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US virtual care clinic bags US$25m from Google Ventures

Midi Health aims to use the new capital to expand operations nationwide

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Dr Mindy Goldman (chief clinical officer, Midi Health), Cindy Gentry, Sharon Meers (co-founder, Midi Health), Dr Kathleen Jordan (chief medical officer, Midi Health), Frédérique Dame (general partner, GV), Joanna Strober (co-founder and CEO, Midi Health), Cathy Friedman (executive venture partner, GV)

The virtual care clinic Midi Health has raised US$25m in funding to expand access to expert midlife care for women in the US.

Midi Health aims to help women navigate the midlife hormonal transition with virtual care guided by physicians and researchers who oversee a network of nurse practitioners trained in women’s health.

The company will use the new capital to expand operations nationwide and to launch additional partnerships with hospital systems and major employers in the US.

Investors Frederique Dame and Cathy Friedman from GV are joined by current investors Felicis, Semper Virens, Icon, 25M and Operator Collective, bringing the company’s total funding raised to date to US$40m. 

Frederique Dame, General Partner at GV, said: “Midi has seen meaningful traction since its launch and takes an innovative approach to address an unmet need for nearly half the global population.

“Midi’s world-class executive and advisory team has decades of clinical and healthcare expertise and a vision for personalised, affordable, and accessible midlife care. GV is proud to back Midi as they modernise perimenopause and menopause care for women everywhere.”

Underdiagnosed, undertreated, and underserved

Every day in the US 6,000 women hit menopause, 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.

A recent Mayo Clinic study found that 15 per cent of women cut back on hours or missed work entirely due to their symptoms, costing them about US$1.8bn a year in lost wages.

“It’s clear that menopausal symptoms can derail women’s lives,” said Joanna Strober, Midi Health founder and CEO.

“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.”

To address that gap, Midi Health says it aims to expand its team of clinicians trained in women’s health, with every patient receiving a personalised care plan based on their health history, genetic risk factors, ethnicity, and race.

“Many practitioners lack the training to manage menopausal symptoms and specialists have nine to 12-month waiting lists,” Strober explained. 

“We provide access to some the most skilled professionals in female health.”

The company has announced a partnership with fertility benefits leader Progyny. Current employer clients include Stanford University and ServiceNow, and agreements are in place with healthcare systems clients such as Lifepoint Health.

Hormonal health

Study links small bowel microbiome differences to women’s health

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Small bowel microbiome differences between women and men may help explain why some conditions are more common in women, a study suggests.

The small bowel microbiome is the community of microorganisms living in this part of the digestive tract, where they play vital roles in immune function, metabolism and hormonal regulation.

Researchers found differences between women and men in the composition and organisation of these microbial communities. One bacterial community containing Granulicatella was found only in women.

The study was conducted by investigators at Cedars-Sinai Health Sciences University.

Ruchi Mathur, director of clinical research and clinical operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study, said: “One intriguing finding was a bacterial community containing Granulicatella, which we found only in women.

“Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”

The researchers also identified differences between women and men in how microbes in the small bowel produce fructans, complex carbohydrates known to trigger digestive symptoms in irritable bowel syndrome (IBS).

IBS is far more common in women than men.

Mathur, who is also a professor of medicine, said: “Our findings show that biological sex is a critical variable in the small bowel microbiome.

“We must consider it as we move toward more personalised approaches to understanding and treating disease.”

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Menopause

Cancer drug could tackle osteoporosis menopause weight gain

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An experimental cancer drug reduced bone loss and body fat in mice modelling post-menopausal changes, early research suggests.

The compound, CADD522, appeared to strengthen bones and help the animals stay leaner after surgery designed to mimic hormonal changes seen after menopause.

The treatment remains at an early experimental stage and has so far only been tested in animals.

The study, led by the University of East Anglia, investigated CADD522, which was originally developed to block a protein involved in the growth and spread of several cancers.

