The women’s health renaissance: From niche to necessity

Women’s health has been a notoriously underserved area. This is not only true in nutraceuticals, but also pharmaceuticals and research more broadly. As a result, women have a poor understanding about how they can address the many changes their bodies undergo throughout their lifetime. Thankfully, this is changing rapidly, as manufacturers realize the opportunity for addressing the spectrum of need states that women experience.

“The women’s health market has experienced exponential growth over the past decade,” says Monica Olivares Martin, RD&A director, women & infant health at Kerry (Naas, Ireland). “Historically, most clinical research was conducted on men until the 1990s, leaving researchers to play catch-up in understanding the differences between male and female health, with female-specific conditions like menopause and mastitis almost completely ignored. This renewed focus on women’s health has driven a greater desire for innovative and effective solutions.”

Tackling the complex needs of women is no easy task, but luckily there are a number of neglected areas that companies can focus on to help fill in the gaps in women’s health. The opportunity for research and development is there, and consumers are receptive to innovative solutions.

From Menstruation to Menopause

Menstruation and menopause are two milestones of a woman’s life that can be difficult and scary to navigate. When women first menstruate, they are at a vulnerable age, and how prepared they are depends entirely on the resources and education they have access to. While women become accustomed to this monthly ritual, they are often forced to contend with unpleasant symptoms with little help in the way of relief. Over-the-counter drugs may be of some assistance, but there is increasingly a demand for alternative solutions.

Recently, a randomized, crossover, double-blind, placebo-controlled trial was conducted to determine the effectiveness of Palmitoylethanolamide (PEA) on acute menstrual pain.¹ In that 16-week study, 80 menstruating females with self-reported mild to moderate menstrual pain were given either the placebo or 350 mg of Levagen+ (which contained no less than 300 mg of PEA), sold by Gencor (Austin, TX), with instructions to take the capsules once menstrual pain reached a certain threshold, based on the numerical rating scale (NRS) of one to 10. A menstrual pain event was considered any day during menstruation with a score of at least 5 on the numerical rating scale (NRS).

Each time a pain score of 5 was reached, participants were instructed to take one capsule and then complete the NRS every 30 minutes for the next two hours. Additionally, a Treatment Satisfaction Questionnaire for Medication (TSQM) was completed within 12 to 24 hours of consuming the product to evaluate overall satisfaction with it. A total of 76 participants recorded at least one pain event. After ingestion of PEA, recorded menstrual pain was decreased at 1, 1.5, and 2 hours afterwards, with a reduction of at least 25% by 2.5 hours, compared with placebo.

More research is necessary, but it’s a promising development for an extremely underserved area. “We’ve had really positive feedback on this first study, and it’s kind of a vicious cycle with women’s health ingredients,” explains Christopher Bailey, Gencor’s director of scientific affairs. “There’s not a lot of research, and if there’s not compelling structure, function claims that brands can make, that means that there’s less excitement about new product development. Now there’s less sales of those products, and then brands think, if the sales interests are low, there’s no need to make those products, and in reality, it’s just there’s not enough options available that’s going to catch the eye of the consumer and compel them to buy that product.”

Menopause can be even more alienating and difficult to navigate for women because of the complex range of symptoms and lack of awareness among women and their families about how to address the changes they are undergoing.

“Women may spend up to 40% of their lives in their post-menopausal years,” says Martin. “Hormonal changes associated with menopause can lead to a variety of visible symptoms like hot flashes, mood swings, and sleep disturbances, affecting approximately 80% of women. With an estimated 1 billion women expected to be in menopause in 2025, it is vital that solutions that provide targeted support are available in the market.”²

Ashwagandha, such as Kerry’s Sensoril ashwagandha, is one ingredient that has been shown in research to help alleviate menopause symptoms. “Sensoril improves menopause-specific quality of life and supports symptom management across various domains: vasomotor (e.g., hot flashes, sweating, and night sweats), psychosocial (e.g., cognitive and mood changes), physical (e.g., sleep issues, fatigue, strength, stamina, energy, appearance, aches and pains, gas, and urination), and sexual (e.g., sexual desire, intimacy and vaginal dryness) in post-menopausal women,” explains Martin.

