keyword> sparks a public health discussion, but leave it to Barbie to do just that, all with a smile and a wink. The findings of this research have been published in JAMA Network Open and can be accessed <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821491">here</a>.

Why did the Barbie movie make the internet start searching for gynaecologists?

A <keyword id="20558223" type="General" weightage="20" keywordseo="blood-test" source="keywords">blood test</keyword> measuring two specific fats, along with <keyword id="20100635" type="General" weightage="20" keywordseo="inflammation" source="keywords">inflammation</keyword>, could help predict a woman's risk of developing heart conditions in the next 30 years, according to a study of nearly 28,000 women in the US. The two fats in one's blood sample that the test measured were LDL, or 'bad' <keyword id="19898368" type="General" weightage="20" keywordseo="cholesterol" source="keywords">cholesterol</keyword>, and lipoprotein(a), which is partly made of LDL. Inflammation was measured by detecting levels of high-sensitivity C-reactive proteins. When the three measures -- inflammation, cholesterol and lipoprotein(a) -- of a woman's blood sample were analysed together, researchers found that women having the highest levels were 2.6 times more likely to have a major adverse <keyword id="23010849" type="General" weightage="20" keywordseo="cardiovascular-event" source="keywords">cardiovascular event</keyword>, including a heart attack. The link was found to be even stronger for stroke -- women with the most elevated levels were 3.7 times more likely to experience a stroke over the next 30 years, the team of researchers, including those from Brigham and Women's Hospital, US, said. They added that the three measures can better predict the risk of major cardiovascular events over the next three decades than measuring only one. The findings were published in the <keyword id="20060225" type="General" weightage="20" keywordseo="New-England-Journal-of-Medicine" source="keywords">New England Journal of Medicine</keyword>. "We can't treat what we don't measure, and we hope these findings move the field closer to identifying even earlier ways to detect and prevent heart disease," author Paul M Ridker, Brigham and Women's Hospital, said. For the study, the researchers analysed blood samples and medical information from 27,939 healthcare providers living in the US, who participated in the <keyword id="23010850" type="General" weightage="20" keywordseo="Womens-Health-Study" source="keywords" meta.keywordsubtype="org" meta.entityname="Women's Health Study" meta.hostid="261" meta.entityid="Women's Health Study">Women's Health Study</keyword>. The women were on average aged 55 at the study's start (1992-1995) and followed for 30 years. Over the study period, about 3,660 of the women experienced a major cardiovascular event for the first time, including a heart attack, stroke, or death due to related reasons. Assessing cardiovascular risk individually due to each of the three measures, the researchers found that the women having the highest levels of inflammation had a 70 % higher chance of a major cardiovascular event. The women with the highest levels of 'bad' cholesterol and lipoprotein(a) were found to be at a 36 % and 33 % higher chance, respectively, of developing heart-related conditions. While only women were studied for this research, the researchers expect to find similar results in men, they said. Studies in recent years have shown how high levels of inflammation can interact with fats to compound heart disease risks, which helps explain why lower levels are better, according to the researchers. They explained that immune cells, which help the body repair wounds or infection, can also sense the accumulation of extra cholesterol in cells or become active in response to the build-up of plaque and send out inflammatory signals. This creates a hyper-inflammatory environment where plaque can form, become larger, or even rupture -- and cause cardiovascular events, the authors said. Through a combination of lifestyle changes and drug therapy, the researchers said that each of the three risk factors can be addressed. Studies have shown that lowering cholesterol and inflammation both significantly reduce the risk of heart attack and stroke, they said. The new data strongly supports earlier and more aggressive use of targeted preventive interventions, particularly among women for whom cardiovascular disease remains under-diagnosed and under-treated, the researchers said.

Fats in blood, with inflammation, could better predict heart disease risk in women, study finds

