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TaraCares: London and York based start-up to address stigma, silence and suffering of the menopause transition experience

By Jyoti Sharma, Founder and CEO of TaraCares

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Presenting at TechNation York Digital Festival, The Guildhall at York - September 2022

Did you know that many frequently used menopause assessment tools were developed almost 70 years ago?

Some examples include – *Kupperman Index (1952), Green Climacteric Scale (GCS, 1976), Menopause specific Quality of Life (MENQOL, 1996), and Menopause Rating Scale (early 1990s), all developed decades ago

As noted in literature, these scales come with several limitations, such as inadequate coverage of all the relevant menopause transition symptoms, lack of thresholds for initiating treatment, lengthy and unsuitable tools for use in primary care – the Menopause Quality of Life (MENQOL) has 30 items while the GCS has 20 items – failure to acknowledge the use of visual scales and the use of clinical language vs colloquial language.

In the absence of breakthrough, patient-centric innovation translated in an evidence-led language that is easy to understand and respond to, the “menopause gold rush economy” will become yet another “blind guiding the blind” and exactly that – a rush!

A UK based start-up is confronting this challenge with new-age research wisdom, clinical excellence and computational science unified into the TaraCares Trifecta.

I founded TaraCares to eradicate misinformation, misdiagnosis, and mismanagement of menopause for females from 18 – 80.

After 22 years of a successful international technology, innovation, and management consulting career, I decided to resign from Ernst & Young, a Big 4 consulting firm based in London, where I worked as a hyper growth technology executive leader.

I used to run the People Experience business for over 100 countries across their EMEIA area (Europe, Middle East, India and Africa) working with software enterprises such as SAP, SAP SuccessFactors, Microsoft, and Qualtrics, but during the pandemic, I made a decisive shift.

I resigned from a fantastic firm and team for my mission and priority to address the global public health challenge of menopause with science and research.

To be close to England’s capital of excellent health sciences research, I moved up from London to York, in North Yorkshire where TaraCares, the mission-led venture was founded with divine grace.

After spending over 3,000 hours interviewing women with lived experience of menopause, I realised no woman wants to be called menopausal.

Therefore, the neuroscience of language in how we understand, research, and inform menopause healthcare has become central to TaraCares.

As I previously mentioned in FemTech World’s recent roundtable debate, the TaraCares team are leading a safe and inclusive future for equitable menopause health and wellbeing by creating it with science in action for every person assigned female at birth.

Jyoti Sharma at the FemTech World X HealthTech World Roundtable in November 

Through an AI-driven platform that uses Explainable AI to deliver trust, transparency and increased precision in how clinicians, especially in primary care, diagnose and treat menopause, we aim to improve adherence to menopause clinical practice guidelines outlined by the National Institute for Health and Care Excellence in the UK (NICE), including how women receive individualised and integrated knowledge.

We realised that to take ownership of your health day to day you need to be adequately and scientifically aware – through solutions that are accessible and affordable, else it is not a solution.

TaraCares mission is 100 per cent aligned with the 2022-2025 strategic delivery plan of UKRI, Innovate UK and Women’s Health strategy. Our inclusive and affordable solutions are being designed to tackle the stigma, suffering and silence of the menopause transition experience with tailored knowledge, timely diagnosis, and total management through preventive and self-driven healthcare.

In a short period of time since incorporation in May 2022, we have gained immense support from the public and respected leaders across the globe, such as Professor Vikram Talaulikar, a celebrated specialist in post reproductive medicine at University College London, Hospital (UCLH).

Tom Velema, entrepreneur and senior EMEIA partner at EY and with whom I worked on EY’s global strategic COVID response initiative continues to be one of my mentors.

TaraCares has started the new year with a sparkle publishing our brand new website over Christmas which has seen a significant reception, especially the section on Menopause Science. We are proud to formally collaborate with many incredible experts – some of whom are featured on our website.