These benefits were demonstrated in a recent randomized, double-blind, placebo-controlled study,³ in which 127 women between the ages of 40 to 55 years old were given either ashwagandha or shatavari. More specifically, women were assigned to one of six groups: 1) placebo, 2) 250 mg of ashwagndha, 3) 500 mg of ashwagandha, 4) 250 mg of shatavari, 5) 500 mg of shatavari, and 6) 250 mg of ashwagandha + 250 mg of shatavari. The participants were analyzed over a 24 week period and during that time had blood samples collected.

Results showed that those taking ashwagandha experienced a 24% decrease in the presence and severity of vasomotor symptoms, a 16% decrease in the presence and severity of psychosocial symptoms, a 14% decrease in the presence and severity of physical symptoms connected to sleep, aches and pains, strength, stamina, fatigue, energy, and appearance, as well as a 13% decrease in the presence and severity of issues related to sexual health. Supplementation with shatavari also saw a dose-dependent effect in vasomotor, psychosocial, and physical domains.

Another herbal ingredient that may help with menopause symptoms is Tongkat ali (Eurycoma longifolia). According to Annie Eng, CEO of HP Ingredients (Bradenton, FL), which manufactures LJ100 Tongkat Ali, the extract is not only effective at supporting testosterone production in men, but also progesterone in women. Progesterone is a hormone that decreases during menopause resulting in the various symptoms related to menopause.

Eng cites a 12-week randomized, double-blind, placebo-controlled, parallel-group trial awaiting publication in the World Journal of Clinical Cases in November that found the branded Tongkat ali at a dose of 100 mg per day was able to significantly improve menopausal quality of life (MENQOL), mood states (Profile of mood, POMS), and energy (Chalder Fatigue Scale, CFS). The extract was also able to significantly increase progesterone levels after six weeks, compared to placebo.4

Pycnogenol, a branded French maritime pine bark extract from Horphag Research (Hoboken, NJ), may also support menopause symptoms. For example, one small study with 38 women found that supplementation with 100 mg of Pycnogenol over eight weeks significantly improved symptoms of hot flushes, night sweats, mood swings, irregular periods, loss of libido and vaginal dryness, compared to placebo. The extract was also shown to significantly lower oxidative stress, which is common in menopausal women.5

Speaking of oxidative stress, according to Kaneka Nutrients’ (Pasadena, TX) medical affairs consultant, Melissa Olivadoti, PhD, ubiquinol may be a valuable addition to menopause support product because of its antioxidant activity.

“Estrogen is a powerful antioxidant in the female body,” explains Olivadoti. “In women going through perimenopause and menopause, estrogen levels fluctuate and eventually decline, naturally reducing the antioxidant protection estrogen typically provides. Oxidative stress also increases during these years, partly due to the decreased antioxidant activity associated with lower estrogen levels, and partly due to age.6 However, supplementation of ubiquinol can support the decline in antioxidant activity during this time.”

Olivadoti cites an internal consumer use study in which 200 women between the ages of 45 and 55 experiencing menopause symptoms saw significant improvements in symptoms after two months of taking 200 mg of ubiquinol twice per day. “At the end of the study, 81% of participants reported feeling less irritable, 82% feeling less sensitive, 82% feeling less stressed, 69% having less muscle or joint discomfort, and 79% reporting better sleep compared to baseline.,” she explains.

There are also greater implication menopause has on women’s overall health, further supporting the supplementation of ubiquinol. “As the body ages, ubiquinol levels decrease due to an increase in oxidative stress and a decrease in the body’s ability to convert ubiquinone to ubiquinol,” explains Olivadota.^{7, 8} “This deficit cannot be replenished by diet alone, as foods are relatively low in ubiquinol.9 Oxidative stress can damage mitochondria, cells, and tissues, which is why it is associated with common age-related health conditions.^{10,11, 12} In addition, women who are in their post-menopausal years have higher oxidative stress than those who have not yet undergone menopause.”¹³

There is also an increased risk to cardiovascular health for menopausal women. Olivadoti explains that the decrease in estrogen and the resulting oxidative stress can cause the oxidation of low-density lipoprotein (LDL) in the blood. This is called lipid peroxidation, which can make LDL more likely to stick to blood vessel walls and damage endothelial cell membranes.¹⁴

Probiotics are another potential asset formulators can use in menopause support products. Of course, benefits depend on the particular strains that are used. Kaneka Probiotics (Pasadena, TX), for example, has developed a blend of three strains (Levilactobacillus brevis KABP 052, Lactiplantibacillus plantarum KABP 051 and Pediococcus acidilactici KABP 021), called KABP Menopause, that may help modulate estrogen levels in healthy peri- and post-menopausal women. In a recent study, researchers performed in vitro screenings of β-glucuronidase activity for 84 strains belonging to 16 different species of lactic acid bacteria and bifidobacteria.¹⁵ The gut is involved in regulating endogenous estrogen levels, and that a portion of estrogen glucuronides can be reactivated by β-glucuronidase, which is a microbial enzyme. Results showed that L. brevis KABP052 had the highest level of β-glucuronidase activity.

