Longevity science runs on one template: extend the healthy years, delay the unhealthy ones, and apply the same playbook to everyone. For women, that template starts from the wrong baseline. Women live longer than men but spend more years in poor health.
BCG’s 2026 Global Study on Longevity, conducted for the St. Moritz Longevity Forum, which surveyed 10,608 respondents across 12 countries, confirms that these differences affect how women approach longevity throughout their life. Despite being more engaged, they are not seeing improved results. A strategy that ignores these differences is missing an opportunity to serve half the population.
The Unmet Needs of Women’s Longevity
Our survey confirms that the mismatch between needs and available offerings is real. Women undergoing perimenopause or menopause transition are the most engaged longevity consumers we surveyed, but also among the least satisfied.
Across the 12 countries that we surveyed, adjusting for age, this cohort adopted longevity interventions at a rate 15 to 22 percentage points (pp) higher than other women or men did.
Strikingly, however, that higher adoption and intervention testing isn’t translating into better outcomes. Women in this cohort express no higher satisfaction than men or women at other life stages; all are stuck around 50%. (See Exhibit 2.)
In the US in particular, women in perimenopause or menopause face the widest gap between adoption and satisfaction across almost every intervention category. (See Exhibit 3.) The gap is especially pronounced in consumables, as 90% of menopausal women have tried at least one product in that category, and only 35% of them say that their needs were met.
Women’s Unique Longevity Journey
Women and men do not age along the same curve. Recognizing that fact is the starting point for any longevity strategy intended to work for women.
Women Live Longer Than Men, but also Spend More Years in Poor Health
Globally, women outlive men by roughly five years, and they spend meaningfully more years in poor health. The healthspan-lifespan gap—the years spent living with disease or disability rather than in good health—runs wider for women than for men across most countries, meaning that women spend 25% more of their lives in poor health.
In the US, women spend 13.7 years in poor health versus roughly 11.1 for men (+2.6 years), but the sex disparity climbs to 3.7 years in Germany and 3.3 years in France.
Menopause Is Not the Single Hinge Point the Market Treats It As
As we described in Closing the Menopause Care Gap, female reproductive aging is phased, not gradual as male reproductive hormone decline is. For women, a long, stable phase gives way to a hormonal transition compressed into a narrow and turbulent window: perimenopause, which typically begins in a woman’s forties and lasts four to eight years, resets her cardiovascular, bone, cognitive and behavioral health trajectories at once.
But perimenopause isn’t where the story starts. We asked respondents when they began thinking seriously about long-term health and whether they wished they had started sooner; then we measured which life events changed their mindset the most. (See Exhibit 5.) The takeaway? For women, the events that trigger an interest in long-term health most often happen years before menopause. Hormonal and contraceptive changes and fertility issues, occurring on average around the ages of 36 to 38, increase interest by 8 pp—nearly double the effect of menopause itself (5 pp). These trigger categories have no equivalent impact for men, who don’t see a similar effect until a decade later, when they begin to report direct aging triggers.
The highest-leverage window in a women’s lifelong longevity trajectory opens a decade before the market starts paying attention. And its tendency to treat the triggering events as short-term symptoms or episodes, rather than as the hinge point that they actually represent, is one of the largest blind spots in how the longevity market currently serves women.
Women’s Needs Go Undiagnosed and Undertreated
BCG’s Closing the Menopause Care Gap put it clearly: there is insufficient provider training on menopause. Even in the US, only 31% of OB/GYN residency programs include any menopause curriculum, and fewer than 7% of residents across family, internal medicine, and OB/GYN feel prepared to support menopausal patients—a shortcoming that leaves risks such as bone loss and cardiovascular disease underrecognized.
This shortfall extends well beyond menopause. Across the 12 countries we surveyed, only 63% of women consult a doctor about hormone-related issues such as PCOS, endometriosis, and menopause, compared with the 78% for cardiovascular conditions such as high cholesterol or hypertension. (See Exhibit 6.) And among those who do seek care, only 72% say that they felt taken seriously, versus 85% among women seeking care for heart-related symptoms.
The Market Imperative and Business Opportunity
As our survey confirms, women are engaged, high-spending health consumers, especially once they enter their menopause transition, yet the market has not built the products or services they need.
Women in perimenopause or menopause already spend more on longevity than any other cohort, with a median of $84 per month, compared with $68 per month for women at other life stages and $73 per month for men. (See Exhibit 7.)
Despite that higher rate of spending, roughly one-third say that they would be willing to spend more— a median incremental amount pf $108 per month—if the right product or service existed. The market is leaving money on the table.
Applied across the estimated population of 1 billion women in menopause globally who are actively engaged in longevity spending, this represents an incremental opportunity of $350 billion waiting to be tapped with the right products and services.
What would earn that spending? Much like other cohorts, women in menopause are looking for proven solutions recommended by a trusted doctor or health care provider that offer better value and minimal side effects, followed closely by insurance coverage and clinical research backing. (See Exhibit 8.)
Addressing the Mismatch
Every path through this argument—biological, structural, behavioral, or commercial—arrives at the same conclusion: women have been asked to fit a template that was never built for them.
The exclusions run deep. Until 1993, women were entirely and systematically excluded from drug trials—and more than three decades later, they still make up only 40% of clinical trial participants on average in the US. This is a meaningful gap, given that they account for 60% of the psychiatric disease burden, 51% of oncology cases, and 49% of cardiology cases.
The cost of this mismatch shows up wherever the template fails to fit: in years lived with disease, in untrained specialists, in benefits that don’t cover the care women actually need, and in demand that the market leaves unmet.
So how can stakeholders close a gap of this size? In the first place, consumer and tech companies must do better. Women in menopause transition have tried almost everything; their inability to satisfy their needs is not due to a lack of effort. If companies hope to capture a share of the $350 billion opportunity, credibility comes first. A stronger evidence base and real clinical endorsement are the price of entry, and everything follows on from that.
Health care has a promising opportunity in this regard, since doctor and health-care provider recommendations are the single biggest driver of spending for women in this life stage. It follows that the care gaps outlined here are a commercial failure as well as a clinical one. Health-care systems have a clear imperative to lead by ensuring better preparedness across specialists and by supporting more research.
Meanwhile, insurers and employers have a parallel opportunity in the form of greater affordability and better access. The demand is already there, and women are already paying out of pocket for solutions that don’t fully work. Better employer benefits would ease that burden and widen access. And since better insurance coverage increases revenue potential, those improvements would allow more companies to realize the market opportunity.
The final call to action applies to all of the different parties involved, including investors supporting innovation. Longevity has been a male-dominated field for years, both on the receiving end and in terms of founders and leaders in decision-making positions. Increased representation by women in those positions is critical to ensure that their needs are better met in the future.
The organizations that move first won’t just capture a market others overlooked. They’ll set a standard of care that the rest of the industry will eventually have to follow.
