Joanna Strober: Founder & CEO of Midi Health

Episode 637

On this episode of The Kara Goldin Show, In this episode of The Kara Goldin Show, we’re joined by Joanna Strober, the inspiring Founder and CEO of Midi Health. Joanna is on a mission to close the care gap for women navigating menopause and midlife—a critical area of healthcare that has been underserved for decades. With Midi Health, Joanna has created a telehealth clinic that delivers accessible, insurance-covered, and compassionate care to women across all 50 states.
Joanna shares how her personal experiences and professional journey inspired her to launch Midi Health, why midlife care is more important than ever, and how her team is using technology to scale while maintaining personalized care. We also dive into the cultural stigmas around menopause, the impact of her high-profile investors like Sheryl Sandberg and Amy Schumer, and what the future of midlife healthcare could look like.
If you’re interested in women’s health, telehealth innovation, or the challenges of building a purpose-driven company, this episode is a must-listen. Tune in now on The Kara Goldin Show!

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Transcript

Kara Goldin 0:00
I am unwilling to give up that I will start over from scratch as many times as it takes to get where I want to be. I want to be you. Just want to make sure you will get knocked down. But just make sure you don’t get knocked out, knocked out. So your only choice should be go focus on what you can control. Control. Hi everyone, and welcome to the Kara Goldin show. Join me each week for inspiring conversations with some of the world’s greatest leaders. We’ll talk with founders, entrepreneurs, CEOs and really, some of the most interesting people of our time. Can’t wait to get started. Let’s go. Let’s go. Hi everyone, and welcome back to the Kara Goldin show. So excited. Welcome Joanna Strober. I’ve known Joanna for many, many years, so it was so nice to catch up briefly right before we started hitting record. But Joanna today is the founder and CEO of an incredible company called Midi Health. She’s on a mission to revolutionize midlife healthcare, tackling one of the most overlooked areas in medicine, menopause and perimenopause. So through Midi Health, Joanna is not just providing accessible, affordable telehealth care to women across all 50 states, but she’s also breaking down so many stigmas and advocating for a more holistic approach to women’s mid life health. So love, love, love. Joanna not only has been a successful founder, but also has been on the VC side, which is always so interesting, because she can really speak to all sides of the table. She’s raised money, she’s she’s invested, she’s done all kinds of things. So I’m always so inspired by everything that Joanna is doing. So so so excited to hear more about Midi Health and everything that she is up to. So welcome.

Joanna Strober 2:06
Thank you. This is so fun. I know super,

Kara Goldin 2:09
super fun. I always tell people like, you know, there’s no gotchas in here. It’s really just, it’s like having a coffee conversation around what you’re up to. And I think that there’s so much inspiration and everything that you’ve done over the years, but also just what you’re doing today. So for those who are unfamiliar with Midi Health, can you give us a quick overview of what you’re doing, and how would you describe his mission in a few sentences, not sentences. I mean, you could take as long as you want, but just share with us the, I guess, the 32nd elevator speech. So

Joanna Strober 2:47
MIDI is a virtual healthcare company to provide care to women in all 50 states, covered by your insurance for all the things that women go through. And I’ve actually come to think of it as A Room of One’s Own for women. When you think back to Virginia Woolf’s concept about how women needed a room, they needed money, they needed financial independence, I’ve come to realize that women need their own health care. They need people who listen to them, who take their concerns seriously, and who understand women’s bodies and then give them the appropriate care. So that’s really what we’re building, is that space for women to come and get honest conversations about the things that are troubling them and help them get the right care.