“The other two strains were selected due to evidence of inhibiting opportunistic pathogens that could improve gut homeostasis,” explains Jordi Riera, chief business officer, Kaneka Probiotics. “By enhancing the estrobolome pathway—the collection of gut microbial genes involved in the metabolism of estrogens—KABP Menopause was formulated to help slow the hormonal decline associated with menopause and was shown in a clinical study to support balanced estrogen levels through a natural, microbiome-based approach.”

Hormone Balance

A unique area of opportunity for women’s health is hormone balance, according to Martin. “The hormone lifecycle spans across a woman’s whole life, beginning with menstruation and continuing until post menopause,” she explains. “Given hormones are crucial for regulating various bodily processes, normal hormonal balance is a key concern for consumers and by extension innovators in the women’s health space, with the women’s hormonal supplements market expected to reach US$8.5 Bn by 2032.”¹⁶

Martin points out that hormonal imbalances can also cause chronic conditions such as Polycystic Ovary Syndrome (PCOS), which impact 10-15% of women of reproductive age. Additionally, this condition is linked to ovulatory fertility disorders, and women with PCOS may be at a higher risk of type 2 diabetes, high blood pressure, and cardiovascular conditions, once again highlighting that the failure to address certain health needs can precipitate into other health problems. For supporting hormone balance and fertility, Kerry offers Caronisitol, which is a natural source of D-Chiro-Inositol.

According to Martin, this is a “comprehensive approach for supporting normal hormonal balance and regularizing menstrual cycles. When the endogenous production of Inositols is insufficient to meet the human biological needs, an adequate intake of this inositol either through specific food and/or supplements becomes necessary. This clinically studied D-Chiro-Inositol supports by ensuring inositol status is in range with results seen after just three months.”^{17, 18}

Urinary Tract Infection

Another important area of support for women is urinary tract support. Urinary tract infections are the most common outpatient infections affecting 50-60% of adult women at least once in their lifetime.¹⁹ Following a UTI, 30-40% of women will have a recurrent UIT and 50% are likely to have a third episode if they’ve had two UTIs in six months.²⁰ This presents an area of need for proactive support, and even in acute support as an adjunct to typical treatments like antibiotics.

The contract manufacturer, Pharmalinea (Ljubljana, Slovenia), recently announced the results of a study²¹ demonstrating the benefits of its formulation >Your< UTI Free Sachets, which contains 2000 mg of D-mannose, 500 mg of Qcran, a proprietary whole-fruit cranberry powder, and 40 IU of vitamin D₃. In the study, 98 female subjects between the ages of 18 and 80 with active acute cystisis were randomized into parallel groups to receive either the antibiotic treatment alone (control) or the antibiotic in combination with >Your< UTI Free Sachets.

Results showed that after 12 weeks, the control group had a significantly higher rate of relapse (77.6%), compared to the group receiving the combined treatment (19.2%). There was also a significant improvement of quality of life in subjects taking the combined treatment (20%).

“Prior to formulating >Your< UTI Free Orosticks, we identified a clear need for nutritional interventions in urinary tract health, since traditionally the options were limited to drinking cranberry juice or seeking antibiotic treatment,” explains Veronika Pipan, head of scientific support at PharmaLinea. “Both approaches have significant drawbacks: cranberry juice’s efficacy is questionable at best, and antibiotics, while highly efficient at clearing infections, fail at a critical task that tremendously affects the quality of life of UTI patients—recurrent infections. There are also relatively few natural alternatives that are backed by adequate clinical evidence, and even among those, the quality and consistency of research can vary significantly.”

For Pharmilinea, the recurrence of UTI was the crucial pain point they wanted to address. “We knew we needed to find the right ingredients with the potency, quality, and safety to handle this task,” says Pipan. “There was emerging science on the potential of D-mannose, and on the correlation between vitamin D deficiency and UTI recurrence. We suspected pairing those with cranberry would produce an efficient formulation, however, not every cranberry ingredient is created equal. Through years of R&D we ended up with our own proprietary 100% whole fruit cranberry ingredient Qcran, whose production process results in high levels of actives and a unique protective mechanism, leading to higher efficacy.”

