Inside Build Health International's new Maternal Center of Excellence in Sierra Leone

The complicated history behind hormone replacement therapy

Executive Summary In this episode of MedCity Fem Forward, host Marissa Plescia sits down with Janna Manjelievskaia, Director of Health Economics and Outcomes Research at Veradigm, to unpack the company's 2026 Women's Health Report. The conversation covers the flawed science behind the 2002 Women's Health Initiative press conference that drove HRT prescribing to near zero, how real-world EHR data shows prescribing is finally climbing again, and what physician clinical notes reveal about the fear-based medicine that still shapes conversations between providers and patients today. Key Takeaways * HRT prescribing collapsed after a 2002 WHI press conference due to a misrepresentation of risk: the reported 24% relative increase in breast cancer incidence corresponded to an absolute risk increase of just 0.1%. * Veradigm's EHR data shows HRT use among eligible women has more than doubled since 2020, reaching 11% among women 50 and older in 2024, with a notable uptick beginning around 2022. * Analysis of physician clinical notes reveals that risk communication centered on breast cancer still dominates HRT discussions, with virtually no mention of cardiovascular benefits, despite modern evidence supporting them. * Women's health research remains chronically underfunded: less than 8% of the NIH budget is dedicated to it, and women were only required to be included in federally funded clinical trials 33 years ago. * Contraindications are not the primary driver of HRT underutilization. A sensitivity analysis with no restrictions showed rates nearly identical to the restricted cohort, pointing to other barriers. Links & Resources Marissa Plescia, Host Email: mplescia@medcitynews.com [mplescia@medcitynews.com] LinkedIn: linkedin.com/in/marissaplescia [https://www.linkedin.com/in/marissaplescia/] Keywords hormone replacement therapy, HRT, women's health, perimenopause, menopause, real world evidence, EHR data, Veradigm, Women's Health Initiative, WHI, breast cancer risk, PCOS, PMOS, cardiovascular health in women, women's health research funding, menopause treatment trends, HRT prescribing, MedCity Fem Forward, Janna Manjelievskaia, Marissa Plescia, fear-based medicine, NIH women's health Episode Highlights * [00:01:17 - 00:03:59] Janna describes her background in health policy and epidemiology and how Veradigm's EHR network powers real world evidence research across therapeutic areas. * [00:04:00 - 00:06:05] Janna explains why women's health remains underfunded, citing the less than 8% NIH budget share and the 33-year-old requirement for women's inclusion in federally funded trials. * [00:06:06 - 00:07:34] Janna shares her personal experience with nearly two decades of misdiagnosis before a correct PCOS identification, and how that shaped her research priorities. * [00:07:35 - 00:09:40] Discussion of why midlife was chosen as a key focus: it is when women are often at their professional and financial peak, yet many leave the workforce due to menopausal symptoms. * [00:09:41 - 00:10:03] Janna explains that menopause is technically just a day, determined retroactively, and that no single medical specialty owns it. * [00:10:04 - 00:14:46] Walk-through of the Women's Health Initiative: its design, the synthetic hormones used (not the FDA-approved products in use today), and how the press conference preceding publication caused a collapse in prescribing. * [00:14:47 - 00:15:18] The 24% relative risk increase vs. the 0.1% absolute risk increase in breast cancer incidence, and why reporting only the relative number was an egregious misinterpretation. * [00:15:26 - 00:19:58] Veradigm's EHR analysis: HRT use reached 11% in 2024 among women 50+, more than double the 2020 level, with the sharpest rates in the 54 to 56 age range at 17%. * [00:19:59 - 00:23:22] Analysis of 2024 physician clinical notes shows breast cancer risk still dominates HRT discussions, with virtually no mention of cardiovascular benefits. * [00:23:23 - 00:25:02] Janna's call to action: persistent gaps in diagnosis, treatment, and evidence alignment exist across all stages of women's health, from adolescence through post-menopause.