Kara Goldin 3:36
So what inspired you to focus on this midlife healthcare area. And how did you Was this a personal professional? I mean, I would imagine that that this was a conversation maybe you were having with some of your friends, that you thought that you had an idea that you could go and solve this problem that so many people had, you

Joanna Strober 4:01
know, I live in Palo Alto, California. There’s a lot of doctors in Palo Alto, California. I was having some anxiety attacks. I had stopped sleeping. Things were just going wrong. They were going wrong in my marriage, quite honestly, because I was angry all the time. I also had lost pretty much all interest in sex, and I was really worried about my life, and I was going to doctors and trying to figure out how to get help, and no one brought up hormones, and no one said to me, Wow, maybe your hormones are impacting all of these things. They sent me to get a sleep study. They told me to go to therapy. We were going to couples therapy. I went to couples therapy for six months, and that couples therapists never said, maybe you don’t like having sex because it’s painful, and maybe that’s because you have menopause. Like I was going to so many different people, and none of them were giving me the right care. So I found a doctor. In San Francisco, a cash pay doctor who was an expert in this, she gave me the right medications, and two weeks later, my whole life had changed like in such a short period of time, I felt like I had not felt in a really long time. And so it’s really that I wanted to give everyone access to that, and give everyone access to the woman in San Francisco who charges $1,000 an hour and gives you great care. The idea was, everyone deserves that. You need it to be covered by your insurance, and we need to make it accessible. And so that’s really what we wanted to do.

Kara Goldin 5:36
So I totally agree you and I were talking about about my own personal care, and I’ve been on hormones for many, many years. And I mean, frankly, I was on hormones before I even went through menopause or and I never realized I was going through it. So I think it’s, it’s it’s something that I’m such a huge believer in and I think that there’s a lot of doctors now that are more aware of it, but they’re still not necessarily experts in it, and I think it is hard to find that doctor, depending on where you are, that’s going to do it, and then the issue of insurance covering it as well. So how difficult has that been to kind of start a business where you’re dealing with, you know, telehealth? I maybe COVID kind of helped that along a lot, but also the the insurance aspect of it, and I think insurance as it relates to women too, because that’s a whole other topic where, you know, it seems like it’s, there’s a little bit of bias that goes on, I believe, on the insurance company side, where, if it was men complaining about it, that’s my opinion. Maybe we’d, you know, have the insurance a little faster than than with women, they’re just the crazy ones, right? So well,

Joanna Strober 7:03
so think about the fact that insurance will cover Viagra, but it won’t cover testosterone for women, and that is the best proven solution for for low libido, right? So it is a complicated morass of laws that you’re navigating that enable, you know, something, probably 50 low low testosterone or low libido issues for men and nothing for women. That’s actually FDA approved, but that’s also the FDA. There’s a whole bunch of different this gets back to A Room of One’s Own. I’m telling you, we need A Room of One’s Own for women’s health, because every part of our medical system has been designed for men. That’s just the reality. And but with regard to to insurance, before COVID, we couldn’t have done this. So the COVID laws that changed over you know, in 20, in 2020, and 2021, are enabling the company. Because we needed, we needed to have telehealth covered by insurance. We also we needed to have our type of care covered by insurance, and all that was enabled by the telehealth regulations that happened over COVID.

Kara Goldin 8:11
So what was the first step that you took in creating this company? I guess you know you would obviously, you knew how to build a business plan, and then you knew that you were going to need capital to do this, but what? And you had a great idea, and you felt like there was interest that people would definitely do this. But I mean, this is hard, right? This is like, this is super, super This is a big idea, and very, very difficult. And you know what? What was the first step?

Joanna Strober 8:40
So actually, I really like the way we did it. The first thing we did was a pilot, and we had two doctors, and we recruited 150 women, and we said, we want to create the perfect health care experience for you. And we have all people who are not on hormones yet we wanted them to have the choice of whether they wanted to go on hormones or not go on hormones. But we started and we said, we’re going to give you the perfect perimenopause menopause experience for free, as much care as you want, as long as you constantly give us feedback on what you like and what you don’t like. So we had a six months pilot, actually, and we took really good care of these women. We also started to learn from them what they liked and what they didn’t like. I’ll give you one example. Our first questionnaire that we created said, Do you want to go down the hormone path or do you want to go down the supplement path? We thought that was giving women choice. They did not want that. Everyone wanted to know after the visit what was appropriate for them and then get the right medication. They also we thought that three month follow ups would be the right amount of time. And they said, Nope, I need a month. I only want to try this dosage of the hormones for a month, and then I want to titrate and I want. Try something else. So we basically built the whole business around these 150 women who gave us their feedback. And then the reason we knew it would work, honestly, is at the end, they all said, I have nowhere else to go to get this care. You cannot go away. And so it was actually them saying this that actually gave us the confidence to go raise money and to build this because they were telling us how valuable it was, what we had created for them.