Adequately spaced pregnancies can significantly improve maternal and <keyword id="22472928" type="General" weightage="20" keywordseo="child-health-outcomes" source="keywords">child health outcomes</keyword>, Union Minister Anupriya Patel said on Friday, underlining that this also reduces risks and empowers women to make informed choices about their <keyword id="20548742" type="General" weightage="20" keywordseo="reproductive-health" source="keywords">reproductive health</keyword>. "The government's efforts have resulted in reduction of <keyword id="20741690" type="General" weightage="20" keywordseo="maternal-mortality" source="keywords">maternal mortality</keyword> from over 130 to 97 per one lakh births," the minister of state for health said and also highlighted the efforts taken by states to involve men in <keyword id="19943279" type="General" weightage="20" keywordseo="family-planning" source="keywords">family planning</keyword>. Patel held a meeting with public health experts as part of a series of programmes to observe the World Population Day. The theme of the meeting was "Reaching the Last Mile for Ensuring Healthy Timing and Spacing between Pregnancies: Issues and Challenges." The minister said the government has always been conscious of these issues. "The launch of initiatives such as the <keyword id="22472929" type="General" weightage="20" keywordseo="Pradhan-Mantri-Surakshit-Matritva-Abhiyan" source="keywords">Pradhan Mantri Surakshit Matritva Abhiyan</keyword> (PMSMA), extended PMSMA, identification of high-risk pregnancy in PMSMA, Anemia Mukt Bharat Abhiyan and the Post-Partum Family Planning Programme (Post-Partum IUCD and Post Abortion IUCD) are some examples of the government's commitment to the cause," she said. Patel also underscored the importance of an effective communication strategy. "The task of achieving Viksit Bharat (developed India) by 2047 cannot be done without empowering our women. Healthy timing and spacing between pregnancies are very important for women's health," she said. Additional Secretary and Mission Director NHM at the health ministry, Aradhana Patnaik, highlighted that India has already achieved a total fertility rate (TFR) of two with 31 states and Union territories achieving the replacement level. There is a need for an effective strategy to bring the TFR under replacement level in the remaining five states, the minister said. Patel said that "we would be able to reach the last mile" by empowering the youth, addressing challenges of equal participation of men and women, increasing couple communication, learning from best practices, taking cues from current and historical trends in family planning data and expanding the contraceptive basket of choices. She also stressed on identifying and mapping regions, districts, and blocks with data of issues such as low uptake of <keyword id="22472930" type="General" weightage="20" keywordseo="family-planning-services" source="keywords">family planning services</keyword>, low demand for modern contraceptives and high unmet needs, and saturating them with services and enhanced social and behaviour change communication.

Healthy timing, spacing between pregnancies crucial for women's health: MoS Patel

