Connect with us

Opinion

Insight: Perimenopause, menopause and your mental health and wellbeing

Published

on

By Dr Haleema Sheikh, a specialist in integrative women’s health and bioidentical hormone balancing for the Marion Gluck Clinic.

Perimenopause refers to the menopausal transition phase in women’s lives when the levels of reproductive hormones become more variable, and they can start to experience physical and mental symptoms related to these changes.

Menopause is diagnosed when a woman has not had a period for 12 consecutive months, and this usually happens between the ages of 45 and 55.

Hormones are our bodies chemical communication messengers which are carried in the blood stream around the body and are responsible for modulating and regulating activity in all our organs and tissues.

Women have receptors for the reproductive hormones produced in the ovary and adrenals (estrogen, progesterone and testosterone) in every tissue in the body including the brain. Thus, the hormonal imbalances during perimenopause and loss of hormones during menopause can have significant far-reaching consequences on our mental health.

Women are more susceptible to hormonal mental health issues as there is a complex interplay of reproductive hormones which need to be in sync to have a regular menstrual cycle.

This delicate interplay is often disrupted during perimenopause with estrogen not being balanced by progesterone (our soothing calming sleep supporting hormone) and then as we progress into menopause, we also lose the supportive effects of estrogen on the brain.

Women’s ovaries have a finite lifespan and during perimenopause which can start on average 6 years before menopause there can be significant hormonal disruption.

Women may start to have anovulatory cycles where they don’t ovulate each month and this results in estrogen being dominant as there is no progesterone rise in the second half of the cycle without ovulation. The lack of progesterone will also impact sleep quality and length which can further disrupt our mental health.

Progesterone enhances the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that promotes relaxation and reduces anxiety. This is why low progesterone levels can contribute to increased stress, irritability, and anxiety which are often seen in perimenopause.

Progesterone is generally the first hormone to be lost in perimenopause. Unfortunately, many women are diagnosed with depression and anxiety at this time and are given antidepressants which may be helpful but do no tackle the root cause which is hormonal disruption.

Estrogen has powerful positive effects on the female brain, affecting mood, memory, cognition, and emotional well-being. It
plays a key role in neurotransmitter activity and boosts serotonin (the happiness hormone) and dopamine which help regulate mood and motivation. Estrogen also enhances the stress response; it modulates cortisol, the stress hormone, helping women cope with pressure more effectively.

By regulating sleep patterns through its influences on melatonin and circadian rhythms it also improves sleep quality and resilience which are key for mental health.

Coming onto Testosterone – it is not just a male hormone and it plays a crucial role in women’s brain health, energy levels and mood. Though women have lower testosterone levels than men, this hormone is essential for mental clarity, motivation, emotional resilience, and overall well-being.

Testosterone levels can be maintained by some women till later in menopause, but a significant proportion of women will have symptomatic loss of testosterone in perimenopause and so it is important to be aware of symptoms and test blood levels if considering support.

Testosterone has a mood stabilising effect and improves emotional wellbeing. It is also involved in neurotransmitter regulation and thereby reduces mood swings, stress and depressive symptoms. It also helps with enhanced confidence and motivation which gives women a sense of self assurance and emotional resilience in their lives.

The brain also receives feedback from the body and the gut and brain are deeply connected through the gut-brain nerve axis.

Changes in the gut microbiome (the friendly bacteria which reside in the large intestines) during menopause can significantly affect mood, mental health, and cognitive function.

As estrogen declines, the composition of the gut microbiome shifts, leading to inflammation, neurotransmitter imbalances, and increased stress response, which ultimately can contribute to anxiety, depression, and mood swings.

The gut communicates with the brain ‘telling’ it that the body is in a hostile environment and puts the brain into a high alert mode which can trigger hypervigilance and anxiety.

Ninety per cent of serotonin (the ‘happiness hormone’) is produced in the gut. Gut dysbiosis (an imbalance of good and bad bacteria) which is more common in menopause can disrupt serotonin and dopamine production, leading to depression, anxiety, and mood swings.

Low estrogen also leads to increased gut permeability (leaky gut), allowing inflammatory molecules and toxins to enter the bloodstream. This triggers neuroinflammation, which is linked to brain fog, fatigue, and low mood.

Healthy gut bacteria help regulate cortisol, the stress response hormone. An unbalanced microbiome can lead to higher cortisol levels, making women more prone to stress, panic, and emotional ups and downs.

The gut microbiome also influences melatonin (our sleep hormone). Dysbiosis can lead to insomnia, night wakings, and poor sleep quality, worsening irritability and emotional instability.