A recent Cochrane review, for example, found that out of 50 studies with a total of 8857 randomized participants, the evidence provided moderate certainty that cranberry products reduced the risk of UTIs.²² The most important factor that determines the efficacy of cranberry products is the content ofproanthocyanidins (PACs) prevents bacteria from sticking to the bladder walls. It is therefore recommended that formulators seek out products with standardized levels of PACs. While there is no official recommendation for PAC content in cranberry products, there is a qualified health claim for reducing the risk of UTI approved by FDA for products that contain a daily serving of 500 mg of whole-fruit cranberry.²

Conclusion

This article barely scratches the surface of the many health needs women have. While many companies are taking the initiative to do research and develop novel solutions to meet unmet needs, there is still more work that needs to be done. Education is an important element to consider here as well.

“As a leader in this space, we understand that our role also needs to go beyond providing solutions; we also need to help educate individuals on discrepancies in women’s health and the women’s health gap that exists,” says Martin. “To support this, we have created ‘HerWay’, an impactful online resource for women and those who care for them. It houses information and science-backed research on health issues unique to the female body.”

Companies like Gen M also work with brands and retailers to help women identify “menopause-friendly” products, helping to take the guesswork out of managing their many symptoms. The company has even partnered with ingredient suppliers like IFF Health, who has develop turn-key formulations for brand owners looking to get into the women’s health category.²⁴

As the category matures, so too will consumer understanding, necessitating high quality and tested products that produce results.

