Scouting Report-Evernow: Improving Symptom Management & Treatment for Perimenopause & Menopause

The Driver:

Evernow recently raised $28.5 million in a Series A funding led by NEA, with participation from 8VC, Refactor Capital and Coelius Capital, plus angel investors, among them Color CEO Othman Laraki, and Carla Harris. The San Francisco based company built its platform focusing on women’s health and more specifically those who suffer from adverse symptoms of perimenopause. The company claims its using its clinically-validated health intakes to fill gaps in care for menopausal women while being inclusive to women from all backgrounds especially in underserved communities. The new funding will be used for expanding the team, building community, and leveraging the company's data and research to focus on product development.

Key Takeaways:

• There are an estimated 1.3 million women entering into menopause every year in the United States. This equals to over “$2,100 per woman per year” in added costs on the healthcare system and overall economy.

• Black women, in particular, have reported longer-lasting and more severe menopause symptoms than other racial groups for years.

• A subscription includes unlimited access to the startup’s medical team and the delivery of hormone therapies estradiol or paroxetine, supplemented with progesterone when needed.

• Although funding has increased for women’s health start-ups overall, it still remains a relatively small portion of the digital health investments.

The Story:

Menopause is defined as as the end of a woman’s menstrual cycle and is diagnosed after a woman has gone 12 months without a menstrual period. Perimenopause is defined as the process of Menopause beginning which most women start in their 40's and is evidenced by skipped cycles and period irregularities. Alicia Jackson, founder and current CEO of Evernow stated that the company’s goal is to “build a new way of delivering healthcare based on science, innovation, and women’s lived experience with menopause”. Established in 2019, Evernow’s goal is to serve as a link between women who are or are about to reach menopause and a team of specialists who can advise and prescribe to them. Evernow aim to provide a resource for the approximately 1.3 million women just beginning the process and entering the perimenopausal phase, a process that spans 10-20 years of their life, produces symptoms for 85% of patients, and yet where there are very few viable options for treatment and management. Studies have shown that women who experience menopause are more likely to be at higher risks for cardiovascular disease, stroke and osteoporosis. As noted by the Office of Women’s Health at the U.S. Depatrtment of Health and Human Services, low levels of estrogen and other changes related to aging (like gaining weight) are indications of these conditions making it crucial in addressing the symtpoms of those who are most at risk.

For example, in a survey of 100,000 women experiencing menopause who filled out Evernow’s intake form, 75% of perimenopausal women reported experiencing fatigue and low energy, weight changes, sleep disruption and brain fog. Almost two-thirds of women (60%) reported anxiety or depression, night sweats, hot flashes and joint or muscular pain.

The Differentiators:

While there are many healthcare companies targeting women’s issues, sometimes referred to as “Femtech”, their efforts generally focus on sectors catering to women under 40 such as pregnancy and fertility, but far fewer focus on the issues of women undergoing the three phases of menopause (Perimenopause, Menopause, and Late Menopause). Evernow is focusing on menopausal issues and trying to make access to education and the necessary treatments to manage the symptoms of this phase of a woman’s life more effective and discreet. For example, although there are a number of tools to address either the physical or the behavioral aspects of menopause, Evernow provides both hormone therapy, like the estradiol patch or pill, and paroxetine as well as an SSRI that can be used to treat night sweats and hot flashes. In addition, when users sign up for the service, they're matched with a clinician who helps build their treatment plan based on the patient's health history and their medications are unobtrusively delivered to their homes. The user is alsl given access to a library of resources and guides aimed at educating not-only women currently experiencing menopause, but also the millions of perimenopausal women who are transitioning into the menopause phase. According to the company, treatment data is based on its studies of more than 100,000 women experiencing perimenopause and menopause symptoms since its founding in 2019.

Also, the company is backed by influential female celebrities such as Gwyneth Paltrow, Drew Barrymore and Cameron Diaz who are known for their activism on women’s health and rights. According to CEO Jackson, “women going through the healthcare system understand where the gaps are in a way that I don’t think men do.” Members pay between $75 and $129 per month for the services which are seemingly cheaper than that of similar companies such as Parsley Health, which offer their subscriptions for approximately $175 per month (however, Parsley does offer out-of-network reimbursement up to 70%). Evernow accepts Health Savings Account (HSA) and Flexible Spending Account (FSA) since they are not in network with any insurance providers.

The Big Picture:

Investors spent $1.023 billion on U.S. women’s health technology startups in 2020, up from $625 million in 2019, according to Crunchbase data. Investment in this space has steadily risen since 2017, with total funding of $2.9 billion since 2016. As the industry shifts its focus to an older generation of women, it is evident how neglected they were. According to the company, while over 55 million women publicly and secretly experience menopausal symptoms, over 75% of those who seek help seldom get it. This appears to be due in part to a lack of attention from the healthcare industry. For example, according to an article by Fortune, of the millions invested in technology for women’s health over the past decade, only 5% has gone to menopause management. Consequently, as the numbers increase for women who are approaching perimenopausal age, there needs to be more talk and concern surrounding this health issue and the health disparities that accompany treatment.

In addition, many of the issues associated with menopause such as cardiovascular disease and stroke often disproportionately affect women of color, so addressing the issues and concerns of underserved communities should be a priority in disease prevention and management. Evernow, and companies like it, are actively taking the steps to address the concerns of millions of women by offering its 24/7 communication services with their clinicians as well as guaranteeing improved conditions for night sweats, and hot flashes among much more in under 3 months. Treatments like this which increase the convenience and accessibility care for menopausal women can improve the quality of life as well as reduce the risk of other health complications that would further burden an already distressed health care system. Clearly many women can directly benefit from utilizing such a platform and it would give them a greater degree of control over their health.

Gwyneth Paltrow, Cameron Diaz-backed Evernow raises $28.5, It’s Time to Prioritize Menopause: Our Investment in Evernow (Note: authors are employees of NEA, lead investor in the company)