There are many signs and symptoms that may indicate the need to support hormonal balance which make sense now that we understand the impact of the hormones on the brain and body

• Frequent emotional ups and downs that disrupt daily life.
• Overwhelming anxiety or panic episodes.
• Difficulty focusing or remembering simple things.
• Persistent sadness or loss of joy.
• Chronic fatigue and lack of motivation.
• Feeling disconnected or unlike yourself.
• Irritability
• Low self-esteem and loss of confidence

There are many ways to restore balance, and a multipronged approach often works well:

• Lifestyle changes – Regular exercise, a healthy diet, and stress management are key to happy hormonal balance.
• Hormone therapy or Supplements – can be very helpful to help cushion the loss of ovarian function. Body identical and bioidentical hormones have the same molecular and chemical structure to our own hormones and have been shown to support the mental health issues that many women face
• Mental health support – Therapy, mindfulness, or journaling can be helpful to process the changes and build resilience.
• Sleep hygiene – Create a relaxing bedtime routine to improve rest is key to remaining high functioning and rebalance the system.
• Social support – Connecting with friends, support groups, or loved ones is protective for women going through this period.

Perimenopause and menopause often hit women during a time in their lives when they are juggling many balls including challenging careers, teenage children, spouse/partner, running a house and possibly looking after elderly parents.

The reproductive hormones provide resilience in the system which diminishes at this time. It is helpful for women to understand what is going on in their bodies during this transitional time and be kind to themselves as they recalibrate to lower hormone levels which can most certainly be done successfully.

The Marion Gluck Clinic is a UK-based medical clinic which uses bioidentical hormones to treat menopause, perimenopause and other hormone related issues.

Opinion

Femtech’s next chapter: Building a truly equal and comprehensive health tech category

Published

on

By Wolfgang Hackl, MD, CEO OncoGenomX, Allschwil, Switzerland

FemTech is moving from a promising niche to a foundational part of modern healthcare.

Over the next decade and beyond, its real promise will not only be better products, but a more equitable system: one where women’s health is treated as an equal area for innovation, investment, clinical care, and public policy.

That shift matters because women’s health has long been under-researched, underfunded, and too often managed through systems that were not designed with female biology and life stages in mind.

The opportunity now is to change that trajectory.

If stakeholders act deliberately, FemTech can become a category that improves outcomes, expands access, and creates measurable value across the HealthTech ecosystem.

From niche to infrastructure

The most important change ahead is a mindset shift. FemTech should no longer be seen as a narrow consumer segment focused only on logging symptoms.

It should be understood as health infrastructure spanning puberty, fertility, pregnancy, postpartum recovery, menopause, pelvic health, chronic disease, mental health, and long-term preventive care.

This broader framing creates a more durable market and a stronger social case. It also encourages innovation that serves people across the full life course, rather than only at highly visible moments.

In practical terms, this means building tools that are clinically relevant, integrated into care pathways, and designed to work for different populations and health systems.

What needs to change

For FemTech to become a truly equal healthcare category and a genuine societal priority, several layers need to move together.

First, the evidence base must deepen. More sex-disaggregated data, more women-inclusive clinical studies, and more research on conditions that disproportionately affect women are essential.

Without stronger evidence, product development, diagnosis, reimbursement, and clinical adoption all remain constrained.

Second, policy and regulation must mature. Privacy protections need to be strong enough to build trust in highly sensitive health data.

Regulatory pathways should be clear enough to help innovators bring safe, effective products to market without unnecessary delay.

Reimbursement frameworks also need to evolve so that useful digital tools are not limited to those who can pay out of pocket.

Third, healthcare systems must become more open to integration. The best FemTech products should not sit outside the care journey as standalone apps.

They should connect with clinicians, diagnostics, telehealth, and care coordination so that patients experience continuity rather than fragmentation.

Finally, society needs a broader cultural shift. Women’s health should be discussed as a mainstream public health and economic issue, not as a side topic or a private concern.

That means normalizing conversations around menopause, miscarriage, postpartum health, chronic pain, infertility, and long-term preventive care.

The role of each stakeholder

A healthier FemTech future depends on the full value chain.

Founders and product teams need to design for clinical relevance, usability, and trust. The strongest solutions will be those that solve real problems, use data responsibly, and fit into everyday life and care.

Investors can help by backing long-term value creation rather than only consumer growth. FemTech deserves capital that supports rigorous validation, regulatory readiness, and scalable business models.

Healthcare providers and systems play a critical role in adoption. By integrating FemTech into clinical workflows, they can reduce delays in care, improve monitoring, and make support more continuous and personalised.

Payers and insurers can accelerate access by recognising the downstream value of early intervention, prevention, and better self-management. Coverage decisions will strongly shape which innovations become standard practice.

Policymakers and regulators should create environments where safety, innovation, and privacy coexist. Clear standards and supportive reimbursement policy can make the difference between isolated success and category-wide growth.

