Hello Heart joins other digital health players taking on menopause as overlooked market gains attention

As a woman transitions to menopause, her risk factors for cardiovascular disease rise, research shows.

In fact, women in menopause have up to almost three times a higher risk of cardiovascular issues, including heart attacks, than premenopausal women of the same age, according to a recent study.

Heart disease is the leading cause of death for women in the U.S., who typically develop the condition several years later than men. Menopause-related hot flashes and night sweats have been linked to a greater risk for high blood pressure and other cardiovascular risk factors, the American Medical Association reports.

Ongoing stigma around menopause means many women aren't aware or informed about the increased health risks when they enter their late 40s or early 50s, according to Maayan Cohen, co-founder and CEO of digital therapeutic company Hello Heart.

"When we hit 40, we need to start doing mammograms and when you hit menopause, you need to start tracking your heart health and checking your blood pressure and your cholesterol," she noted.

Hello Heart, a startup that helps people manage their heart health at home using their smartphone, rolled out a new feature that provides menopausal women with the tools and information they need to take control of their heart health. 

“Women face a myriad of challenges in seeking and receiving adequate care for heart health issues,” Cohen said. “When it comes to menopause, women often face stigma, embarrassment, and a lack of clear and quality information. By receiving real-time data about their own health, women going through menopause will be armed with the resources to understand their heart health, its relationship to menopause, and advocate for adequate care.”

While symptoms like hot flashes and night sweats are widely recognized, the cardiovascular risks for women entering menopause often can't be seen or felt and many women aren’t even aware of them. 

Menopause sharply reduces estrogen levels in women and can increase the risk for heart disease, according to Edo Paz, M.D., cardiologist and senior vice president of medical affairs at Hello Heart.

Hello Heart's new mobile app feature will provide women with credible information about menopause and the hormonal changes that can contribute to increased heart risk, as well as actionable insights around managing symptoms and reducing heart risk, Paz said.

The company's flagship solution is a Food and Drug Administration-cleared blood pressure monitor coupled with an app.

In the past year, Hello Heart has been ramping up its enterprise business. Cardiac diseases are massive cost drivers in the U.S. healthcare system, and employers are increasing their investment in digital tools to help tackle workers' heart health.

Hello Heart now works with more than 100 large self-insured employers, and its solution is available to 2 million members, Cohen said.

The company, founded in 2013, has raised around $138 million to date, according to Crunchbase, backed by Stripes growth equity, IVP and Khosla Ventures.

Cardiovascular disease is the leading cause of death worldwide. Around 17.9 million people died from cardiovascular disease in 2019, equating to around 32% of deaths globally. While men are more likely than women to have cardiovascular conditions, research indicates that women have worse outcomes during hospital stays than men after a heart attack and are more than twice as likely to die after a heart attack than men.

screenshot of Hello Heart app
Hello Heart's feature for menopausal women (Hello Heart)

Women make up 60% of Hello Heart's workforce, according to Cohen, and as a female executive leader she felt that the digital health company should step up and offer women education, support and tools to better understand how menopause impacts their heart health and find ways to improve it.

"This topic is very close to my heart. I have a lot of friends that are going through similar things," she said. "Women die two times more of heart attack versus men, and that's a topic that we've been talking about for months now. And it's a key initiative for us as a company to close that gap. Once we realize that we've established the company, we established our client base, and now we can do things that we really want to do with the product. Women's heart health became a key focus area for the company and the product team."

She added, "Many women start menopause and they don't understand their heart risk jumps. We have the ability to influence their life in a very meaningful way, and hopefully by raising awareness, helping them catch risk in time and even potentially saving lives."

When women use the Hello Heart monitor to check their blood pressure and heart rate, the app automatically syncs a user’s heart health profile with the latest clinical knowledge. Users then receive a detailed report they can share with their doctor that offers data-driven looks at their heart health, with statistics on their blood pressure, visualization of heart rate and activity, and readouts of the impact of movement on their health.

For women going through menopause, the feature also provides educational content on menopause including symptoms that can contribute to heart risk and suggestions to control risk factors and healthy lifestyle changes, consistent with best practices and medical guidelines.

"We developed a feature that first helps you understand this is how pre-menopause, menopause and post-menopause look like. And, how does that relate to your heart health? We using digital coaching to help women improve their ability to manage their heart health. But alongside that we also find it a great opportunity to actually guide them about what is menopause. What are the side effects? Here are some tips that can help you with that. Because a lot of women won't go to a designated menopause solution to basically navigate their health," Cohen said.

While menopausal women face increased heart health risks, they are also often trying to manage symptoms that can have a profound impact on women in the workplace.

study published in Mayo Clinic Proceedings found that nearly 11% of women managing menopause symptoms reported missing work in the last 12 months due to symptoms like hot flashes and sleep disturbances. The annual cost for those missed work days is $1.8 billion, not accounting for reduced work hours, employment loss or early retirement. 

The broader women's health market has attracted digital health innovation and millions in investment dollars, for the past several years. Menopause is one sector of women's health that as flown under the radar but is starting to gain traction. More digital health companies are now offering innovative solutions to help women manage their symptoms and provide treatment and support. 

According to digital health investment firm Rock Health, investors poured $28 million into U.S.-based menopause digital health startups in 2020. That number jumped to $91 million in funding in 2021, according to data Rock Health provided to Fierce Healthcare.

Rock Health estimated the size of the U.S. digital health startup market supporting perimenopause and menopause care by identifying U.S. digital health startups addressing women's health that explicitly note supporting perimenopause, menopause or midlife women's health.

In 2022, digital health companies focused on menopause raised $62 million in venture capital funding.

It is an enormous market opportunity and is considered a new frontier in women's wellness. In the U.S., approximately 1.3 million women become menopausal each year. The global menopause market is expected to reach $24.4 billion by 2030, up from $15.4 billion in 2021, per a report from Grand View Research.

The Female Founders Fund considers menopause a $600 billion opportunity for companies.

Alloy Women's Health offers science-based solutions for women over the age of 40, including to help manage menopause. Describing itself as “health empowerment for women over 40,” Alloy is part telehealth, part prescription home-delivery service and part online community, Fierce Pharma Marketing reports.

Many women's health players have expanded into the menopause market. Carrot Fertility rolled out menopause services on its platform last year. Maven Clinic, the largest virtual clinic for family health, broadened its services to include a dedicated program for menopause and ongoing care. Evernow also launched virtual menopause treatment including hormone therapies and 24/7 support.

Other companies in the menopause space include Kindbody, Joylux, Thermaband, Gennev, Elektra Health, Lisa Health, Embr, My Modern Menopause, Vira Health, Peppy and Chorus Health.

Northwell Health is partnering with Upliv to offer the startup's clinical menopause support as an employee benefit. Through a pilot program with Northwell, select nurses experiencing perimenopause and menopause will gain access to the platform before a full rollout takes place this year.

Cohen said employers are eager for solutions that help women manage menopause symptoms.

"Similar to heart health, it's kind of a hidden topic; there's a lot of stigma, there's a lot of shame around it. It doesn't come up as a need for people, but the need is there, they just don't talk about it. A lot of the buyers and clients that we work with are actually women around that age group, and their team members and their employees are women in that age group so they were very excited to hear about it. They understand that we need to start bringing awareness to this topic and help women close that gap," she said.