Electronic Health Reporter

More than 80% of midlife women with menopause symptoms never seek medical care for them, according to a Mayo Clinic study of nearly 5,000 women published last fall.

The study, which appeared in Mayo Clinic Proceedings, drew on patients ages 45 to 60 who were surveyed at four Mayo primary care sites. Over three-quarters reported symptoms. About a third called them moderate to very severe. Yet only one in four was getting any form of treatment when the survey was taken. When researchers asked why, the answers were mundane: women said they’d rather handle it themselves, they were too busy, or they didn’t realize effective treatments existed.

Ekta Kapoor, an endocrinologist and menopause specialist at Mayo Clinic, said: “Menopause is universal for women at midlife, the symptoms are common and disruptive, and yet, few women are receiving care that could help them.” Untreated symptoms, the Mayo team noted, wear on sleep, mood, cognition and productivity at work.

Those answers explain a lot about what happens further up the chain, where research budgets and venture dollars get allocated. Leen Kawas, CEO of drug developer EIT Pharma and co-founder and managing general partner of the life sciences investment firm Propel Bio Partners, sees a direct line between women staying quiet about their symptoms and investors staying away from the conditions behind them.

What Perimenopause Looks Like From the Patient’s Side

For many women, the confusion begins years before menopause itself. Perimenopause can bring anxiety, irritability, disrupted sleep and weight gain, symptoms that overlap with stress, depression and plain exhaustion. Women interviewed by Investigate TV in September described rage, irritability and brain fog, and one recalled a doctor who chalked it all up to stress.

The clinical workforce isn’t built to catch it. The same Investigate TV report counted roughly 49,000 OB-GYNs in the U.S. against just under 4,500 Menopause Society Certified Practitioners. Fewer than a third of OB-GYN residency program directors say their programs follow a standardized menopause curriculum. “We have a deficit in education,” Dr. Carrie Wieneke, an OB-GYN at the University of Kansas Health System, told the outlet.

Put the pieces together and a predictable cycle appears. A woman notices changes, isn’t sure they’re medical, mentions them to no one or to a clinician without specialized training, and leaves without a diagnosis. Her experience is never recorded in a form anyone can count.

Silence Has a Cost Investors Can Measure

Leen Kawas argues that stigma keeps this cycle running. Plenty of women hesitate to describe what they’re feeling to a doctor, and they’re even less likely to raise it with family or an employer, where admitting to brain fog or poor sleep can feel like confessing to a performance problem.

The consequences spill into the financial side of health care. Market sizing for a new therapy usually begins with diagnosed patients. If most women with moderate or severe symptoms never get diagnosed, a startup’s addressable market looks smaller on paper than it is in real life, and a diligence team working from claims data will reach the same undersized conclusion. A condition affecting tens of millions of people can end up priced like a niche.

Kawas has spent her career arguing that drug developers should start with patients and let the business case follow. “Track the success and satisfaction of your customers (in life sciences, the patients). That’s going to drive value,” she has said. “You are developing therapies. You are changing people’s lives. Once you achieve that, the financial value is going to follow.” Women’s health is a case where that advice cuts both ways: companies can’t serve patients well when the patients themselves are largely invisible to the system.

Where Women’s Health Funding Actually Stands

Silicon Valley Bank’s latest women’s health report found venture funding for the sector dropped to roughly $2 billion in 2025, down from $3.2 billion in 2024, BioPharma Dive reported. Women’s health slid from 7.4% of all healthcare venture investment to 5.7%. Biopharma startups in the category absorbed the sharpest cut, with funding falling from $1.3 billion to $610 million.

W Group, which released its first global women’s health investment report this summer, reached a more upbeat conclusion. It counted $1.55 billion in disclosed equity for 2025, up 41% from the prior year, with a record 85 companies raising money, Fierce Healthcare reported. The reports measure different things. Neither describes a category drawing capital anywhere close to the number of people it serves. W Group’s data showed endometriosis companies raising $57 million over the full year and women’s bone health companies raising $8 million.

SVB also noticed founders adjusting their pitches. Some now lead with conditions like depression, obesity and heart disease that affect both sexes, and play down the women’s health label. Getting funded has become harder across early-stage biotech generally. Megan Scheffel, who leads life sciences at SVB, told BioPharma Dive that “progress that used to be the province of Series A is now required to raise a Seed round.”

The People Writing the Checks

Leen Kawas traces much of the shortfall to who holds decision-making power. Investors tend to fund problems they recognize from their own lives and the lives of people around them. Men still make most investment decisions in life sciences, and menopause is something they learn about secondhand, if at all.

She has made a parallel observation about career advancement in biotech. “If it’s a man who’s promoting another person, they relate to the experience of the males, not the woman. It’s easier for them to make that promotion,” she has said. The same instinct shapes which pitches feel urgent to an investment committee.

Leen Kawas has also pointed out that women-led biotech companies often ask investors for less money than they need, while men tend to ask for more, and she has called for more funding for women-led companies as one of several steps toward more women in biotech leadership. Relatively few women run venture firms, and fewer still run firms that invest in life sciences. Her case for changing that rests on performance. “There are studies that show that in women-led companies, or companies that have women executives, there are higher returns to the shareholders,” Kawas said.

Washington Starts Paying Attention

Public institutions have been slow to notice, too. On Sept. 16, the Senate Special Committee on Aging held the first congressional hearing ever devoted to menopause. Figures released by Sen. Kirsten Gillibrand’s office put menopause’s toll on the U.S. economy at $26.6 billion annually, including $1.8 billion in lost work time. Roughly one in ten women leave the workforce because of it, and 80% of OB-GYN residents say they aren’t adequately prepared to discuss it with patients.

Federal research spending hasn’t kept pace. Less than 1% of federal women’s health research funding goes to menopause, according to the same release. Gillibrand, the committee’s ranking member, and chairman Rick Scott have since asked the Government Accountability Office to examine how federal agencies coordinate and fund menopause research and care.

Demand That Already Exists

Veozah, a menopause treatment from Astellas, brought in about $300 million in sales last year, according to BioPharma Dive. It reached that figure in a market where, by Mayo’s count, three out of four women surveyed weren’t receiving any treatment.

For Leen Kawas, a biotech investor and operator whose approach centers on patients first, that gap is where the opportunity sits. Better diagnosis would enlarge the visible market. Trials designed around what women actually report would produce more useful data. And investment committees with more women at the table would be less likely to dismiss a pitch because the condition feels unfamiliar. None of those changes requires a scientific breakthrough. Each requires the people who fund health care to start counting the patients who have been there all along.