POV - Leslie Schrock - Investing in Women's Health for a Decade, Longevity Is Leaving Women Behind

The women's health investment landscape has shifted dramatically in recent years. What's your take on the forces reshaping this sector, and where do you think the smart money is heading for the rest of 2025 and into 2026?

Menopause and longevity are finally getting their due in the public sphere, and many companies have popped up to serve this population. Eight states in the US have now passed menopause-related legislation, with a total of 19 states introducing over three dozen bills in 2025 alone. There's real political and cultural momentum here.

The FDA's November 2025 removal of the black box warning on hormone replacement therapy (HRT) is a genuinely historic development that could improve access to HRT for millions of women. FDA Commissioner Marty Makary (and many others) called the original warning "one of the greatest mistakes in modern medicine." Labels will now include age-specific guidance showing that HRT may offer significant benefits—including reduced cardiovascular risk and cognitive decline—when started within 10 years of menopause onset. This was something the menopause community has been petitioning for since 2014.

Regardless of your political leanings, the USA is one of the wealthiest countries in the world, yet much of the population is unable to access basic healthcare and is struggling with chronic disease. The food system has become a flash point for consumers (even if the obsession with seed oils and dyes misses the larger point), especially for parents like myself who worry a lot about what we feed our kids. The flip of the food pyramid is a welcome change, and something I expect to filter into how we make food and think about nutrition.

The promise of a better quality of life versus preventing disease is far more resonant with consumers. I'm biased, as it's the topic of my next book, but I am thrilled to see this market explode—though we have a long way to go for women. We may live longer than men, but our quality of life is projected to decline even further in the decades to come. We have a higher prevalence of Alzheimer's, osteoporosis, and migraines, to name a few health conditions. This problem is urgent and needs more research, funding, and attention. I'd like to see more businesses focus on earlier risk detection for cardiometabolic and neurodegenerative conditions and the management of autoimmune conditions.

Incumbents like Maven are already serving this population at scale—with over 2,000 employers and health plan customers, approximately 117,000 enrolled members, and a 98% retention rate. Their menopause program grew 300% year-over-year in 2024 to 550 clients. The challenge among newcomers is finding a distinctly different, AI-first model.

Investors often say they want to fund women's health, but then pass on deals. What do you think founders in this space need to understand about investor psychology and market dynamics to break through?

I could talk all day about this topic (and did in this piece on my Substack). Here are the top areas I wish women’s health founders all truly understood: 

1. Most women’s health companies are founded and funded by women, but there is less investment for women founders overall—just 2-3% of venture funding goes to companies founded solely by women. While it’s possible to get a company off the ground at seed with angels, it’s much harder to secure funding at later stages, as only 15% of venture firm partners and managing directors in the US are women. We need more men to step up and invest in women’s health companies. Which brings us to the second point…

2. Every women’s health founder I know has fundraising war stories involving a male partner not understanding (or wanting to hear) words related to women’s bodily functions and anatomy. I call this the “yuck factor.” I find it absurd that we can’t just call body parts by their biological names, but it is a pervasive problem when it comes to getting investors to take a look at these companies, much less get them over the line to fund them. 

3. The Total Addressable Market (TAM) problem is another hurdle in women’s health, as narrowly-focused startups aren’t a great fit for venture capital, where a small number of investments drive the majority of returns. The narrow focus may have been an issue in the past for women’s health companies that only focused on solving one condition, like Polycystic Ovary Syndrome (PCOS). However, there are numerous multi-billion-dollar problems to address, including pelvic floor, MSK, and diagnostics issues, as well as multiple companies with billion-dollar valuations (e.g., Maven’s at $1.7B in 2024), which may be of interest to those seeking comps. 

4. Low reimbursement rates in women’s health are a frequent gripe from investors, and it’s true: they are low, and they do make it tough to build in-person care at scale. Medicaid data shows that female-specific procedures are reimbursed at a lower rate than comparable procedures for men. This isn’t a problem founders can solve, but the more attention we bring to this problem inherent in the bureaucracy, the better the care and ecosystem will become. 

Women often live with more chronic conditions than men. What's your perspective on how the longevity movement is (or isn’t) addressing the unique challenges of women's healthspan?

Women are more likely to get migraines, experience depression and anxiety, and develop Alzheimer’s disease. They suffer from nearly 80% of all autoimmune diseases and osteoporosis cases. Women are also far more likely to be misdiagnosed than men, even when it comes to heart conditions. Because much biomedical research has historically centered on male bodies, some diagnostic criteria and reference intervals underperform for women, despite many tests having sex-specific ranges.

I am here for all of the longevity hacks, but some work for men, not for women. For example, cold plunge benefits are mixed for both sexes, but in the limited studies on women, they can also cause adverse side effects like heightened cortisol levels. While it’s fun to watch what’s happening with the worried well (those who seek medical care despite being healthy), I’d like to see far more research done in the areas that really move the needle, like lowering the risk of preventable conditions like cardiovascular disease for women. 

Another thing that isn’t really clicking for women is the practical side of these longevity protocols, most of which are multi-hour, high-intensity, and expensive. Women carry the load at home, even when they are also employed, so telling a working mom to find 2 hours a day to do this stuff does not land. We need to do a better job of describing ways for women to integrate healthier habits into their daily lives and control what they can easily control, versus adding more to their plates. 

The health tech ecosystem produces incredible innovations, but adoption remains a challenge. What's your view on why some breakthrough technologies fail to reach the families who need them most?

The obvious answer is cost—a lot of these breakthroughs, at least when they launch, are simply too expensive for mass adoption. Most digital health initiatives that aren’t payor-facing or reimbursable, particularly those directly targeting consumers, have relied on selling to the out-of-pocket crowd who is willing and able to pay upfront. Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) are growing more popular, too. As these companies reach scale and reduce costs, they become more accessible to everyone else. The longevity industry will eventually exhaust its potential customers with $20k per year to spend on high-touch clinical care and relentless testing. But it’s still early days.