<ul class="summary-list"><li>The Soula app has an AI chatbot, Dua, that aids mothers with postpartum depression support.</li><li>AI chatbots like Dua aim to reduce healthcare burdens and improve mental health access.</li></ul>Caring for a month-old newborn and two-year-old son felt overwhelming for LeRonika Francis.During her first postpartum period, Francis said she experienced a heavy wave of depression while dealing with a baby with <a target="_blank" class="" href="https://www.businessinsider.com/guides/parenting/why-is-my-newborn-crying">colic</a>. She ultimately sought the help of a counselor. It was not until her most recent pregnancy that she also started to use an AI chatbot on the fem-tech app Soula, which she said helped with reducing depressive symptoms and reassuring her about her mental health."It tells me: 'Welcome back, LeRonika. Your reactions are natural,'" said Francis, who is based in New Iberia, Louisiana.The AI chatbot called "Dua" also sent her some videos that she could watch about self-hugging, a practice that could reduce stress levels."I feel like Dua is there more than anything. It really showed me: OK, this is what you could do. Make sure you make time for yourself, too, because that's important as well," said Francis.Soula was co-founded by Natallia Miranchuk and Andrei Kulik, who conceptualized a 24/7 AI doula that could close the gap in mental health support for mothers during pregnancy and postpartum periods. Rather than replacing medical providers, apps such as Soula aim to increase broader access to maternal healthcare. Healthcare providers said that these apps could also help reduce the burden on the healthcare system, where wait times can be long and <a target="_blank" href="https://www.businessinsider.com/new-york-nurses-strike-labor-union-staffing-shortage-covid-2023-1">workers face burnout</a>.Business Insider spoke with OB/GYN doctors and doulas, who largely welcomed the rise in AI chatbots because they can make information more accessible to patients.According to data obtained from Sensor Tower, Soula now has more than 35,000 downloads. The startup has fundraised over $750,000 and is backed by investors such as Andrey Mikhaylyuk, the former vice president of product at <a target="_blank" class="" href="https://www.businessinsider.com/unicorn-pitch-deck-flo-health-raises-200-million-series-c-2024-7">Flo Health</a>, a period tracking app.Miranchuk told BI that her experiences as a single mother of two and her work as a former maternity photographer inspired her to develop a supportive app for women. Initially conceptualized as a hub to connect doulas worldwide to those in need, the generative AI boom shifted the startup's focus to integrating a chatbot that could serve more populations."Women are shy to ask questions, even in the community, because they have the feeling that maybe 'as a mom, I should have known that, but I don't.' And she doesn't know where to go," Miranchuk said.The ease of customizing ChatGPT has spurred a wave of new AI-based chatbots like Soula. According to Sensor Tower, the companion apps <a target="_blank" href="http://Character.ai">Character.ai</a>, Talkie, and Paradot have more than 73 million collective downloads, soaring more than 130% between 2023 and 2024. AI therapy apps such as <a target="_blank" href="https://www.businessinsider.com/wysa-mental-health-startup-raises-fresh-vc-funding-expand-coverage-2021-5">Wysa</a> and Woebot received over 1 million downloads, the data said.Corenia Smith, director of the Birth Justice Collaborative in Minnesota, said that while popularizing tools like chatbots can help broaden healthcare access, it is important to avoid a "one size fits all" and ensure that AI can reflect the communities it serves."There are cultural practices that exist and have existed for thousands of years that people still use," Smith said. "A human could talk about all their experience and what they've seen and give referrals. When you reach that limitation with an AI, it has to have the ability to hand over care or make a referral in a way where people don't feel dropped."<h2 id="245c9b56-b4a4-4a1a-abbc-5f6bbf950f49">The role of a doula</h2>The AI chatbot Dua aims to function like a doula, providing mothers with information about the pregnancy experience during a time of transition.Doulas are trained professionals who can provide non-medical, continuous physical, emotional, and information support for women before, during, and after childbirth, helping to <a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10292163/">reduce</a> mental health-related morbidity for the mother and reduce infant mortality rates.Access to <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/reproductive-health/what-is-a-doula">doulas</a> can be costly. While there's Medicaid coverage for doulas in several states, not all private health insurance plans cover these expenses. <a target="_blank" href="https://www.sciencedirect.com/science/article/pii/S0266613821003120">Long wait times and socioeconomic inequality</a> also contribute to increased levels of stress and lack of healthcare usage among mothers and pregnant people."Traditionally, it's been something that's been available only to folks with a lot of money and a lot of resources. The people that benefit the most from doula care are those that might not trust the healthcare system," said Dr. Devon Rupley, an attending physician and OB/GYN specialist at NYC Health. "That tends to be people of color who've had previously negative experiences with racism and bias that can really harm their experience in the healthcare system generally."Rupley added that using an AI healthcare app to address basic questions can allow patients to spend higher-quality time with doctors by asking high-level questions and discussing their healthcare issues.<div type="image" title="Dua, an AI chatbot, talks to the user with texts." height="3000" width="4000" msid="114502558" hostid="261" sizebytes="72158"></div><h2 id="7b015d0f-002f-4d99-8f8d-2ae73851d6bc">How to design an empathetic AI chatbot</h2>Soula enlisted real-life doulas to help train its chatbot and strike the right tone."We can't create it to be as personable as talking to a real-life person, but we can try to create that as much as possible," said Lexi Pacheco, a doula from Arizona who worked to help refine the dialogue in Soula's chatbot Dua. For $22 per hour, she helped improve the chatbot by using it "hand-in-hand" during her pregnancies, adding in her expertise.While asking questions on Google could yield more informational responses, Pacheco said mothers would want something that provided "more of that reassurance that Google wouldn't."For Armani Grant, a Soula user who became pregnant at 18, Google felt overwhelming. The chatbot allowed her to ask questions that she wouldn't feel comfortable asking her mother. Pacheco said many women she's worked with reported similar experiences."They might even feel incompetent to ask the question, which no woman should ever feel, but with my history of working with people, they definitely tend to revert to: I'm sorry, I'm asking this question for some reason, and that might just be because of the societal pressure that more medicalized doctors have put on people that they don't give the time and day to us," Pacheco said.The app isn't meant to completely replace a doula. Moreover, retention rates of AI healthcare chatbots can be low, said Johannes Eichstaedt, a computational social scientist and assistant professor of psychology at Stanford University. The high dropout rates for healthcare apps are "an elephant in the room," he said.At the same time, Pacheco said AI bots can help "calm nerves" and fill the gaps when patients feel they are "bothering" their healthcare providers."AI isn't like a healthcare provider to give you guidance, but it's supposed to be there to give you a little bit more comfort," Pacheco said.