As an experienced, driven, ambitious for impact and patient-centric, healthtech startup, we have already forged alliances working with the Department of International Trade in the UK to enter underserved countries with our solutions.

Our team is also running research studies, collaborating with leading universities in England such as the University of Huddersfield.

But our work doesn’t stop here. In early 2023, we are launching our scientific community to tackle misinformation on menopause with clinicians, scientists, and technologists because we believe that together, we can help every woman take ownership of their menopause.

If you would like to join the TaraCares community or take part in our research, email [email protected]

For a conversation with thoughtful, responsible, and impact-oriented members of the public, clinicians, data scientists, engineers, and investor communities, I can be reached at [email protected].

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US virtual care clinic Midi Health to expand in all 50 states

The clinic provides insurance-covered, expert care for women in perimenopause and menopause

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The US virtual care clinic Midi Health will expand its services in all 50 states in an effort to help women navigate menopause.

Midi Health aims to provide holistic perimenopause and menopause care and help women navigate the midlife hormonal transition through virtual care.

The company offers personalised care plans and services, including hormonal and non-hormonal medications, supplements, lifestyle coaching and vital preventative health guidance.

Over 6,000 women in the US reach menopause every day, which is defined as starting 12 months after a woman’s last period.

On average, they reach menopause at 51, but perimenopause can occur much earlier. This lead-up period, when hormones can fluctuate wildly and symptoms may be at their worst and most unpredictable, lasts four to seven years, although in some cases it can extend as long as a decade.

Symptoms, which may include hot flashes, insomnia, anxiety, depression, brain fog, memory loss and genitourinary problems, have a significant impact on women’s quality of life and career growth.

“We can’t talk about women’s success at work without talking about menopause,” said Joanna Strober, CEO and co-founder of Midi Health.

“With far too few practitioners trained in managing menopause, women are underdiagnosed, undertreated and underserved.

“Midi provides an insurance-covered solution that focuses on women’s unique needs, closing a major gap in health access, quality and equity.”

She added: “We are expanding rapidly to ensure that we can support employers and employees in all 50 states with Midi’s care.”

The expansion comes weeks after Strober announced a US$25m funding round from Google Ventures (GV) aimed at accelerating partnerships with hospital systems and major US employers, bringing the company’s total funding raised to date to US$40m. 

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Updated menopause toolkit to help doctors provide better care

The toolkit includes new advice and therapies for assessing and treating menopause-related health issues

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An updated toolkit that guides health professionals in treating menopause health issues has been published in an effort to improve care for women globally.

Endorsed by the International, Australasian and British Menopause Societies, the Endocrine Society of Australia and Jean Hailes for Women’s Health, the 2023 practitioner’s toolkit for managing the menopause is designed to be used anywhere in the world.  

The toolkit, published originally in 2014, has been updated with new advice and therapies based on a systematic review of the latest menopause research and best practice.

The new version includes bone health guidance, such as recommendations about when menopause hormone therapies might be needed to prevent bone loss and osteoporosis in asymptomatic women.

The update also incorporates new medications including fezolinetant for hot flushes, ospemifene for painful sex, and vaginal DHEA for vaginal dryness.

First author and Monash University women’s health research programme head professor Susan Davis, who also led development of the toolkit in 2014, said the update included some new therapies but did not support menopause hormone therapies for cognitive symptoms or clinical depression.

“Clinical trials have not shown a benefit of menopause hormone therapies for cognitive function,” she explained.

“The most robust studies have shown it to be no better than placebo.”

She added: “Regarding depression, menopause may cause symptoms such as low mood, anxiety, irritability, and mood swings, but clinical depression needs to be assessed and managed in its own right.

“Menopause might exacerbate underlying depression but should not be assumed to be the cause of clinical depression.”

Davis said the advice was now much clearer around preventing bone loss and fracture.

“To our knowledge this is the only document that provides guidance for using hormone therapy to prevent fracture. Other recommendations have been vague such as ‘can be used to prevent bone loss/fracture’ or ‘use to treat osteopenia’.”

