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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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Osteoporosis screening tool secures FDA breakthrough designation

In the US alone, 50 per cent of women over the age of 50 will experience a fracture caused by osteoporosis

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London-based health tech company Naitive Technologies has received breakthrough device designation from the US Food and Drug Administration (FDA) for its osteoporosis screening tool.

OsteoSight aims to address the unmet need for earlier diagnosis of osteoporosis, a condition characterised by a progressive decrease in bone density, which is often diagnosed when a patient suffers a debilitating fragility fracture.

Worldwide, a fragility fracture caused by osteoporosis occurs every three seconds, costing global healthcare systems US$400bn annually.

In the US alone, 50 per cent of women and 25 per cent of men over the age of 50 will experience a fracture caused by osteoporosis.

The Bone Health and Osteoporosis Foundation reports that fragility fractures are responsible for more hospitalisations than stroke, breast cancer, and heart attacks combined. Despite this, it is estimated that up to 75 per cent of those affected remain undiagnosed and untreated.

Menopause significantly speeds bone loss and increases the risk of osteoporosis in women. During the menopausal transition period, the drop of oestrogen, a hormone essential for healthy bones, leads to a rapid decrease in bone density, resulting in osteoporosis.

OsteoSight aims to enhance detection rates by using the signals contained within X-rays that are taken every day, often for unrelated concerns.

By including an estimate of bone density, along with an osteoporosis classification based on World Health Organization (WHO) guidelines, into the radiology report, Naitive says its technology could alert physicians sooner to their patient’s bone health.

“While treatments exist that can help slow the progression of bone loss, the biggest challenge we face is the persistent underdiagnosis of osteoporosis and low bone density,” explained Robert Pignolo, Professor of Medicine, Geriatric Medicine and Gerontology at the Mayo Clinic and member of the scientific advisory board of Naitive Technologies.

“Patients are still being diagnosed after a fracture, instead of during a period of timely intervention. By screening patients who are having routine X-rays, we have a real opportunity to identify early bone loss and osteoporosis and prevent fractures.

“I’m delighted that the FDA has seen OsteoSight’s potential, and I’m excited to see the difference it will make in clinical practice.”

The FDA’s Breakthrough Device Program is intended to provide patients with more timely access to medical devices that have the potential for more effective treatment or diagnosis of life-threatening or irreversibly debilitating diseases or conditions.

As part of the programme, the FDA will expedite development, assessment, and review of OsteoSight for regulatory clearance.

Will Briggs, founder and CEO of Naitive, said: “We are thrilled that OsteoSight has received Breakthrough Device Designation.

“It’s a key milestone for our technology and validates our strong belief that OsteoSight has the potential to revolutionise the way we find patients at-risk for osteoporosis.

“We look forward to bringing this technology to market and helping improve patient outcomes.”

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