The AI app Soula seeks to improve healthcare access for pregnant women

When Josef Woodman's shoulder gave out in 2012 — strained from chopping firewood on his farm outside Chapel Hill, North Carolina — he said he was quoted between $2,400 and $3,200 for an MRI at Duke University Hospital.He didn't want to shell out the cost of a nice vacation just to find out he didn't need surgery, so he decided to wait, even as his mobility decreased to the point where he had to severely limit his farm work and could hold only one-third of the weight he normally could. Two years later, his patience was rewarded: While on a work trip to Bangkok, he got an MRI for just $460, landing an appointment two days after his consultation at a hospital."The results came back and they said, 'You don't need surgery. You've got a separated rotator cuff,'" Woodman said. The surgeon prescribed physical therapy, which he completed in the US. "The shoulder got way better," he told me. He was glad he waited.Like Woodman, millions of Americans travel abroad for medical procedures each year, saving anywhere from 40% to 90% on the services they receive. Many <a target="_blank" href="https://www.amjmed.com/article/S0002-9343(18)30620-X/fulltext">don't have health insurance</a> or don't get coverage for the procedures they seek out — dental work and cosmetic procedures like breast implants and liposuction are by far the most popular. There's also a small but growing market for people seeking thorough checkups and testing abroad. An ascendant medical-tourism industry is offering these types of screenings, including MRIs and electrocardiograms, in beautiful locations around the world and packaging them with transportation, accommodations, food, shopping, and sightseeing. And with an increasing obsession with "wellness" and celebrities like Kim Kardashian promoting full-body imaging, it's easy to see why more and more Americans are looking to pair cabanas with CAT scans."If you've got some kind of joint pain, or if you have some kind of condition that isn't progressing, incorporate that into your normal travel plans," Woodman, now 72, said. In 2007, he founded Patients Beyond Borders, a healthcare-consulting company that helps Americans plan medical vacations, after growing up taking trips to Mexico for dental work with his dad. "In any kind of industrialized nation, you'd be able to get access to good-quality screening and people who can interpret the results," he said.Medical tourism comes with risks; the American Medical Association recommends going only to medical facilities recognized by international accrediting bodies and following up testing with care at home. But a growing number of Americans are willing to take those risks, as suites of tests abroad are often cheaper and faster than just a single test in the US."We just don't have a preventative-oriented society here in the United States," Woodman said. "Our approach is reactive."In a July <a target="_blank" href="https://www.tiktok.com/@bryn.elise/video/7386406512593325355?lang=en">TikTok</a> that's amassed over 17 million views, Bryn Elise documented her experience at a Turkish hospital where she received over 30 scans and tests, including an EKG, chest X-ray, and abdominal and thyroid ultrasounds, in a single day. The bill? $830. Without insurance, the cost of an EKG alone in the US <a target="_blank" href="https://enhancehealth.com/blog/how-much-does-an-ekg-cost-at-urgent-care-without-insurance/#:~:text=The%20total%20cost%20of%20an,where%20you%20get%20the%20service.">can vary from $100 to $5,000</a>."Personally, I'd rather spend $700 on a flight to Turkey, get dozens of tests there, and take a whole vacation than spend the thousands that this would have cost in the United States," Elise said in the video, which also featured clips of her on a beach, poolside, and eating a spread of delicious-looking Turkish veggie bowls. The 29-year-old health- and beauty-tourism influencer said she booked the trip because she wanted to investigate some "mysterious ailments," including brain fog, vision problems, and heart palpitations, without paying America's sky-high healthcare costs. She told her followers she had struggled with an eating disorder for 10 years and that "since our US checkups are only a tap on the knee and a blood-pressure check, I've been low-key terrified that I've caused permanent damage to my body but would never find out until it's too late."Her tests unearthed an astigmatism, early signs of osteoporosis, and "critically low" levels of vitamin B12. "The feeling of impending doom I've had due to health concerns is gone," Elise said.She chose a hospital that had been accredited by the Joint Commission International, an Illinois-based organization that has accredited over 1,000 health facilities in more than 70 countries. Dr. Paulo Neno, an international-accreditation surveyor at the commission, told Business Insider the accreditation process takes up to two years to complete and is renewed every three years. It includes a 12-part evaluation, during which a team of doctors and nurses visit the medical facility and assess everything from its operating theaters and intensive-care units to its power and water systems."We are focused on understanding how they are providing safe care for high-risk patients," Neno said.It's unclear, though, how many medical tourists visit accredited facilities, and there's still the question of whether all these tests are useful for someone who is seemingly in good health. Woodman knew he had an issue that needed to be examined, but Elise was more interested in a holistic screening regimen. One person commented on Elise's TikTok, "The hypochondriac in me thinks this is the perfect vacation. I'd go every year."Since COVID-19 came into the picture, health screenings and extensive physicals have received some buzz. Last year, Kardashian got a full-body MRI done by Prenuvo, a US chain of diagnostic clinics that offers the service for $2,500. In an Instagram post promoting it, Kardashian described it as a "life saving machine" that could detect cancer or conditions like aneurysms in their earliest stages. Especially given the <a target="_blank" href="https://www.businessinsider.com/colon-cancer-cases-doubled-young-people-2024-5">rise in colon cancer</a> among young people — a disease that can spread with no or minimal symptoms — <a target="_blank" href="https://www.businessinsider.com/get-colonoscopy-colon-cancer-symptoms-colorectal-oncologist-2024-4">early screenings</a> are on more people's minds.But Arturo Vargas Bustamante, an associate professor of health policy and management at the University of California, Los Angeles, said these kinds of rigorous tests can often do more harm than good."You may get a lot of things that you may not need based on your age profile, or you may get screenings that ultimately would find something that could lead to treatment that may harm you," he said. US guidelines on which demographics should get tested are based on scientific evidence, he added, while clinics abroad may be more motivated by profit.If a test finds cancer at a very early stage when it's very slow-moving, Vargas Bustamante said, the patient may feel compelled to treat it immediately, subjecting themself to chemotherapy and radiation. But in reality, it's possible they could have gone years without needing to start treatment. "Sometimes knowing too much may not be