Menopause – The Missed Health and Business Opportunity – Asrar Qureshi’s Blog Post #1177

Menopause – The Missed Health and Business Opportunity – Asrar Qureshi’s Blog Post #1177

Dear Colleagues! This is Asrar Qureshi’s Blog Post #1177 for Pharma Veterans. Pharma    Veterans Blogs are published by Asrar Qureshi on its dedicated site https://pharmaveterans.com. Please email to pharmaveterans2017@gmail.com  for publishing your contributions here.

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Preamble

The  Boston Consulting Group report states, “Every year, 2 million women in the US enter menopause, each one experiencing hormonal changes that can affect the brain, heart, bones, and mental well-being. However, only 60% of women with significant menopause symptoms seek medical attention, and of those, only 25% are treated. Women going through menopause are increasingly well informed and vocal about their needs, creating unprecedented demand for high-quality midlife care. Failing to deliver adequate treatment isn’t just a critical care gap—it’s a missed business opportunity. If all women with moderate to severe menopause symptoms received sufficient treatment, the annual market for US menopause health care could grow eightfold, to almost $40 billion, by 2030”.

This blog post is based on some insights from the above report and Pakistan perspective has been added. Link to report at the end.

Menopause Care: The Overlooked Frontier in Women’s Health

Menopause is a universal phase for women, yet for many, it remains one of the most neglected transitions in healthcare. The BCG article highlights that while up to 90 % of women experience menopause-related symptoms (and many more suffer longer-term health consequences), only a fraction seek care and far fewer receive adequate treatment.

Beyond hot flashes and sleep disturbances, the hormonal shifts of menopause affect the heart, brain, bones and mental health. Early menopause or poorly managed mid-life can triple cardiovascular disease risk, increase depression likelihood by 40 %, and cause accelerated bone density loss.

In short: this is not just a symptom-management issue; it is a broad health-span and life-span issue for midlife women. And the care gap in menopause represents both a moral failure and a large market/innovation opportunity. 

Situation in Pakistan

Several studies in Pakistan report that the average age at natural menopause is lower than in many Western countries. For example, one study from Karachi found a mean age of 47.1 years. Another Karachi-based prospective study reported a mean age of 44.6 years. These earlier ages may reflect poorer nutrition, high parity, higher physical workload and other socioeconomic stressors.

Symptom burden

Research shows high prevalence of menopausal symptoms among Pakistani women. In rural Sindh, a study found hot flushes in 42 % of women, sleep problems 41 %. In Lahore, among 200 post-menopausal women, 84.8 % were hypertensive after menopause (vs 15% before) and 46% reported chronic joint pain. Another study found that 29% of women had early menopause (<40 yrs) and 33% reported vasomotor symptoms; 66% had physical complaints post-menopause.

Awareness and attitudes

Knowledge of menopause and related health risks is low. One study found only 37% of surveyed Pakistani women were aware of menopause-related health risks. In Lahore, 70% of women had prior “knowledge” of menopause, but 60% believed it to be life-altering and many felt they lacked lifestyle support. Qualitative interviews in Karachi show women experiencing anxiety, lack of partner support, misperceptions about menopause and care-seeking gaps.

Why the Care Gap Persists

Lack of Awareness, Diagnosis and Provider Training

Many primary care providers lack adequate training in identifying and managing menopause-related risks. Symptoms are sometimes normalized (“that’s just part of aging”) and long-term risks (cardio, bone) are under-addressed. Frequency of care remains low: only about 60% of women with moderate/severe symptoms seek help, and just 25% of them get treatment.

Menopause care falls between specialties: obstetrics/gynecology, endocrinology, cardiology and mental health. There is no fully integrated “mid-life women’s health” routine care pathway in most public-sector facilities.

Women often present late, with symptoms accepted as “ageing” rather than treatable transitions.

Few guidelines or training programmes explicitly target menopause in primary care.

Cultural barriers, low female labour force participation, and low health-literacy reduce access to care.

Why this matters: The stakes for Pakistani women and the healthcare system

Quality of life & productivity

Menopause symptoms such as sleep disturbance, joint pain, hot flushes, mood changes significantly reduce quality of life, impair work productivity and burden families. Early menopause in Pakistan (mean ~45) means women may live ~20+ years post-menopause with unmanaged risk.

NCD burden & healthcare cost

Pakistan already faces rising NCDs (diabetes, cardiovascular disease, osteoporosis). Unmanaged menopause accelerates this transition. Hypertension, bone loss and mental health challenges increase healthcare costs. Early investment in mid-life women’s health can reduce downstream burden on hospitals and public budgets.