Kara Goldin 10:26
So you start with this pilot, and then where do you go from there? So then you went out and actually raised angel money to get this going. You have a number of high profile investors, like Amy Schumer, Sheryl Sandberg,

Joanna Strober 10:43
they all came later, to be clear. Oh, they all invested much later. Initially, we really, you know, I joke a lot about the idea of Emily’s list. Early money is like yeast, right? It’s actually hard to get that early money. And even though we had this pilot and things looked really good. We it was really hard to get the original funding. So we did find women’s health funds primarily, and some angels who were willing to take big bets on us very early. But it was, it was hard initially to get, to get the funding. So a lot of those other people came in later, and I’m really grateful to all of them for working with us. But initially, it was hard.

Kara Goldin 11:20
How difficult is it for you to get the word out about what you’re doing too that, I think so often. I mean, again, like I was saying, I’m a huge proponent and taking hormones. But when I talk to people who have never, they don’t have the same friend group, right? That’s taking hormones. They’re, they’re like, you know, I don’t want to do that. Am I going to grow hair with in all the wrong places on, you know, with testosterone, I mean, they have all this idea about what’s going to happen, so they allow fears to prevent them from even trying. Midi Health, so what, what was kind of the, I guess, what was the hardest part about getting the word out about and how do people typically find out about Midi Health today?

Joanna Strober 12:08
Yeah, but you know, half the people now come through word of mouth. So a lot of people hear about us from their friends or their book group. A lot of book groups. A lot of actually, physicians refer their patients to us. Lots of primary care physicians will refer their patients to us. We have oncologists. So one of the things that we are expert in is women who had breast cancer who need specialized hormone care or specialized menopause care after having breast cancer. And so we have a lot of oncologists who refer patients to us. So I would say, yeah, a lot of our is either grant organic or physician referrals. We do have a lot of doctors that like that, like sending patients to us. They know that in their six minutes that they have with the woman sitting in front of them, they don’t have time to talk to them about anxiety and painful sex and sleep issues and joint pain and migraines and all the other things that are related to perimenopause. So they come to us, and we are able to have much longer conversations with them. We’re set up for much longer conversations. And our people are really trained to know women’s bodies. And you know, most primary care people, they don’t specialize in women’s issues, right? They have you’re going to have pink eye, or you’re going to then come in with cholesterol, cholesterol issues, or diabetes, or, you know, heart issues, and they don’t have time to focus just on the women’s specific issues, and so a lot of doctors will send people to us to do that for them.

Kara Goldin 13:35
So you mentioned breast cancer, because it’s definitely, I feel like, although the treatments for breast cancer are definitely better every single year, what are some of the issues that, or I should say, what are some ways that somebody who has gone through breast cancer and then they’re referred to you. I mean, what have you, I guess. What are the things that are kind of thought like, I can’t take hormones because I’ve had breast cancer, but actually, you might be able to do X, and I’m not asking you to, to prescribe or or, obviously, but if you could sort of story tell around somebody that has had that experience.