that good for you," he said.Others, however, think that America's lack of access to robust preventive screening is a critical failure.Dr. Misael Uribe Ramos is the director of international medicine at Médica Sur in Mexico City, a Joint Commission International-accredited hospital that offers checkups with eight different specialists for $1,600. Uribe Ramos has seen interest in rigorous physicals boom since the outbreak of the COVID-19 pandemic — and he thinks it's a good thing.Often when you go to the doctor, it's to treat a specific issue or disease, he said. "But why is that? Because you don't have prevention," he said. "Prevention is the best way to be healthy."In America, chronic illnesses such as heart disease, diabetes, and cancer are leading causes of death and disability, driving the majority of the US's $4.5 trillion in yearly healthcare expenses, <a target="_blank" href="https://www.cdc.gov/chronic-disease/about/index.html">according to</a> the Centers for Disease Control and Prevention. These illnesses are largely preventable. The CDC also says that between 30% and 50% of cancers diagnosed today could be prevented by reducing risk factors (like not smoking and maintaining a healthy body weight) and getting recommended screenings and vaccinations. However, according to the <a target="_blank" href="https://health.gov/news/202401/prevention-still-best-medicine">US Office of Disease Prevention and Health Promotion</a>, only 5.3% of Americans 35 and older received all recommended clinical prevention services in 2020 — a number that dropped from 8.5% in 2015. Why? Simply put, many Americans aren't regular healthcare users. They often don't have a family doctor, they live too far from one, they don't have a way to get there, or they simply can't afford it, the Office of Disease Prevention and Health Promotion says. Meanwhile, preventive-care services aren't prioritized because healthcare providers are paid to treat diseases — not to prevent them by keeping people healthy. A 2020 study said the National Academy of Medicine <a target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309216/">estimated</a> that missed prevention opportunities cost the US $55 billion annually.Other countries take a different approach. In Japan, for instance, the most basic annual checkups include EKGs, chest X-rays, blood tests, eye and hearing tests, and stool and urine tests. And some residents require a more comprehensive version that includes cancer screening. Japanese employers are required to provide them for all of their employees. In 2019, about 74% of men and 66% of women in Japan completed some type of medical checkup, according to the country's Ministry of Health, Labour and Welfare.South Korea's regimen is similar to Japan's. On a work trip there in 2010, Woodman had extensive testing done, including an MRI and CT scan, as part of a "wellness preventative program" he tried out for work, he said. He was offered an endoscopy and colonoscopy as part of the package but declined."Testing in the United States is really kind of pathetic," Woodman said. "They weigh you. They take your blood test. 'How tall are you?' And that's pretty much it."Americans seeking better preventive screening tend to visit South Korea, Thailand, and the United Arab Emirates, while Mexico, Barbados, and Thailand are popular for genetic and fertility testing, as well as testing related to gender-affirming care, medical-tourism advocates told BI.Many of these countries have hospitals that cater to foreigners. In Mexico, Médica Sur's checkups take about five hours, with screenings across disciplines such as internal medicine, cardiology, gynecology, and ophthalmology. (In the US, a typical physical takes less than an hour.) Packages include breakfast, transportation, accommodation, menus catering to dietary restrictions, discounted sightseeing for an extra cost, and concierge staff who help patients coordinate their stay and remain by their side for the duration. The hospital is also connected to a Holiday Inn if visitors want to stay on-site.Results are available within two weeks, at which point the patient can discuss the findings with a doctor in person or remotely; a checkup three months later is also included in the price. If, for example, the screenings indicate a malignant tumor, Uribe Ramos said, doctors will explain to a patient which follow-up tests they need, either in their home country or at Médica Sur. He recommends getting a thorough exam once a year.Since opening its international-medicine wing in 2019, the hospital has seen 5,000 foreign patients, most of them American and Canadian, Uribe Ramos said.Imani Bashir was living in Cancún three years ago when she felt what she thought was a lump in her breast. At the time she was 34 — <a target="_blank" href="https://www.cancer.org/cancer/screening/screening-recommendations-by-age.html#:~:text=Women%20ages%2040%20to%2044,should%20get%20mammograms%20every%20year.">young</a> to be receiving a mammogram — but her family had a history of the disease, so she booked an appointment anyway. In the US, the median <a target="_blank" href="https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.e18917">cost</a> of a mammogram ranges from $140 to $360 for women who aren't insured. In Mexico, it was under $50. As a Black woman who grew up in the US without health insurance, the 37-year-old communications director found the experience especially validating."When we go to the doctor and say that we're in pain, it's kind of just shooed away, like it's not a big deal," Bashir said. In Mexico, the medical center didn't question her. Now that she's living in Washington, DC, she continues to travel to Mexico for both her and her son's dental appointments and other medical issues because it's cheaper and easier to get appointments. "It always feels good when you feel like you can take care of yourself, and financially, it's not going to be a detriment to your life and your health," she says.Given how many people experience difficulty navigating the American healthcare system, it's no surprise that the medical-tourism market is growing rapidly. Patients Beyond Borders estimates the industry is growing between 15% and 25% each year. And 2022 <a target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104082/#:~:text=The%20increase%20in%20medical%20tourism,other%20time%20in%20the%20past.">research</a> found that the increase in international tourism had helped fuel the trend. As <a target="_blank" href="https://www.businessinsider.com/travel-agents-back-gen-z-millennials-vacation-planning-overseas-resorts-2024-6">more people spend time abroad</a>, it becomes easier to tack a few small medical tests onto your trip.Vargas Bustamante thinks traveling internationally for rigorous testing probably most benefits healthy people who just want "peace of mind." Despite the risk factors, the industry's growing appeal illustrates the limitations of American healthcare."Why would someone have to buy a plane ticket to go all the way on the other side of the world just for an adequate amount of healthcare? It's nuts," Bashir said. "But if people have the privilege, if people have the money to be able to do so, then I say, yeah."<a target="_blank" class="" href="https://www.businessinsider.com/author/manisha-krishnan">Manisha Krishnan</a> is an Emmy award-winning journalist who covers healthcare. She is based in Brooklyn.

