Menopause (and Midi) is Hot

Mallun Yen

Today, we’re excited to unveil another way Operator Collective is helping accelerate the future growth of Midi Health, a startup we’ve backed since the early days -- an SPV as announced in Fortune today: Celebrities, CEOs & sports stars pile into $5M fundraise for Midi Health, a startup providing menopause care. Here’s a little about how this effort came to be. It takes a village, and this was no exception.

The untapped opportunity

A core part of our strategy at Operator Collective 🔆 is leaning on and learning from our close knit community of high-powered operators (aka our LPs in the fund), who are senior leaders at companies like Stripe, Atlassian, Databricks, AWS, ServiceNow, OpenAI, Anthropic, Datadog, Zoom, Hubspot, Box, Rubrik, and Cloudflare. As such, we have a unique pulse on evolving enterprise needs—the current and future challenges our Operator LPs face as they run their companies help inform our decisions on which startups to invest in. Beyond that, our Operator LPs are also mostly women and mostly over the age of 40.

As an investor and a woman with my own journey through perimenopause (which can start as early as your thirties!), I knew that there was an enormous market for this unaddressed segment of the healthcare industry—women spend more than a third of their lives in perimenopause or menopause, with more than 1.2 billion women globally expected to be in these life stages by 2030.

Despite this, there was a real question by many venture investors whether this was a big enough space. Indeed whether it was a “space” at all - some assumed it was just a part of beauty/wellness supplements or tacked onto fertility.

Perhaps it’s because no one had really figured out a compelling business model. When we started digging into the space years ago, we weren’t fans of the business models of the startups we met, most of which were selling products or providing referral services on a subscription basis using membership models. They weren’t providing actual visits with doctors or NPs, and most, if not all, weren’t covered by health insurance. Long story short, we passed on every company we met with.

Although progress has been made for women’s health in the workforce, the focus (and startups) had been largely on fertility, our hunch was that enterprises would soon recognize the opportunity and impact of perimenopause and menopause for their employees. A Mayo Clinic study last year revealed nearly 11% of women aged 45-60 missed work in the last 12 months due to perimenopause and menopause symptoms, at an annual cost of $1.8B to the U.S. economy (and that doesn’t even account for reduced work hours, employment loss, or early retirement). We verified this with our Operator LPs and their companies’ HR departments—all but one came back and said their company would be interested in providing access to these healthcare services for such a significant percentage of their workforce.

Enter Midi Health

Fast forward a few years, and I reconnected with Joanna Strober, whom I had met many years earlier and had heard was working on a menopause startup.

Unlike the others we’d met with, Midi’s strategy was to provide comprehensive, evidence-based, high-quality expert medical care spanning dozens of common symptoms of perimenopause and menopause. These included not just hot flashes but fatigue, brain fog, joint pain, weight gain, depression, anxiety, and dozens more. And the plan was to offer virtual appointments with doctors and NPs—key because only 50% of counties in the United States actually have OB/GYNs, 80% of which have little to no training in menopause. Also unique was the fact that Midi was on a path to have its care covered by insurance in all fifty states and was laying the groundwork for referral relationships with health systems and employers.

Their model was a game-changer, and so were Joanna and her cofounder Sharon Meers, both experienced execs over the age of 50 who had had first-hand experience with the dearth of health services when entering their menopause years. As soon as we talked, I knew that they would be relentless—which is exactly what this undertaking would need.

This, among other things, convinced me that they were building the company that would be the breakout in this sector. In short, we at OpCo quickly realized this was the one.

From seed to SPV

Soon after deciding we were all in on Midi, we reached out to several VCs in our network. A number of them passed but in October 2022, Midi’s $14 million seed round closed, with OpCo, Allison Baum Gates of SemperVirens, Victoria Treyger of Felicis, and Fern Mandelbaum of Emerson Collective participating along with others who believed in the company, its mission, and the market on board. Just six months later, the company closed its $25 million Series A round of funding led by Frederique Dame and Cathy Friedman of GV (Google Ventures), joined by OpCo and Midi’s original investors.

Midi’s business was on its way. Midi was inking partnerships with healthcare systems and employers and the company’s direct-to-consumer pipeline was also proving to be fruitful. When we first invested in the seed in 2022, they had just started seeing patients and generating revenue. Midi has now conducted more than 100,000 patient visits, with the goal to serve 1 million+ women per year by 2029. Midi is expected to triple their year over year revenue this year, all while maintaining a 95% customer satisfaction rate.

