a $600,000 business

At the beginning of the 20th century, thousands of women demanded a birth en masse called twilight sleep: a mixture of morphine and scopolamine that did not take away the pain, but it did erase the memory. It was one of the first major female rebellions to demand that medicine take their suffering seriously. More than a hundred years later, that battle is still open in another stage of life.

The big hole in women’s health. Melinda French Gates has recently focused on a figure that, by itself, sums up a systemic failure: women live on average nine more years in poor health than men. It’s not just about longevity, but about quality of life lost right in the middle decades, when many are at the peak of their career, raising children or supporting entire families.

For Gates, the problem is not biological, but structural: medicine has historically treated the male body as a default model and has left huge gaps in knowledge about inevitable stages like perimenopause and menopause. Its conclusion is devastating: half the planet is going through this process and, even so, the system continues to act as if it were a marginal issue.

A business of 600,000 million. That is where the paradox that Gates has detected appears. As menopause becomes a esteemed market at 600,000 million dollarswith startups, supplements, telemedicine and specialized cosmetics, the healthcare infrastructure continues to lag behind decades.

Companies like Midi Health or Maven Clinic are growing at high speed because they have found a brutally unsatisfied demand. The market has understood before that the medicine that was here a gigantic need. And that is precisely what is disturbing: there is business because the system has failed. A gap that should have been filled decades ago by research, medical protocols and public access is being monetized.

Menopause as silent sabotage. Because the impact is not only health-related, but also economic and professional. They remembered in a wonderful report from Fast Company that menopause usually arrives just when many women are reaching positions of maximum responsibility, and their symptoms (brain fog, insomnia, anxiety, hot flashes, memory loss, irritability) are causing resignations, early retirements or career slowdowns that are rarely accounted for.

The data is brutal, although even more so in a country like the United States, where symptoms related to menopause generate about 26,000 million of dollars annually between medical costs and loss of productivity. Many women don’t even know what is happening to them until they the damage has already been done. Gates said in one New York Times column that this has a fairly clear political reading: if women leave the labor market at their moment of greatest influence, their access to power is also curbed.

A system that continues to arrive late. The harshest criticism comes because not even the doctors are prepared. Less than one-third of gynecology training programs in the United States include menopause-specific curriculum, and less than 20% of primary care physicians receive adequate training. That explains, according to Fast Companywhy so many women wander from consultation to consultation without diagnosis or treatment.

And the decline is even more striking with hormone replacement therapy: twenty years ago about 40% of women used it, today less than 5%largely due to the fear generated by misinterpreted studies in 2002. Now new evidence They are rehabilitating its use, but the damage has already been done.

It’s not just discomfort, it’s much more. One of the most important points is that menopause is not simply an uncomfortable stage. In fact, it can profoundly alter future health. A large international study published in Obstetrics and Gynecology has shown that premature menopause increases the risk of suffering serious cardiovascular events such as stroke, heart attack or heart failure by around 30%.

The reason is biological: estrogens function as a kind of metabolic and vascular shield. When this shield disappears early, the body ages faster in cardiovascular terms. This makes menopause a primary clinical marker, not a simple hormonal transition.

The revolution that Gates proposes. For all these reasons, Melinda Gates’s commitment to its 215 million dollars It is not about filling shelves with products, but about trying to change the entire architecture of the problem: more research, more medical training, more insurance coverage and more labor protection. Your idea is to use the philanthropy as a sign to drag governments, companies and investors into an area that was ignored for decades.

Because the big question no longer seems to be whether menopause it’s a marketthat is more than resolved with the numbers in hand. The question is why a universal need has been allowed to become in business opportunity than in medical priority.

And that, perhaps, is one of the greatest silent defeats of modern medicine.

Image | Unsplash, Buderim

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