Mojitos and an MRI: Meet the Americans who are getting health screenings on vacation 

<keyword id="20082498" type="General" weightage="100" keywordseo="Cameron-Diaz" source="keywords">Cameron Diaz</keyword> recently opened up about her nearly decade-long break from acting, revealing that the decision was deeply personal and driven by a need to regain control of her life. Known for her roles in blockbuster films like There’s Something About Mary and The Mask, Diaz surprised many when she stepped back from <keyword id="19900806" type="General" weightage="20" keywordseo="Hollywood" source="keywords">Hollywood</keyword> after her performance in the 2014 remake of Annie. During a candid discussion, the actor shared insights into why she felt it was the right time to walk away from the limelight, despite her successful career. “For me, it was something I had to do to take care of myself,” Diaz said as per an ANI report originally attributed to Deadline. She added that her decision was about reclaiming her life and building a future that aligned with her personal values. “I didn’t care about anything else—no one’s opinion, no one’s success, no one’s offer. It was about me wanting to focus on my own life and what I wanted it to be,” she said. The actor was clear that stepping away from her profession allowed her to prioritise what she was most passionate about: <keyword id="19895682" type="General" weightage="20" keywordseo="family" source="keywords">family</keyword>. In 2015, Diaz married musician <keyword id="23571177" type="General" weightage="20" keywordseo="Benji-Madden" source="keywords">Benji Madden</keyword>, and the couple now has two children. Her desire to build and nurture her family was a significant factor in her decision to take a break from acting. Beyond family life, Diaz also explored other creative avenues during her hiatus, writing several health-related books, including The Body Book and The Longevity Book, focusing on wellness and longevity. Diaz recently spoke at <keyword id="23581899" type="General" weightage="20" keywordseo="Fortunes-Most-Powerful-Women-Summit" source="keywords">Fortune’s Most Powerful Women Summit</keyword>, where she reflected on the importance of taking time to engage in activities that truly “feed the soul”. She encouraged others to pursue what brings them peace and fulfilment, even if it means stepping away from a successful career. “Whatever it is, if it speaks to your soul, then it’s worth pursuing,” she added. After nearly a decade away, Diaz is returning to acting in the upcoming Netflix action-comedy <keyword id="20441935" type="General" weightage="20" keywordseo="Back-in-Action" source="keywords">Back in Action</keyword>, set to premiere in January 2025. The film reunites her with actor Jamie Foxx. In addition to this project, Diaz is expected to reprise her role as Princess Fiona in <keyword id="20444362" type="General" weightage="20" keywordseo="Shrek-5" source="keywords">Shrek 5</keyword>, slated for a 2026 release, and is reportedly in talks to star in the Jonah Hill-directed dark comedy Outcome, alongside Keanu Reeves and Hill. Her return to acting is eagerly anticipated, but for Diaz, her time away was essential for building the life she envisioned. (With ANI inputs)

Cameron Diaz talks about taking a break from acting, says it was to build her family