Inside Partum Health's partnership with UChicago Medicine with Meghan Doyle

Episode Summary In this episode of Med City Fem Forward, host Marissa Plescia sits down with Meghan Doyle, CEO and co-founder of Partum Health, to explore how innovative care models are reshaping maternal health. Meghan shares how her personal experience as a mother revealed critical gaps in the healthcare system, inspiring her to build a company focused on comprehensive, patient-centered support during pregnancy and postpartum. The conversation dives into Partum Health's new partnership with the University of Chicago Medicine, which provides 24/7 access to doula support during labor and delivery—at no cost to Medicaid patients. Meghan explains the measurable impact doulas have on birth outcomes, maternal satisfaction, and postpartum health, as well as the broader mission to integrate multidisciplinary care (including mental health, nutrition, and physical therapy) into the maternal journey. This episode highlights the importance of continuous, preventive care and the role of partnerships in addressing disparities and improving maternal health outcomes at scale. Links & Resources * Connect with Marissa Plescia * mplescia@medcitynews.com * https://www.linkedin.com/in/marissaplescia/ [https://www.linkedin.com/in/marissaplescia/] Keywords Maternal health postpartum care doula support healthcare innovation Medicaid telehealth women's health birth outcomes healthcare access patient experience preventive care maternal mortality healthcare partnerships digital health care navigation lactation support behavioral health Episode Highlights * 00:00–01:00 – Introduction to Meghan Doyle and Partum Health's mission * 01:00–02:00 – How personal motherhood experience revealed gaps in maternal care * 02:00–03:00 – Overview of Partum Health's multispecialty care model * 03:00–04:00 – Origin of the University of Chicago partnership * 04:00–05:00 – Launch of 24/7 doula access during labor and delivery * 05:00–06:00 – Key benefits of doula care backed by research * 06:00–07:00 – Impact on C-section rates, birth outcomes, and patient satisfaction * 07:00–08:00 – Importance of postpartum care and maternal mental health * 08:00–09:00 – Navigating postpartum support and care continuity * 09:00–10:00 – Workforce challenges and scaling doula access * 10:00–11:00 – Why in-person support still matters in an AI-driven world * 11:00–12:00 – Addressing disparities in maternal health outcomes * 12:00–13:00 – Vision for full-spectrum maternal care access * 13:00–14:00 – Expanding beyond doulas: mental health, nutrition, PT * 14:00–16:00 – Future growth through partnerships with health systems

ACOG's new guidelines around endometriosis

Summary In this episode of the Med City Fem Forward Podcast, host Marissa Plescia speaks with Dr. Barbara Levy about the latest clinical guidance on endometriosis from American College of Obstetricians and Gynecologists. The conversation highlights a major shift in how endometriosis is diagnosed—from invasive surgical confirmation to a clinical, symptom-based approach centered on listening to patients. Dr. Levy explains the systemic nature of the disease, its widespread impact (affecting ~10% of women), and the historical challenges women have faced due to dismissal and lack of objective diagnostic tools. The episode also explores modern, multidisciplinary treatment approaches, the importance of addressing chronic pain holistically, and the urgent need for better medical training and research into root causes. Ultimately, this discussion reframes endometriosis care as a patient-centered, whole-body experience. Links & Resources * Connect with Marissa Plescia * mplescia@medcitynews.com [mplescia@medcitynews.com] * https://www.linkedin.com/in/marissaplescia/ [https://www.linkedin.com/in/marissaplescia/] Keywords Endometriosis women's health chronic pain ACOG guidelines pelvic pain Diagnosis healthcare innovation Gynecology Inflammation Fertility patient-centered care virtual health Visana Health chronic illness medical education pain management OB-GYN holistic care Episode Highlights * 00:00–00:28 – Introduction to new endometriosis guidelines and guest * 00:00:37–00:01:11 – Dr. Levy's background and overview of Visana Health * 00:01:50–00:02:28 – What endometriosis is: a systemic inflammatory condition * 00:02:28–00:03:26 – Key shift: diagnosis no longer requires surgery * 00:03:26–00:03:54 – Importance of validating women's symptoms * 00:04:17–00:04:49 – Prevalence: ~10% of women affected globally * 00:04:49–00:05:52 – Historical dismissal and impact on quality of life * 00:06:45–00:07:48 – Modern treatment: from diet to hormonal therapy * 00:07:48–00:08:42 – Chronic pain, muscle tension, and mind-body connection * 00:08:53–00:10:01 – Personalized care approach at Visana Health * 00:10:01–00:11:19 – Education gaps in medication usage * 00:11:37–00:12:10 – Why diagnosis has been historically difficult * 00:13:47–00:15:02 – Need for research into root causes and biomarkers * 00:15:52–00:17:28 – Gaps in physician training on chronic pain * 00:17:47–00:18:53 – Final message: listening to women is key to better care