Employers and public institutions also have a role. Women’s health affects productivity, retention, and long-term wellbeing, which means workplace benefits and public programs can help expand access and reduce inequity.

FemTech is not only “women for women.” It is “everyone to solve a health and social issue that has been ignored for far too long.”

When stakeholders across the value chain recognise women’s health as a shared responsibility, FemTech moves from a segmented category to a mainstream force for better outcomes, fairer access, and stronger social impact.

Why the upside is larger than the market

The benefit of getting this right is not only commercial.

Better women’s health tools can improve early detection, support self-management, reduce avoidable complications, and lower the burden on social and healthcare systems.

They can also help close persistent gaps in access and outcomes that affect families, workplaces, and economies.

For HealthTech innovators, this is an opportunity to build products that are both mission-driven and scalable. For health systems, it is a chance to improve care quality and efficiency. For society, it is a way to move women’s health from an afterthought to an equal priority.

Actions that will move the field forward

The right direction will not happen automatically. It requires deliberate action across the ecosystem.

  • Build products around real clinical needs, not only consumer engagement.
  • Invest in women-inclusive research and validation from the start.
  • Design privacy and governance into the product architecture.
  • Create reimbursement models that reward prevention and continuity.
  • Integrate FemTech into mainstream care pathways.
  • Expand education for clinicians, employers, and the public.
  • Expand the category to the invisible concerns to cover the full range of women’s health needs.

When these actions align, FemTech can mature into something larger than a market category. It can become a model for how health innovation should work: evidence-based, inclusive, trusted, and built to improve lives at scale.

A strong FemTech future is not just possible. It is a practical next step if the ecosystem chooses to treat women’s health as what it truly is: a core healthcare priority and a major driver of innovation.

Table: FemTech Focus Areas

FieldApproximate number of active solutions/companies
Reproductive health & fertility120+
Pregnancy & maternal care80+
Menstrual health60+
General women’s health & wellness50+
Diagnostics & monitoring45+
Menopause & perimenopause40+
Pelvic & uterine health30+
Chronic women’s health / integrated care30+
Sexual health & wellness25+

Legend: FemTech is becoming a multi-category healthcare layer. Reports also show that software/apps remain the largest product type overall, while reproductive health continues to dominate as an application area. Best-effort estimates based on category listings, company directories, and market reports, not audited totals.

Continue Reading

Opinion

Q1 momentum: Female founders are advancing, but the system still hasn’t caught up

Published

on

By Melissa Wallace, CEO Fierce Foundry

The first quarter of 2026 tells a familiar but evolving story for female founders in the U.S.: measurable progress, paired with persistent structural gaps.

On the surface, the numbers suggest momentum.

A recent Pitchbook report showed female-founded companies captured 27.7 per cent of U.S. venture capital in 2025, up significantly from 19.9 per cent the year prior.

This is not a marginal shift, it reflects a broader recognition that women are building scalable, investable companies across sectors.

But the deeper cut tells a different story.

When you isolate companies founded solely by women, funding drops to just 1.1 per cent of total venture dollars.

As many of us continue to preach, this gap has remained largely unchanged for decades, hovering around 2 per cent on average.

This is the paradox: performance is not the issue—access is.

Research consistently shows that women-led companies generate stronger capital efficiency, yet they continue to receive a fraction of funding.

As Leslie Feinzaig has pointed out, the challenge is not a lack of ambition or quality, it’s that the system still evaluates women through a narrower lens, often expecting more proof, more traction, and more certainty before capital is deployed.

A Shift in How Women Are Getting Funded

What’s changed in Q1—and what’s most important—is not just how much funding is flowing, but how it’s being accessed.

Based on the data shared by Forbes in their 6 Trends Reshaping Women’s Health Investments this is what is clear:

  • A rise of angel and operator capital: More women are entering the cap table as investors, not just founders, reshaping early-stage decision-making
  • Alternative vehicles gaining traction: Donor-advised funds (DAFs), syndicates, and community-driven capital pools are stepping in where traditional VC has been slow
  • Lower barriers to entry for investors: Smaller check sizes and structured angel education are expanding who participates in funding innovation

This diversification matters. Traditional venture capital has historically been concentrated both in who writes checks and what gets funded.

Broadening capital sources doesn’t just increase access; it changes what is considered “investable.”

At Fierce Foundry, this is a core assumption.

The venture studio model is not just about building companies, it’s about engineering capital access from day one.

By combining capital with shared services, investor networks, and early validation, the goal is to reduce the friction female founders face long before a Series A.

Why This Matters for Women’s Health

Nowhere is this shift more critical than in women’s health.

