New Mission for Menopause: Extending Women's Lifespans

In just a few short years, the menopause care field has transformed from a quiet corner of healthcare into a bustling hub of research and investment capital. From flashy startups to emerging therapies, talking about hot flashes has suddenly become red-hot.

"Three years ago, no one wanted to talk about menopause, and now you hear about it more and more," said Alicia Jackson, founder and CEO of Evernow, a telehealth company that supports menopausal women.

This attention is long overdue.

According to the National Institute on Aging, more than one million women in the U.S. experience menopause each year. And an AARP survey shows that 84% of women say menopausal symptoms interfere with their daily lives.

However, AARP found that only 20% of obstetrics and gynecology residency programs offer menopause-related training, creating a huge treatment and service gap. According to a 2020 estimate by venture capital firm Female Founders Fund, the market size to fill this gap could be as large as $600 billion.

Among the many companies emerging in the menopause space, Evernow has made headlines with its star-studded roster of investors. Earlier this year, actresses Gwyneth Paltrow, Drew Barrymore, and Cameron Diaz all signed on as investors in Evernow. The company raised $28.5 million in a Series A funding round.

Although Evernow is one of several startups offering menopause telehealth and hormone support (including Alloy Women's Health and Elektra Health), its mission is more far-reaching.

In fact, Jackson didn't initially enter this field merely because women lack adequate education and treatment for the various symptoms of menopause, nor just out of a passion for breaking the stigma surrounding it. What truly caught her attention was a study she happened to read one night—a study showing that women who experience early menopause may face a risk of earlier death.

"It's a disaster for the female body," she said. "It can lead to cardiovascular problems, osteoporosis, metabolic issues, cognitive issues... We also think it's one of the triggers for Alzheimer's disease."

"My mind was blown," Jackson continued. "I live in Silicon Valley, where people are obsessed with longevity, and here was a very clear factor—yet no one was talking about it."

At that moment, she realized "the game was over"—Jackson had found her mission: to help women live longer, healthier lives by treating menopause.

From Senator to Startup

For Jackson, finding the right career path meant first realizing she was on the wrong one. While pursuing a PhD in nanotechnology at MIT, she noticed the long hours her advisor spent in the lab.

"I began to realize that I didn't have the same passion he did for spending all day in the lab, and maybe this path wasn't right for me," she recalled. "But I thought: 'Oh my god, I've already been in a PhD program for four years, what am I going to do next?'"

After a dinner conversation with the president of MIT, Jackson was steered toward public policy. Through an introduction, she met the legislative director for then-Senator Joe Lieberman, and subsequently earned a Capitol Hill fellowship working on clean energy policy. Importantly, Jackson said, working on public programs taught her how to think at a national level and how to drive change on a large scale.

Years later, Jackson's government connections also helped her land a position at the Defense Advanced Research Projects Agency (DARPA). The agency focuses on investing in emerging military technologies, and this role gave Jackson a "front-row seat" to the development of cutting-edge biotech innovations—such as CRISPR and mRNA—long before they became mainstream in the industry.

Ultimately, this position also sparked her desire to be on the other side—alongside bold entrepreneurs forging new paths in healthcare.

"I wanted to join a visionary team to bring something that never existed in the world to life... but Washington doesn't have a startup culture," Jackson said.

Jackson officially dove into Silicon Valley's startup scene, co-founding diagnostics company Drawbridge Health. Then, through another project focused on fertility, she gradually shifted toward women's health. Although Jackson initially intended to target the "huge innovation opportunity" in fertility, a startling discovery about menopause—a study linking early menopause not only to an increased risk of early death but also to a two-fold increased risk of developing type 2 diabetes—opened her eyes and ultimately led her to found Evernow.

Beyond Menopause

Initially, Jackson envisioned creating a "cool science" solution for menopause (characterized by a sharp decline in estrogen). Then, a doctor corrected her thinking, explaining that the problem wasn't a lack of treatments—many hormone therapies on the market are generally effective—but rather that doctors and patients are insufficiently informed about these options.

In 2019, Evernow was born, aiming to connect women with menopause-certified experts who assess their health and guide them through treatment. Patients pay $49 per month for regular communication with these experts, prescription care, and educational materials.

Evernow is not yet connected to larger healthcare systems, but Jackson says she can see the potential for such partnerships to develop.

"Just as you might be referred to a specialist, you could be referred to us, and then we can share medical records back and forth with your regular doctor," Jackson said.

Evernow continues to grow. According to Jackson, about 150,000 women have completed initial health assessments to date, and the company has exceeded its 2022 target of $6 million in annual recurring revenue. The company is also considering expanding its prescription products to include medications for various menopausal symptoms.

As its market position solidifies, Jackson says the company has reached a stage where it can consider partnering with pharmaceutical companies to develop new therapies. She particularly believes that selective estrogen receptor modulators—which can bind to an estrogen to improve menopausal symptoms without increasing cancer risk—could become a new frontier in menopause care.

"We have two estrogen receptors in our bodies: alpha and beta. It's believed that alpha receptors cause cancer cells to self-proliferate, which, if uncontrolled, could lead to an increased risk of certain cancers," Jackson explained. "So if you can create an estrogen that only binds to beta receptors, you can get many of the positive effects while reducing the negative ones."

Alternatively, to have a more significant impact, Jackson says she hopes to research how to delay ovarian aging, thereby postponing the onset of menopause.

"Just because it's natural doesn't mean it's a biological inevitability," she said.

As the industry begins to realize that menopause could be "big business" for healthcare companies, Jackson says Evernow is evolving into a "telehealth 2.0" company—not only providing prescriptions but also collecting longitudinal patient data, collaborating with other players in the industry, and leveraging its entire platform to "improve overall care for women."

"I want to be the premier healthcare company for women over 40," she said. "From my perspective, that's the huge opportunity."