Inside Build Health International's new Maternal Center of Excellence in Sierra Leone

Episode Summary In this episode of Med City Fem Forward, host Marissa Plescia speaks with Allison Adamson, architect at Build Health International, about the creation of a Maternal Center of Excellence in Sierra Leone — a project designed to transform maternal healthcare delivery in one of the world's highest-risk regions for childbirth. Allison explains how healthcare infrastructure directly impacts patient outcomes, why design choices influence trust and dignity in care, and how global partnerships are addressing preventable maternal mortality. The conversation explores how architecture, community collaboration, and sustainable healthcare systems come together to support women before, during, and after childbirth. Listeners will gain insight into how thoughtful healthcare design can save lives, empower communities, and reshape global health equity — and why American healthcare stakeholders should pay attention to these efforts. Links & Resources * Connect with Marissa Plescia * mplescia@medcitynews.com [mplescia@medcitynews.com] * https://www.linkedin.com/in/marissaplescia/ [https://www.linkedin.com/in/marissaplescia/] * Allison Adamson * Guest Email aadamson@buildhealthinternational.org Keywords Maternal health Global health infrastructure Healthcare architecture Women's health equity Maternal mortality prevention Build Health International Partners In Health Sierra Leone healthcare Global nonprofit healthcare Healthcare design innovation Maternal Center of Excellence Healthcare access Equitable healthcare systems Global public health Hospital design Community-centered healthcare Medical infrastructure development Women's healthcare systems Nonprofit healthcare partnerships Healthcare sustainability Episode Highlights 00:04–00:21 – Introduction to the episode and focus on global women's health infrastructure 00:26–01:15 – Allison Adamson introduces Build Health International and its global mission 01:15–02:44 – Origins of the Maternal Center of Excellence and partnership with Partners In Health 02:44–03:32 – Sierra Leone's healthcare challenges and maternal mortality crisis 02:53–05:26 – Inside the 120-bed maternal facility and range of care services offered 03:32–04:40 – Designing dignity, trust, and comfort into healthcare environments 03:50–04:13 – Mother dormitories supporting families with babies in NICU care 04:13–05:03 – Education spaces and community health engagement within the hospital 05:29–06:50 – Lessons learned from healthcare projects in Haiti and other countries 06:58–08:12 – Community collaboration and clinician input shaping the design process 08:12–08:47 – Partners In Health's operational role in delivering care 09:02–10:42 – Why global healthcare infrastructure matters to American audiences 10:09–10:42 – Repurposing medical equipment to expand global healthcare access 10:50–11:57 – Future projects supporting women's health and healthcare systems worldwide

Why women's health is a scalable sector

Summary In this episode of MedCity FemForward, reporter Marissa Plescia talks with Anna Jeter of AOA Dx. about a pivotal report on the booming potential of women's health sectors. Discover why this already lucrative field isn't just a niche but a smart investment, with 27 unicorns and over $100 billion in exits. Whether you're an entrepreneur or investor, tune in to learn why women's health is not only crucial for societal well-being but also a golden business opportunity.. Episode Highlights 00:10:47 - Misconception of women's health as niche. 00:11:59 - $100 billion in women's health exits. 00:17:26 - 27 unicorns in women's health. 00:31:28 - Diagnostics as a foundational pillar. 00:42:39 - Oncology as a hot spot in women's health. 00:53:11 - Women's health beyond maternal health. 01:15:45 - Response to JP Morgan presentation. 01:41:26 - Women's health as a significant business opportunity. Episode Resources * Anna Jeter * anna.jeter@aoadx.com * Connect with Marissa Plescia * mplescia@medcitynews.com [mplescia@medcitynews.com] * https://www.linkedin.com/in/marissaplescia/ [https://www.linkedin.com/in/marissaplescia/] Keywords * MedCity FemForward * women's health * AOADx * biotech * ovarian cancer detection * diagnostic test * women's health exits * investments in women's health * healthcare sector * McKinsey report * trillion dollar opportunity * merge and acquisition * IPO * exit strategy * unicorns in women's health * oncology * breast cancer * cervical cancer * screening programs * capital efficiency * funding allocation * PitchBook * healthcare innovation * strategic buyers * investment opportunities