Mice treated with the compound for eight weeks showed significant improvements in bone health. Scans found increased bone volume and better preservation of the honeycomb-like structures inside bones that are crucial for strength and resilience.

Blood tests suggested the treatment stimulated new bone growth without interfering with the body’s normal process of breaking down and rebuilding bone.

Dr Darrell Green, lead researcher from UEA’s Norwich Medical School, said: “Osteoporosis affects around one in three women over the age of 50, leaving sufferers vulnerable to painful fractures that can seriously impact quality of life.

“Current treatments exist, but many are plagued by side effects, safety concerns or inconvenient dosing schedules that make long-term use difficult.”

The researchers also found that mice receiving CADD522 weighed less than untreated mice despite eating the same amount of food.

They had less body fat and fewer fat deposits in their bone marrow, a process commonly seen after menopause and linked to declining bone health.

The team also examined brain tissue and found that the drug appeared to reverse several menopause-related changes in fatty acids.

Levels of omega-3 fats including DHA remained largely intact, while several other lipid abnormalities shifted back towards healthier patterns.

Green said: “We didn’t directly test for memory or thinking ability, but our work raises questions about whether this drug could one day help address wider menopause-related health problems.”

Safety experiments in mice, rats and dogs found that CADD522 could be taken orally and was well tolerated.

The compound also appeared to be metabolised more slowly in human tissue than in rodents, potentially improving its performance in people.

“This is still in the early stages and has so far only been tested in animals but we hope that the benefits will translate to humans to ultimately reduce fracture rates,” added Green.

The research was led by UEA in collaboration with the University of Maryland, the Scintillon Research Institute in San Diego and the University of Stirling.

Safety testing was funded by The Sir William Coxen Trust as part of the development of CADD522 as a childhood cancer treatment.

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Fertility

Weight loss surgery improves menstrual health and PMOS symptoms, study finds

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Weight loss surgery was linked to more regular periods and fewer polyendocrine metabolic ovarian syndrome (PMOS) symptoms in women aged 18 to 45 living with obesity in a recent study.

The researchers recommend that women undergoing the procedure have access to preconception care and reproductive counselling to support their reproductive health.

Researchers at the University of Surrey analysed data over 24 months from 84 women who underwent bariatric surgery and 18 women living with obesity who did not have surgery.

Of those who underwent surgery, 49 had gastric bypass procedures and 35 had gastric sleeve surgery.

Women who underwent metabolic bariatric surgery lost more than 30kg on average at 12 and 24 months after the procedure.

Among women with polycystic ovaries, the condition persisted in only 10 per cent after 24 months.

Women also reported a resolution of clinical hirsutism, or excess body hair, by 12 months.

Women who had previously experienced irregular periods reported more regular menstrual cycles after surgery.

Professor Martin Whyte, co-author of the study and professor of metabolic medicine at the University of Surrey, said: “A large proportion of those undergoing bariatric surgery are women of reproductive age, who may be planning a pregnancy in the coming years.

“So much remains unknown about the impact of this type of surgery on women who are planning to have children.

“This raises the question of when the ideal time after surgery is to conceive.”

Women have a higher prevalence of obesity than men, with 57 per cent of women in the UK classified as overweight and 27 per cent living with obesity, which can affect fertility and the health of an unborn baby.

The researchers said 17 women had healthy pregnancies following surgery.

Although this was not specifically examined in the study, no difference in birth weight was observed between babies conceived within or after the first year.

Dr Kathryn Hart, co-author of the study and associate professor in nutrition and dietetics at the University of Surrey, said: “What we have found is that bariatric surgery positively affects the reproductive health of women living with obesity and can improve the likelihood of them having a healthy pregnancy after surgery.

“Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are affected by obesity.

“By reducing this, what we have seen is that it can lead to improvements without the need for medication.

“We would suggest that clinicians consider medical intervention for obesity to treat irregularities in the menstrual cycle and issues with fertility.”

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