Social equity

Women’s health beyond reproductive years is often neglected, reflecting gendered health investment biases. Addressing the menopause care gap is a matter of gender equity and health justice. The gender gap in Pakistan (in labour, health access, decision-making) amplifies this.

Industry and innovation opportunity

From a healthcare-market perspective, the unmet need among mid-life women is large. Pharma, biotech and FemTech innovators who design diagnostics, treatments, digital-health tools for Pakistani women (and South Asia more broadly) can serve a growing segment, align with public health goals and build sustainable business models.

Strategic Actions for Pakistan

Raise awareness & build health-literacy

Launch a national campaign: “Mid-life Women’s Health Matters” via Lady Health Workers, community clinics, media.

Incorporate menopause education in medical & nursing curricula and continuous professional development for GPs/OB-GYNs.

Develop multilingual, culturally-sensitive educational materials for rural and urban women on symptoms, risks & options.

Create an integrated mid-life women’s health-care pathway

At district-level hospitals, establish a “Women’s Mid-Life Health Clinic” combining gynecology, endocrinology, cardiology, mental-health screening.

In primary-care settings, adopt protocols to screen women age 40–55 for menopause symptoms, hypertension, hyperlipidaemia, bone density risk and refer appropriately.

Use tele-health and digital platforms to extend reach into rural areas.

Link menopause care to NCD prevention & screening

For women ≥ 45 years, integrate menopause into national NCD screening programmes (blood pressure, glucose, lipids, bone-mineral density where feasible).

Public-sector clinics should monitor bone health (especially in women reporting joint pain, early menopause) and offer supplementation/therapies.

Empower the private sector & Pharma/Health-Tech

Encourage local pharma to develop affordable hormone-replacement therapy (HRT) options, bone-health drugs, digital adherence tools.

Incentivise FemTech startups to produce menopause-symptom trackers, remote counselling apps, community support networks.

Partner with insurers or employers to cover mid-life women’s health programs, early intervention leads to lower long-term cost.

Policy & reimbursement reform

The Ministry of National Health Services, Regulations & Coordination should incorporate mid-life women’s health (including menopause) into the essential-services package.

Public-sector budgets should allocate to “Women’s Health Beyond Reproduction” to signal priority and secure resources.

Health-insurance schemes (Sehat Sahulat, etc.) should expand to include menopause-related consultations and preventive screening.

Data, research & monitoring

Commission a national survey of menopause symptoms and care patterns among Pakistani women (urban/rural, across provinces).

Collect real-world data on age at menopause, time to care, outcomes (cardiovascular, bone fractures, mental health).

Academic-industry partnerships to pilot digital-health interventions, evaluate cost-effectiveness of early mid-life women’s health programmes.

Inclusion & equity lens

Focus on rural, low-income, and less-educated women who have lower access to care and earlier menopause.

Address cultural barriers: training male partners/community leaders about mid-life women’s health; create women-only clinic slots; deploy female health-workers.

Target provinces with weaker infrastructure (e.g., remote districts of Balochistan, rural Sindh) to avoid widening urban-rural care gaps.

Sum Up and Call to Action

Mid-life women in Pakistan, often responsible for families, households and the informal economy, deserve health services tailored to their changing bodies and lives. The menopause transition is not just the end of reproductive years, it is the gateway to a second half of life that can be healthier, more productive and full of potential. But only if our healthcare systems, policies and markets catch up.

By recognising menopause and mid-life women’s health as a strategic frontier, Pakistan can not only improve quality of life for half its population but also reduce downstream disease burden, build a more inclusive workforce and unlock innovation in women’s health. The time to act is now.

Concluded.

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For most blogs, I research from several sources which are open to public. Their links are mentioned under references. There is no intent to infringe upon anyone’s copyrights. If, any claim is lodged, it will be acknowledged and duly recognized immediately.

Reference:

https://www.bcg.com/publications/2025/closing-the-menopause-care-gap-in-womens-health?utm_campaign=none&utm_description=ealert&utm_topic=none&utm_geo=global&utm_medium=email&utm_source=esp&utm_content=Oct%2024,%202025&mktNoTrack=1&mkt_tok=Nzk5LUlPQi04ODMAAAGdtU7DTB3eieIwRurtuSd3mLwfJO95yrSDhLjieF0NzsMG_va9cHPb0F-LCBqqMKTCl6O2Vg8Aw1FC8etvLQsuDQT5TtwXh7kDnbQW-hl01wGFXaY