The author said it was important for women to see their GP if they experienced troubling physical or mental health symptoms.

“We have updated this as part of an NHMRC Grant to upskill GPs and to embed the care algorithms into GP practice software in the MenoPROMPT study programme, which aims to improve care for women who need it. This is a very important feature of this update.”

Senior author Dr Rakib Islam, from the Monash University School of Public Health and Preventive Medicine women’s health research programme, said the updates would make a difference for many.

“The 2023 practitioner’s toolkit is the most up-to-date evidence-based practical guidance for health care providers to menopause care globally,” he said.

The paper’s authors said the recommendations needed to be applied in the context of local availability and the cost of investigations and drug therapies.

“Most importantly, the toolkit provides the full spectrum of available options and therefore can be used to support shared decision making, and patient-informed care,” they added.

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US fertility benefits provider to introduce perimenopause and menopause support

Patients will be able to have access to specialist health providers trained in menopause and perimenopause care

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The US fertility benefits company WIN is to launch a new initiative to help women access perimenopause and menopause support.

The WIN PowerPause programme aims to provide women with perimenopause and menopause support and help patients access specialty care through the virtual menopause clinics Midi Health and Visana Health.

Nurse care advocates will be able to discuss with women perimenopause and menopause symptoms and help them prepare questions to ask their provider during doctor visits. They can also match patients with providers best suited to treat their symptoms.

Patients in all 50 states will have access to providers who are specially trained in menopause and perimenopause care.

WIN says its PowerPause project will also ensure patients have access to behavioural health coaching, nutritional guidance, and prescription medications.

“We are proud to roll out WIN PowerPause to simultaneously address both health and business concerns,” said Roger Shedlin, president and CEO at WIN.

“At WIN, our clients recognise that overlooking menopause care widens the equity gap, given the impact perimenopause and menopause can have on women at a critical time in their careers.

“This is especially true for members in the BIPOC community who tend to experience longer transition periods with more intense symptoms.

“Employers offering comprehensive women’s healthcare to employees is a strategic investment in supporting diverse workforces and fostering a healthier, more productive and engaged team.”

Shelly MacConnell, chief strategy officer at WIN, said: “The population navigating menopause and perimenopause have been underserved, misdiagnosed, or even mistreated due to lack of specialised support and care coordination—until now.

“Through WIN PowerPause and the partnerships with Midi Health and Visana Health, WIN’s goal is to help patients minimise the impact of their symptoms and support them in finding the highest levels of care through seamless coordination.

“This creates a positive patient experience during what can be a stressful and uncertain time in a woman’s life.”

Joe Connolly, co-founder and CEO at Visana Health, added: “We are proud to partner with WIN, a long-standing and trusted fertility benefit company, to provide our patients with access to fertility care and family-building resources.

“This partnership also provides employer partners with the most comprehensive women’s health solution that meets the needs of all women in the workplace, regardless of what stage of life they’re in.”

Joanna Strober, co-founder and CEO of Midi Health, said: “Midi is excited to partner with WIN to expand access to expert-level care for women. Perimenopause and menopause symptoms are treatable, and there is no reason for women to just power through.

“With care protocols created by world-class specialists and a team of highly trained clinicians, Midi’s treatment ensures women are heard and treated appropriately.”

Each year in the U.S., nearly US$1.8bn is lost in work productivity due to menopause symptoms and the associated chronic, yet preventable, conditions, but quality menopause care is hard to find.

Only 1,500 providers worldwide are menopause certified, less than 20 per cent of OB/GYNs receive menopause training, and nearly three-quarters of women report not receiving the necessary treatment for menopause symptoms.

“Menopause is a profound and transformative period in a woman’s life, and it deserves the same level of specialised attention and expertise,” said Dr Lubna Pal, professor of obstetrics, gynaecology and reproductive sciences at Yale School of Medicine and consulting medical director and at WIN.

“Offering dedicated menopause care allows women the knowledge and support they need to navigate this transition in life.”

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