Joanna Strober 14:24
Yeah, so if you have estrogen positive breast cancer, you’re likely not to be able to take hormones. Some people can, and we can. If you’re interested in that, you have to book a visit with MIDI, because I’m not going to be able to get into all the medical specifics here, but if it’s been more than five years, you should talk to us about that. However, for most women, they cannot take hormones if they have estrogen positive breast cancer. That said, there’s so many, so many things you can do. You can pick SSRIs at a low dose that help you with mood issues. You can take gabapentin, which can work very well for sleep and also for night flat night sweat regulation. Black cohosh is something else that you can take for hot flashes. Then there’s actually also new medications out there, and the last two years from a few drug companies that actually make really good, non hormonal hot flash and other symptom things that can make you feel better. So there are a lot of options, and I think what so dr Mindy Goldin, who is our Chief Medical Officer, she was at UCSF, and she ran the survivorship clinic there. So this is one of our specialties. And what she says is, you do not need to suffer if you, even if you had breast cancer, what happens is, those doctors, they just, they’re so worried about the cancer, they don’t worry enough about what happens after the cancer. But the reality is, you do not need to suffer, and there’s a lot that we can do. And then the other thing actually, is vaginal estrogen is totally fine for people who have cancer. So, you know, painful sex is something that happens to 95% of us. It gets much worse. If you had cancer, you can use vaginal estrogen and strengthen the walls of your vagina and make it moisture and make it so sex is pleasurable again, and that is totally fine for women who had cancer. So there are a lot of things, and all of our providers are basically trained so that we don’t say, you know, you just have to suffer. Instead, we’re here to help.

Kara Goldin 16:26
So we talked about the insurance aspect of this, I guess. What can you walk us through the process? So somebody is listening to this podcast, they’re they’re like, Okay, I’m going to go check it out now and and see exactly how this works. Can you explain what the process that somebody will go through when they’re signing up for Midi Health?

Joanna Strober 16:50
Yeah, it’s really easy. I mean, essentially, you go on our website, you see, if we take your insurance, we take most PPO plans in California, we have great insurance. In some states, we have less good insurance, but we’re by the end of this year, we’ll have all the PPO plans on this on the system, and then you book a visit with one of our providers, and then you will come for that visit. We will send you in advance a long questionnaire, which we would love you to fill out beforehand so that we can be the most prepared for your visit. We will then talk to you about hormone options, about supplement options, about lifestyle options, give you some choices so that you’re making the decisions, not us. Instead, we’re going to give you the understanding of what your options are, so that then you can try the different medications, and then you’ll come back and you will titrate, because titrating is key. You don’t just slap something on you don’t just slap on a patch, right? You might want to pie a patch that’s a certain percentage. And you might want to try a progesterone a certain percentage. And then you’ll see how you feel. Maybe you’ll want to up that a little bit or decrease it, depending on how you’re feeling. Maybe you want to add testosterone. You’re interested in using testosterone, and after a few visits, we might add that as well, but we think of it very much as a titration exercise to make sure that you have enough time in between visits to test and see how you’re feeling. And then we iterate with you until you feel good. And then you might just come back once a year to titrate, or you might come back because you have a new symptom, and maybe you start having itchy ears, or you want to come back and talk about your face because or your hair, because you’re starting to have some hair issues, because that’s another part of menopause. You might also be worried about osteopenia or osteoporosis, and you want to make sure you have the right things for that. So really, what we’ve created is a room for women’s health and a place of women’s health experts to come back whenever you have questions,

Kara Goldin 18:46
so you also have tons of content too. So I think that there’s such a great opportunity too. That’s what I love about what you’re doing as well, that it’s not just about you, but you can also learn through other people’s experiences, and what is the newest, latest and greatest research to you guys have put so much time and effort into that, which I think is it’s just super valuable. In fact, I was at my hair salon and I and my my hairdresser was talking about you guys, and of course, didn’t really know that you were going to be on the podcast. But anyway, I was just really excited about what she was saying. How much so

Joanna Strober 19:29
you know, one thing that happens in your before I was before I started taking my hormones. I don’t know about you, I had all these little hairs here because my hair was falling out and getting really thin, and um, I went back to a hairdresser that I hadn’t gone to for a long time, and he’s like, What are you doing? Like, your hair is completely changed. That’s hormones, you know. But no one tells you that as your hormones go down, it’s going to impact your hair, and it’s going to impact your your face, which is going to start feeling dry and brittle, and there’s you. Can put estrogen cream on for that, but, like, there’s just not enough knowledge, because who’s ever taken care of your hair doesn’t understand hormones, or the dermatologists aren’t trained in hormones, so no one’s viewing you as a woman, like first and foremost, right? And that, like so many, so many aspects of our lives are dominated by hormones, and if you can understand them, and understand how they go up and down and how they regulate them, you can give them the right treatment. But there’s just not enough women’s health experts out there to do that. So that’s what we’re doing, is training an army of women’s health experts who can then give you that care.