<keyword id="19895063" type="General" weightage="20" keywordseo="india" source="keywords">India</keyword>'s status as the most populous nation has propelled its development to unprecedented heights. However, the trajectory of the world's largest democracy is poised for a significant downturn due to a rapid decline in fertility rates. From an average of 6.2 births per woman in 1950 plummeting to merely two in 2021, India faces a staggering decline in fertility rates that could jeopardise future <keyword id="48933" type="General" weightage="100" keywordseo="population" source="Orion">population</keyword> stability. Yet, this predicament is not exclusive to India alone. A groundbreaking study by the <keyword id="20965687" type="General" weightage="20" keywordseo="institute-for-health-metrics-and-evaluation" source="keywords">Institute for Health Metrics and Evaluation</keyword> (IHME) forecasts a global demographic shift in the coming decades, with a substantial decline in <keyword id="31250" type="General" weightage="20" keywordseo="childbirth" source="Orion">childbirth</keyword> across most regions. Over three-quarters of countries are expected to struggle to maintain their population sizes by 2050, escalating to more than 97% by the century's end. This trend will create a stark contrast between regions experiencing declining birth rates and those witnessing a surge in childbirth, leading to what experts term a "demographically divided world." Industrialised nations grappling with shrinking birth rates will confront economic challenges stemming from a dwindling workforce and the burden of supporting ageing populations. Conversely, low-income countries, particularly in Sub-Saharan <keyword id="12925" type="General" weightage="20" keywordseo="africa" source="Orion">Africa</keyword>, anticipate a <keyword id="1227942" type="General" weightage="20" keywordseo="baby-boom" source="Orion">baby boom</keyword>, with the region projected to account for over half of the world's births by the century's close. While youthful population growth can drive economic and social progress, nurturing these burgeoning populations in resource-constrained settings, plagued by political instability and strained healthcare systems, presents formidable challenges. Several factors contribute to the declining fertility rates, including the economic strain of raising children and the empowerment of women through education and <keyword id="1110231" type="General" weightage="20" keywordseo="reproductive-rights" source="Orion">reproductive rights</keyword>. However, safeguarding women's rights amidst the fertility crisis remains paramount, as nations may resort to restrictive measures that curtail reproductive freedoms. Natalia Bhattacharjee, study author, underscores the importance of upholding women's rights, which correlates with improved health outcomes and economic growth. The study underscores the urgency of proactive planning to address demographic shifts, suggesting policy interventions such as parental leave, childcare support, and financial incentives. Nonetheless, many countries, including India, are projected to fall below replacement levels, necessitating reliance on immigration to sustain economic vitality in the long run. The findings of this study have been published in The Lancet.

Nearly all countries will struggle to maintain population levels by 2100, thanks to crashing birth rates: IHME