As we reviewed the stats at a board meeting late last year, I looked at Joanna and asked what was stopping Midi from moving faster. She said she wanted to be mindful of cash burn, but the market need was there to accelerate, and the fundamentals were in place and working. We decided Joanna would test the venture market to understand the appetite for an additional round that would allow Midi to meet the clear demand. As it turned out, the market was hungry. Emerson Collective came in to lead what turned out to be an oversubscribed Series B round that included OpCo and all of the above investors yet again plus added notable investors Gingerbread Capital, Black Angel Group, and G9.

At the seed round, I first raised the idea with Joanna of putting together an SPV as an efficient way to surround Midi with powerful stakeholders who could help accelerate the company at the right moments. The Series B was the perfect time to revisit it: the need for Midi is clear, the model is working - now it’s time to hit the gas.

A special purpose vehicle, or SPV, is a legal entity that allows multiple investors to pool capital and make a single investment together. Heather Mirjahangir Fernandez, co-founder and CEO of Solv (and OpCo LP and Midi SPV participant!), had done it successfully at her company in 2022. With the Midi model now cranking, it was a good time to bring in key leaders, including those who might not normally have access to invest in Midi but could help accelerate and spread the word. Midi set aside $4 million (later increased to $5 million due to overwhelming interest) out of the $63 million Series B round. And OpCo, as the organizer and manager of the SPV, started working our extended network.

Taking the model we developed behind OpCo itself, here, we wanted to bring together a cross-section of women leaders from different industries who didn’t necessarily know each other—and wouldn’t otherwise have had an opportunity to partner on a common purpose. Here was a chance to bring powerful leaders from different industries together and invest in an innovative company—to accelerate and amplify something we all believed in and that needs to exist for women everywhere. One introduction here and one connection there led to another, people opening up their Rolodex to make warm intros, and then another, and then another.

Operator Collective LPs and Midi SPV participants Connie Britton, Erica Ruliffson Schultz, and me

The result was an SPV that included 80 investors—a high-powered group of women leaders spanning entertainment, sports, media, beauty & fashion, health & wellness, technology and business. Celebrities and media executives like actors Amy Schumer, Connie Britton, and Alysia Reiner, Danielle Lee at Warner Media, Richelle Parham at Universal Music Group, Campbell Brown, and Phenomenal Media’s Meena Harris (Kamala’s niece!), Angel City co-founder Kara Nortman of Monarch Collective, soccer star Brandi Chastain, fashion designer and entrepreneur Tory Burch, former Thinx CEO Maria Molland all joined in. OpCo Operator LPs who are leaders at iconic tech companies like Waymo co-CEO Tekedra N. Mawakana, Cloudflare co-founder/President Michelle Zatlyn, Toast CFO Elena Gomez, Stripe’s Claire Hughes Johnson, Confluent President Erica Ruliffson Schultz, Atlassian President Anu Bharadwaj, ServiceNow CFO Gina Mastantuono, Webflow CEO Linda Tong, plus leaders from OpenAI, Databricks, Amazon, and many more all were on board.

It’s a privilege that OpCo is not just an investor in Midi but has been an integral part of the company’s exciting journey since the early days. This investment opportunity for others who are passionate about high-quality medical care for women in midlife has brought together so many leaders who didn’t previously know each other and wouldn’t have invested together if not for Midi and for this SPV. And this wasn’t just a collection of women from diverse industries—about 40% of the investors in our SPV are women of color, mirroring the ratio of Operator LPs at Operator Collective.

There is another differentiator I’m proud of here: While most other SPVs are purely financial, this one pooled money from women who care about Midi’s success from a personal point of view too. These are not just financial backers looking to generate a return, they wanted to do what they can to help accelerate the company. And Midi wanted them in their camp—they could have easily allocated that $5 million elsewhere.

Big things happen when entrepreneurs dream big, in relentless pursuit of a service or a product that they themselves need. Big things also happen when passionate leaders come together with a common purpose. We’re so grateful to those who enabled us to open the door for even more women to join us—and for more and more women across the country to have access to the health care they need.

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Menopause (and Midi) is Hot

The untapped opportunity

Enter Midi Health

From seed to SPV

ENTERTAINMENT, SPORTS, & MEDIA

HEALTH, WELLNESS, BEAUTY, & FASHION

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