Kara Goldin 20:34
Do you think you’ll ever go beyond women? Because I think that there’s men’s issues as well, and we hear more and more about that, I also feel like, you know, clearly, there’s, there’s teams that are that go through, you know, this, not the same issues, but but hormonal issues that could be prevented in many ways. So one

Joanna Strober 21:01
of the things I joke about is I say that we’re the hymns for people who want to talk right? Like you can go to a product company, you can go to hymns or row and buy it. If you’re a guy, you can buy a hair loss product, or you can buy an erectile dysfunction product. But the truth is, there are men who actually want to talk too, right? And they want to say, can you explain to me the difference between these five different things, and I’m also worried about this, and I’m also worried about this, so we’re not doing men now, but I could envision a world in which we would, because I’m getting a lot of men asking me, saying, You know what about me? Like, who’s supposed to talk to me? And you know, we’re not, we’re not training that. We’re not trained in that right now, but we will eventually.

Kara Goldin 21:44
Yeah, I could see you, I could definitely see you guys doing this, and I feel like a lot of these, a lot of the health issues that you are addressing now, they do spill over, not only into, you know, the physical but the also the emotional and mental aspects of women’s health. Can you talk a little bit more about that?

Joanna Strober 22:04
Yeah, you know, honestly, marriage is the best example, right? Like, the truth is, I was at a party this weekend, and this woman said, she comes up to me and she goes, you know, before I went to MIDI, I thought we were going to get divorced, and her husband comes walking up. He’s like, I thought we were gonna get divorced too and

Kara Goldin 22:25
and only laugh about that, right?

Joanna Strober 22:28
It was, but they said, and this was, you know, at a party, and they were pretty open about it. They said it was not about sex. It was that she was angry all the time, and she was a she was super frustrated and angry. And he was feeling the sad that his wife was angry at him all the time, and they were thinking that they needed to get divorced. And she said, like, now they have a new marriage after going to MIDI and getting the right medications. And, you know, he said to me, why did this take so long, like, and I think that’s, you know, the interesting thing. Like, he was like, why did it take so long for her to know about you? Because we really had some hard years. And I’m not, you know, someone said to me the other day, you’re blaming it on the women. I’m not blaming it on anyone. You know, marriage is hard. We’re all going to acknowledge marriage is hard. I’ve been married for 27 years. It’s not always easy to be marriage, right to be married. That said when your hormones are off and you don’t feel right, everything feels worse, and so you have less tolerance and you have less resilience. And I think estrogen coming back up just helps you to feel better, which then makes the whole world easier. So and honestly, I’ll tell you, I get notes all the time from young women who say, I need you to help my mom. Like they’re like my mom is really struggling and suffering, and it’s really hard for me to see my mom. Can you talk to my mom?

Kara Goldin 23:50
Oh my gosh.

Joanna Strober 23:55
You know that happens a lot. You just wouldn’t believe and then also, on LinkedIn, I get these matches as men, can you please talk to my wife? I really think she’s going through what you’re posting about, and I need her to get care so we just haven’t made this an open conversation. Like, why have we not? Why are we secretive about this? Like, we just need to, kind of, like, yell about it, and we need to say, like, this is what’s going on in our bodies, and it’s fixable, not embarrassing if you know it’s fixable. So let’s get you the right care so you can feel good. And that’s really what this is about, me. Is just enabling people to get the right care so they can thrive in their lives.