<ul class="summary-list"><li>Online platforms reflect a growing demand for menopause care like hormone-replacement therapy.</li><li>More research is needed to better tailor virtual clinics' treatment plans.</li></ul>When Jodi Miller was 49, she started to experience mood swings, hot flashes, weight gain, and <a target="_blank" class="" href="https://www.businessinsider.com/teledermatology-future-of-skincare-musely-ceo-jack-jia-2024-6">adult acne</a> — some of the many <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/reproductive-health/menopause-age">symptoms of menopause</a>.When Miller, then a middle-school teacher in Rochester, New York, sought care from her OB-GYN, she said she felt dismissed."I was told to stop focusing on the negative and to start focusing on the positive," Miller, who is turning 50 this month, told Business Insider.Levels of estradiol, or estrogen produced by the ovaries, typically drop to below 20 picograms per milliliter, compared with the 40 to 300 pg/mL produced during a normal menstrual cycle, according to Dr. Mary Jane Minkin, an OB-GYN and clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine.This hormonal shift can lead to hot flashes and night sweats and negatively affect bone health, cardiovascular function, cognition, and skin elasticity. It can also lead to discomfort during sex because these hormonal shifts contribute to the thinning and drying of a woman's vaginal walls, Minkin said.Frustrated by the lack of support for her menopause symptoms, Miller reached out to Midi Health, a virtual care clinic that specializes in helping patients navigate <a target="_blank" class="" href="https://www.businessinsider.com/perimenopause-symptoms-tech-founder-shares-treatment-2024-9">perimenopause</a> and menopause, or the stages in midlife when a woman's hormones fluctuate and then decrease drastically.Since launching in September 2022, Midi Health says it has served more than 100,000 patients. It's one of a few dozen <a target="_blank" href="https://sjfventures.com/sjf-ventures-market-analysis-outlines-startups-disrupting-menopause-care-and-opportunities-for-investors/#_ftn3">menopause-care startups</a> that have launched since 2010 and one of a handful of virtual and hybrid clinics that offer menopause-symptom support, such as hormone-replacement therapy, to women.An estimated 1.3 million women in the US reach menopause each year. Now, as millennials — one of the country's largest generational groups — enter their 40s and many begin to experience perimenopause symptoms, some health professionals anticipate an uptick in patients seeking this specialized care.<h2 id="cabb2b87-466e-4def-9596-2a67fa519cac">Patients are demanding solutions for common and debilitating menopause symptoms</h2>The menopause market — which includes supplements, medical devices, HRT, and telehealth services — is valued at an estimated $5.3 billion in the US and projected to grow by about 4.8% each year until 2030, according to an analysis from Grand View Research, a US- and India-based consulting firm for the energy, healthcare, and technology industries, among others.One reason menopause-care initiatives are gaining visibility is women's increasing presence in executive roles in the workplace, said Dr. Neel Shah, the chief medical officer of Maven Clinic, a digital platform that employers and health plans use to provide care for women and families.With more women in top decision-making and hiring roles — many experiencing perimenopause or menopause themselves — there tends to be more awareness and empathy for employees seeking this type of midlife health support, Shah said.And <a target="_blank" class="" href="https://www.businessinsider.com/how-employers-can-help-menopausal-women-2022-1">companies need to retain talent</a>, so preventing absenteeism and attrition due to employees' severe perimenopause or menopause symptoms could motivate employers to seek solutions like telehealth clinics for their workers, Shah said.Miller, for example, said that her hot flashes and heart palpitations made it difficult for her to teach her classes. She was also transitioning to a career in higher education at the time and becoming an empty nester."I felt so horrible, and my energy levels were so low that I was ill-equipped to manage it all," Miller said.Shah added that millennials entering perimenopause and menopause may be more willing to advocate for the care they want than previous generations experiencing the same symptoms.Fortunately for Miller, a combination of treatments — including low-dose HRT for estrogen and progesterone, another sex hormone — helped her manage tough-to-handle symptoms. After undergoing the therapy, she said she experienced fewer hot flashes and an increased sex drive. Miller's doctor also prescribed her a low-dose antidepressant to help get rid of her mood swings and a GLP-1 medication to help her lose about 60 pounds, which helped regulate her blood pressure.According to Joanna Strober, Midi Health's CEO and cofounder, doctors may also prescribe supplements and lifestyle changes to patients who want to manage their symptoms.<h2 id="4b765042-0d6a-48bb-8bfe-e17b54eb8608">Ramping up menopause research</h2>As the demand for women's midlife-healthcare support grows, research and education are critical to improving treatments and support."We started Midi out of a realization that very few doctors or medical providers are trained in understanding the issues of women in this age category, particularly with regard to their hormones," Strober said.Knowledge about perimenopause and menopause is still evolving, so more research into effective treatments and interventions is needed to improve and tailor treatments, Minkin said.Researchers are collecting data as part of two long-term National Institutes of Health projects: "The Study of Women's Health Across the Nation" and "Menopause Strategies: Finding Lasting Answers for Symptoms and Health." These studies aim to develop a better understanding of women's menopause symptoms like depression, insomnia, and hot flashes, with the goal of developing <a target="_blank" class="" href="https://www.businessinsider.com/guides/health/reproductive-health/how-to-stop-hot-flashes">more helpful treatments</a>.Another influential — but controversial — piece of research has been the Women's Health Initiative. Study results published in 2002 described some types of HRT as increasing some health risks, such as breast cancer and blood clots. In response, doctors resisted prescribing the therapy, Shah said.However, the interpretation of the data in the media and in clinical practice lacked nuance, and secondary research papers have since demonstrated HRT's benefits in most women, according to Shah. "To be honest, the medical profession is still catching up on the data," Shah said.To further address the need for perimenopause and menopause research and medical care, Congress introduced in May the bipartisan Advancing Menopause Care and Mid-Life Women's Health Act. The bill is being reviewed by the Senate Committee on Health, Education, Labor and Pensions. If it's passed, the legislation would boost federal research and public-health promotion of menopause care. Additionally, in his 2024 State of the Union address, President Joe Biden called on Congress to invest $12 billion in women's health research, which would include menopause.Most recently, a phase 3 Bayer study found that the nonhormonal treatment elinzanetant can help reduce the severity and frequency of hot flashes, according to a September 10 press release from the pharmaceutical company.<h2 id="4a418015-96ba-41b3-bf0f-9ec33fffe2f5">Expanding treatment options and providers for patient satisfaction</h2>Overall, Minkin said, advancing women's health during perimenopause and menopause requires a comprehensive approach that blends technological innovations like online care platforms with strong research and educational initiatives.An estimated 30% of residency programs in the US offered a formal menopause curriculum, according to a 2023 report published in the journal Menopause. Minkin said this may be a lingering effect of the Women's Health Initiative's preliminary results. She added that an increased focus on menopause across all levels of medical training was needed."Addressing the physiological, mental-health, and social-support needs of women during these stages of life demands a multifaceted strategy," Minkin said. "By integrating technological tools with a strong foundation in research and education, we can work toward closing this gap and improving menopause care for all women."After roughly a year of treatment for her menopause symptoms, Miller is flourishing."I'm getting my doctorate in higher educational administration, and I would have never been able to navigate such an enormous responsibility without menopause care," Miller said. "I feel like anything is possible now."

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