Despite being one of the fastest-growing sectors in healthcare, projected to exceed $200B globally in the next decade, FemTech and women’s health startups remain significantly underfunded. In 2024, only ~6 per cent of healthcare venture funding went to this category.

This disconnect is not due to lack of opportunity. In fact, the opposite is true.

Thanks to another incredible article from Geri Stenger in Forbes, we know women’s health has already generated over $100 billion in exits, with 27 billion-dollar transactions and increasing M&A activity.

This is not an emerging category, it is a proven one that has simply been misclassified, undercounted, and undervalued.

The implication is clear: capital is not flowing in proportion to outcomes.

The Role of New Models in Closing the Gap

This is where new models, particularly venture studios, are becoming essential.

The traditional startup pathway assumes equal access to networks, capital, and operational expertise.

Female founders, particularly in women’s health, are often navigating all three deficits simultaneously:

Limited access to early-stage capital

  • Higher burden of proof in clinical and regulatory environments
  • Fewer embedded operators with domain expertise
  • The studio model addresses this by collapsing time and risk:

Co-building companies alongside founders

  • Providing shared services across product, regulatory, and go-to-market
  • Embedding investor alignment and exit pathways from the beginning

What Q1 Signals for the Future

If Q1 tells us anything, it’s that the narrative is shifting but the infrastructure is still catching up.

We are seeing:

  • Increased participation of women across both sides of the cap table
  • New funding mechanisms that challenge traditional VC gatekeeping
  • Growing recognition that women’s health is not niche, but foundational

But we are also seeing that progress is uneven, and in many cases, still fragile.

The next phase of growth will not come from incremental increases in funding percentages.

It will come from rebuilding the systems that determine how capital flows in the first place. Because the real opportunity is not just funding more female founders.

It’s building an ecosystem where they don’t have to fight so hard to access what they’ve already proven they can return.

Learn more about Fierce Foundry at thefiercefoundry.com

Continue Reading

Opinion

India’s top court rejects menstrual leave petition

Published

on

India’s top court rejected a menstrual leave petition for women and female students, saying such a law could mean “no-one will hire women”.

The two-judge bench, headed by chief justice Surya Kant, said mandatory leave would make young women think they were “not at par” with their male colleagues and would be “harmful for their growth”.

The subject of menstrual leave has long divided opinion in India. While many agree with the judges’ view, others argue that a day or two off can help women manage painful periods.

Some states and a number of large private companies have already introduced menstrual leave for employees.

The court’s comments came while hearing a petition filed by lawyer Shailendra Mani Tripathi, who was seeking a national menstrual leave policy, legal website LiveLaw reported.

Tripathi later told news agency IANS that he had hoped working women would receive “two-to-three days of leave” to account for menstrual difficulties.

The judges, however, said introducing such a policy would not benefit women. Instead, they said it would reinforce gender stereotypes and affect employability.

They said this could make private-sector employers hesitant to hire women and might ultimately discourage their recruitment.

They added that “the government could come up with a menstrual leave policy in consultation with all stakeholders”, LiveLaw reported.

The comments from the top court have again put the issue in the spotlight in India, reviving debate over whether menstrual leave is a progressive step or whether it encourages stereotypes that women are weaker and unfit for the workplace.

Public health expert and lawyer Sukriti Chauhan told the BBC that by saying menstrual leave would make women “unattractive” as employees, the judges “reiterate the taboo around menstruation and rights that we have failed to address”.

She said there were laws in India covering “workplace dignity, gender equality, and safe working conditions” for women and that “denying menstrual leave violates these principles by forcing women into uncomfortable, undignified or hazardous work environments”.

“Providing menstrual leave not only supports women’s health and well-being, but also promotes productivity and efficiency in the workplace,” she added.

Some argue that giving women extra leave would be discriminatory to men and that, in a country where periods are often a taboo subject, with women barred from temples or isolated at home as “unclean”, menstruating women may be too shy to claim it.

But campaigners point out that countries such as Spain, Japan, South Korea and Indonesia already offer menstrual leave, and that studies have shown this time off can be beneficial to women.

Some Indian states also offer limited menstrual leave. Bihar and Odisha give two days per month to government employees, while Kerala provides it to university and industrial training institute staff.

Last year, the southern state of Karnataka introduced a law approving one day off a month for all menstruating women.

In the past few years, several companies have also introduced similar policies for female staff.

In 2025, industrial and services conglomerate RPG Group announced a two-days-a-month period leave policy for employees in its subsidiary CEAT.

Engineering giant L&T also introduced a similar policy, offering a one-day leave in a month, while food delivery company Zomato offers up to 10 days of period leave a year.

Continue Reading

Trending

Copyright © 2025 Aspect Health Media Ltd. All Rights Reserved.