In my conversation with Joanna Strober, CEO of Midi Health, a recentl Times 100 Health awardee, we explored the current landscape of menopause care — a space where millions of women experience significant symptoms yet remain underserved by traditional healthcare systems.

Despite hormone therapy being one of the most effective treatments for menopause symptoms such as hot flashes, mood swings, sleep disturbances, and fatigue, usage rates remain strikingly low; recent research shows that fewer than 4% of women aged 45–59 use hormone therapy, even though up to 80% of women are affected by symptoms at some point in midlife. Compounding this care gap is a broader systemic challenge: only about one in five obstetricians/gynecologists and even fewer primary care physicians receive formal training in menopause management, leaving many women without knowledgeable clinicians to guide them through this critical life stage.

Meanwhile, perimenopause — when hormone levels surge and crash unpredictably — can begin years before the final period and trigger mood fluctuations, physical changes, brain fog, and anxiety, underscoring the emotional and physiological complexity of this transition.

Against this backdrop, Midi Health has emerged as a provider platform designed specifically to support women’s menopause journeys with personalized, evidence-based care that meets patients where they are.

Launched to close the care gap that traditional healthcare has long ignored, Midi leverages a nationwide telehealth model with clinicians trained in midlife women’s health protocols, offering both hormonal and non-hormonal treatment plans that are often covered by insurance.

With tens of thousands of patients served and ambitious plans to scale to care for more than a million women per year, the company is striving to transform how women experience midlife health — from dismissive, fragmented care to proactive, supportive treatment that acknowledges both the physical and emotional effects of menopause at scale

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In this HLTH Forward episode, I spoke with Fidel Strub, and I felt the kind of strength and hope that transforms pain into power. He isn’t just a survivor — he is living proof that with knowledge, compassion, and action, tragedy can become a force for change. According to the World Health Organization, Noma — the devastating, gangrenous disease that ravages the mouths and faces of malnourished children — once afflicted an estimated 140,000 individuals per year globally, with a case-fatality rate as high as 90%.

Survivors often endure severe disfigurement, lifelong difficulties eating, speaking, or breathing, and face social isolation — yet many never receive timely treatment, because far too many healthcare workers don’t recognize Noma early enough.

Fidel shared that surviving Noma gave him a “second chance at life.” But survival alone wasn’t enough — dignity, acceptance, and opportunity were what truly mattered. As a co-founder of the survivor-led advocacy group Elysium, he and his fellow survivors turned personal trauma into a public mission. Their campaign helped ensure that in 2023, Noma was finally added to the WHO’s official list of neglected tropical diseases. This milestone opens the door to funding, research, education, and treatment.

Now he champions early detection, basic antibiotic treatment, and reconstructive surgery — but most of all, he fights for the right of survivors to be seen as people deserving of dignity, not pity.

And Noma is far from an isolated tragedy. Across the globe, millions suffer from rare diseases — deeply misunderstood, under diagnosed, and grossly under-resourced. Experts estimate there are more than 7,000 rare diseases worldwide, affecting up to 3.5–5.9% of the global population — that’s hundreds of millions of people.

Many begin in childhood: around 70 % of rare diseases are genetic, and a significant proportion manifest before adulthood. Yet over 95% of these conditions lack an approved treatment, reflecting a shocking disparity between need and support.

At its core, Fidel’s story — and the broader rare-disease crisis — challenges us to expand our vision of healthcare and humanity. It’s not just about surviving illnesses; it’s about ensuring dignity, inclusion, and opportunity for every human being, regardless of where they were born or how rare their condition.

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In this episode, featuring Dr. Eric Nestler, offers a fascinating glimpse into the intersection of neuroscience, addiction, and depression. Dr. Nestler explains that both conditions share similar brain mechanisms, particularly within the limbic system, which regulates emotion and motivation. His laboratory’s research delves into how chronic stress or drug exposure alters molecular pathways in these emotional brain regions, leading to maladaptive behaviors. Through advanced techniques like transcriptomics, his team analyzes thousands of brain molecules simultaneously, helping to uncover key differences between healthy and diseased brains. This cutting-edge work not only enhances our understanding of mental health disorders but also opens new possibilities for targeted treatments and resilience-building therapies.

Beyond the science, Dr. Nestler highlights broader social and ethical dimensions. He emphasizes that the global rise in addiction and depression reflects modern societal stressors—social isolation, technological pressures, and post-pandemic effects.

While innovative approaches like AI-driven analysis and brain–computer interfaces show promise, he cautions that such technologies must be pursued with great ethical care. Ultimately, his message centers on balance: advancing research while nurturing everyday resilience through healthy living, social connection, and emotional awareness. His closing insight—that true health comes from integrating science, empathy, and humanity—resonates as both hopeful and urgent for the future of healthcare.

About

Dr. Eric J. Nestler, MD, PhD, is a leading neuroscientist and physician renowned for his groundbreaking research on the molecular and epigenetic mechanisms underlying depression and drug addiction. Currently serving as the Interim Dean of the Icahn School of Medicine at Mount Sinai and Chief Scientific Officer of the Mount Sinai Health System, Dr. Nestler has played a transformative role in advancing brain science through his leadership of the Friedman Brain Institute and his own laboratory’s work. His research has shed light on how chronic stress and repeated drug exposure alter gene expression and neural circuits, particularly through discoveries such as the transcription factor ΔFosB, a key regulator of long-term changes in the brain’s reward pathways. Dr. Nestler earned his BA, MD, and PhD from Yale University and has held prominent academic positions at Yale, UT Southwestern Medical Center, and Mount Sinai. He is an elected member of the National Academy of Sciences, the National Academy of Medicine, and the American Academy of Arts and Sciences, and has published hundreds of influential scientific papers. Deeply committed to diversity in science, Dr. Nestler is also known for promoting inclusive leadership and mentorship throughout his career.

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