Kara Goldin 24:31
So it’s so true. So building a company is hard work. What’s been your biggest I can’t believe we pulled this off. Moment at Midi Health. Oh,

Joanna Strober 24:44
you know, honestly, not going to say it’s one thing, but the concern at the beginning was, could we scale this great care? We had some amazing providers we started with, and what I was most worried about is, could we have 1000s. Of people providing that high quality care. You know, when you think about the Four Seasons Hotels right, like they have figured out how to scale service, customer service, right? And they they do that really well. And there are other organizations that do that well too, but I just think of them because they are so you know, prize themselves on their customer service. We are a customer service company. I have an army of providers who are working from their houses around the country, and I need to make sure that every time a patient comes to me, I provide really high quality care. And so the question has been, can I scale that and with it is working, I’m really proud of the fact that it is working. You know, I would say that my mom or my sister could go to any of our providers, and I wasn’t sure that was the case. Like at the beginning, when my mom came, I was like, Oh, you have to go to x provider. And you, you know, when my sister, as I made sure that, like they went to certain people. But now actually, we have the training system, and we have a lot of information for the NPS online to make sure that they can do this care really well. So now I’m feeling like we can really scale this and make sure that everyone gets access to really good care.

Kara Goldin 26:17
So what’s the one thing you wish every women, every woman in midlife, knew about their health and their options.

Joanna Strober 26:27
Honestly, it sounds trite that you don’t have to suffer. I mean, I think we have so many ideas about suffering is okay. You know, when your eyes go bad, you get glasses, right? You don’t say, Okay, I’m gonna have bad eyes. But for some reason, for the rest of these symptoms, the doctors have just said for women for generations, just you’ll be fine, just deal with it. And that, you know, we’ve kind of accepted, I think we’ve accepted women’s pain, quite honestly, and we’ve just accepted that women are gonna feel shitty. And I just don’t think we should do that anymore. I think if you’re not feeling right, you deserve a provider who’s going to listen to you and give you things to try. No gatekeeping, no like, oh well, there’s these medications, but you’re not sick enough to try them, who’s deciding if you’re sick enough to try them? Like, you know, honestly, who is making those decisions? There’s a lot of gatekeeping in the industry that we need to get rid of. So if there’s a medication and it is safe for you to try, you should try it, and you should see if you feel better. And we should demand better care. And we should demand that our providers understand women’s bodies and understand how to take care of us and we don’t have to suffer. And I just feel really strongly about that?

Kara Goldin 27:40
Yeah, no, I love that. Well, Joanna, thank you so much for joining us today and sharing your incredible journey. And MIDI, health is amazing. I’m so proud of you, what you’re building. I mean, I mean that sincerely, and everyone needs to sign on, even if you’re a gentleman and you’re curious about it. I mean, I do. I really, everyone’s got a mom and a sister, and not that you should be telling them that they need to go to Midi Health, but they might, they might. Right. So you just never

Joanna Strober 28:15
we need to do gift certificates. We were thinking that we haven’t done totally gift certificates that men could give to their spouse for. Like, here you go.

Kara Goldin 28:23
Yeah, no, I love it. And for everyone listening, we’ll have all the info in the show notes. But it’s, it’s really, really something that that Joanna is just killing it, and I appreciate that you’re focusing on this and scaling it and and doing all the right things for so many women. So thank you again, and thank you everyone

Joanna Strober 28:47
for listening. Yeah, this was so fun. Thank you.

Kara Goldin 28:51
Thanks again for listening to the Kara Goldin show. If you would please give us a review and feel free to share this podcast with others who would benefit. And of course, feel free to subscribe so you don’t miss a single episode of our podcast, just a reminder that I can be found on all platforms at Kara Goldin, I would love to hear from you, too. So feel free to DM me, and if you want to hear more about my journey, I hope you will have a listen or pick up a copy of my Wall Street Journal, best selling book undaunted, where I share more about my journey, including founding and building. Hint we are here every Monday, Wednesday and Friday. Thanks for listening, and goodbye for now. You.

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