References 

1. Rao, A.; Erickson, J.; Briskey, D. Palmitoylethanolamide (Levagen+) for Acute Menstrual Pain: A Randomized, Crossover, Double-Blind, Placebo-Controlled Trial. Women & Health.2025, 65 (3), 237-245. DOI:10.1080/03630242.2025.2458243 
2. Talaulikar, V. Menopause transition: Physiology and symptoms. Best Practice & Research Clinical Obstetrics & Gynaecology. 2022, 81, 3-7. DOI:10.1016/j.bpobgyn.2022.03.003 
3. Pingali U.; Nutalapati C.; Wang Y.; Ashwagandha and Shatavari Extracts Dose-Dependently Reduce Menopause Symptoms, Vascular Dysfunction, and Bone Resorption in Postmenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Study. J Menopausal Med. 2025, 31 (1), 21-34. DOI: 10.6118/jmm.24025
4. Muniandi S, et al. “The effects of Eurycoma Longifolia Water Extract (Physta®) on Quality of Life of Peri and Postmenopausal Women: A Randomized, Double-Blinded, Placebo Controlled, Parallel Group Study” World Journal of Clinical Cases 2025 November 6; 13(31): 109113 
5. Errichi, S.; Bottari, A.; Belcaro, G.; Cesarone, M.R.; Hosoi, M.; Cornelli, U.; Dugall, M.; Ledda, A.; Feragalli. Supplementation with Pycnogenol improves signs and symptoms of menopausal transition. Panminerva Med. 2011, 53 (3 Suppl 1), 65-70. PMID: 22108479; 
6. Doshi, S.B.; Agarwal, A. The role of oxidative stress in menopause. J Midlife Health. 2013, 4(3):140-6. DOI: 10.4103/0976-7800.118990; 
7. Wada, H.; Goto, H.; Hagiwara, S.; Yamamoto, Y. Redox status of coenzyme Q10 is associated with chronological age. J Am Geriatr Soc. 2007, 55 (7), 1141-2. DOI: 10.1111/j.1532-5415.2007.01209.
8. Niklowitz, P.; Onur, S.; Fischer, A.; Laudes, M.; Palussen, M.; Menke, T.; Döring, F.Coenzyme Q10 serum concentration and redox status in European adults: influence of age, sex, and lipoprotein concentration. J Clin Biochem Nutr. 2016, 58 (3): 240-5. DOI: 10.3164/jcbn.15-73 
9. Bhagavan, H.N.; Chopra, R.K. Plasma coenzyme Q10 response to oral ingestion of coenzyme Q10 formulations. Mitochondrion. 2007, 7 Suppl, S78-88. DOI: 10.1016/j.mito.2007.03.003 
10. Lee-Glover, L.P.; Picard, M.; Shutt, T.E. Mitochondria - the CEO of the cell. J Cell Sci. 2025, 138 (9), jcs263403. DOI: 10.1242/jcs.263403 
11. Bratic, A.; Larsson, N.G. The role of mitochondria in aging. J Clin Invest. 2013, 123 (3), 951-7. DOI: 10.1172/JCI64125 
12. Pallotti, F.; Bergamini, C.; Lamperti, C.; Fato, R. The roles of coenzyme Q in disease: direct and indirect involvement in cellular functions. Int J Mol Sci. 2021, 23 (1), 128. DOI:10.3390/ijms23010128 
13. Vincent, J.; Inassi, J. Comparison of oxidative stress between premenopausal and postmenopausal women. Nat J Physiol Pharm Pharacol. 2020, 10 (5), 359-362. DOI: 10.3390/ijms23010128 
14. Alleva, R.; Tomasetti, M.; Bompadre, S.; Littarru, G.P. Oxidation of LDL and their subfractions: kinetic aspects and CoQ10 content. Mol Aspects Med. 1997;18 Suppl, S105-12.DOI: 10.1016/s0098-2997(97)00039-3 
15. Honda, S.; Tominaga, Y.; Espadaleer-Mazo, J.; Huedo, P.; Aguiló, M.; Perez, M.; Ueda, T.; Sawashita, J. Supplementation with a Probiotic Formula Having β-Glucuronidase Activity Modulates Serum Estrogen Levels in Healthy Peri- and Postmenopausal Women. Journal of Medicinal Food. 2024, 27 (8), 720-727. DOI: 10.1089/jmf.2023.k.0320 
16. Women’s Hormonal Supplements Market Size Analysis. SNS Insider. July 2024. https://www.snsinsider.com/reports/women-hormonal-balance-supplements-market-4427 (Accessed 2025-09-16) 
17. Mendoza, N.; Galan, M.I.; Molina, C.; Mendoza-Tesarik, R.; Conde, C.; Mazheika, M.; Diaz-Ropero, M.P.; Fonollo, J.; et al. High dose of d-chiro-inositol improves oocyte quality in women with polycystic ovary syndrome undergoing ICSI: a randomized controlled trial. Gynecological Endocrinology. 2020, 36 (5), 398-401. DOI: 10.1080/09513590.2019.1681959 
18. Kachhawa, G.; Kumar, K.V.S.; Kulshrestha, V.; Khadgawat, R.; Mahey, R.; Bhatla, N. Efficacy of myo-inositol and d-chiro-inositol combination on menstrual cycle regulation and improving insulin resistance in young women with polycystic ovary syndrome: A randomized open-label study. Int J Gynaecol Obstet. 2022, 158 (2), 278-284. DOI: 10.1002/ijgo.13971 
19. Medina, M.; Castillo-Pino, E. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol. 2019, 11, 1756287219832172. DOI:10.1177/1756287219832172 
20. Brubaker, L.; Carberry, C.; Nardos, R.; Carter-Brooks, C.; Lowder, J.L. American Urogynecologic Society Best-Practice Statement: Recurrent Urinary Tract Infection in Adult Women.Female Pelvic Medicine & Reconstructive Surgery. 2018, 24 (5), 321-335. DOI: 10.1097/SPV.0000000000000550 
21. Khodyreva, L.A.; Bernikov, A.N.; Kupriyanov, Y.A.; Arefieva, O.A.; Orešnik, M.; and Pushkar, D.Y. Prospective study on the efficacy and safety of Uronext® in parallel groups in women with acute cystitis. EC Gynaecology. 2024, 13 (2) 
22. Williams, G.; Hahn, D.; Stephens, J.H.; Craig, J.C.; Hodson, E.M.Cranberries for preventing urinary tract infections. Cochrane Database of Systemic Reviews. 2023, 11. DOI: 10.1002/14651858.CD001321.pub7.; 
23. U.S. Food and Drug Administration. FDA Announces Qualified Health Claim for Certain Cranberry Products and Urinary Tract Infections. July 21, 2020. https://www.nutritionaloutlook.com/view/fda-allows-qualified-health-claim-for-cranberry-products (Accessed 2025-09-16). 
24. Grebow, J. IFF Health partners with GenM, an organization uniting brands serving the menopause-health market. Nutritional Outlook. November 8, 2022. https://www.nutritionaloutlook.com/view/iff-health-partners-with-genm-an-organization-uniting-brands-serving-the-menopause-health-market (Accessed 2025-09-16)