Vira is motivated to make lives happier, healthier and more productive for the 1bn women worldwide (13m UK) coping with menopause. 80%+ of women with menopause report symptoms that interfere with daily life and 50% say it has made work difficult or untenable, with 900k UK women quitting jobs annually. Symptoms include physical (hot flushes, weight gain, loss of libido) and psychological (mood swings, difficulty concentrating, depression, anxiety). Menopause can have severe long-term health implications: issues affecting women in later life, including cardiovascular disease, diabetes, osteoporosis and dementia, can be triggered at menopause. Improving treatment for menopause is urgently needed. Yet the current care model is broken, with <10% of UK women saying they are unhappy with the care they receive. To address this, Vira has created two digital products: * Our first product, Stella, is a personalised menopause treatment and coaching app for women, and is already transforming symptom management. It enables women to access support -- individually or via B2B subscriptions made by their workplace -- including exercise and diets plans, information, online yoga classes, access to cognitive behaviour therapy, etc. * Our second product, Stella+, is a clinical assessment tool for menopause, designed to support GPs and allied health professionals, including pharmacists, in making better decisions about prescriptions of hormone replacement therapy (HRT), and to optimise treatment review processes, with better identification of treatment ineffectiveness, side and adverse effects. Stella+ builds upon our Class IIa algorithms for prescribing HRT. This project will co-develop a pharmacy-led menopause care service so that women across the UK initially, and then across the US, will be able to go to their local pharamacy to access: 1) easy, affordable high-quality menopause prescribing via Stella+, and 2) ongoing, scientifically validated holistic, psychological menopause support (digital and in-person - pharmacists) - via Stella.

Vira is motivated to make lives happier, healthier and more productive for the 1bn women worldwide (13m UK) coping with menopause. 80%+ report symptoms interfere with daily life and 50% say it has made work difficult or untenable, with 900k UK women quitting jobs annually. Symptoms include physical (hot flushes, weight gain, loss of libido) and psychological (mood swings, difficulty concentrating, depression, anxiety). Menopause can have severe long-term health implications: issues affecting women in later life, including cardiovascular disease, diabetes, osteoporosis and dementia, can be triggered at menopause. Improving treatment for menopause is urgently needed if we are to tackle these early on. The current care model is broken, with <10% of UK women saying they are happy with the care they receive. Fixing the model is a key priority of the All-Party Parliamentary Group on Menopause, which sets out need for urgent help for women: boosting support in the workplace, training on symptoms for health workers, improving access to treatment, and checks for all women at 45\. To address this, Vira has devised its Stella platform: Our first product, _Stella_, is a personalised menopause treatment and coaching app for women, and is already transforming symptom management. It enables women to access support --individually or via B2B subscriptions made by their workplace -- including exercise and diets plans, information, online yoga classes, access to cognitive behaviour therapy, etc. This project addresses the specific problems of training health practitioners and improving access to treatment by delivering Stella+. Stella+ is a clinical assessment tool for menopause, designed to support GPs and allied health professionals in making better decisions about prescriptions of hormone replacement therapy (HRT), and to optimise treatment review processes, with better identification of treatment ineffectiveness, side and adverse effects. Stella+ will build upon our Class IIa algorithms for prescribing HRT.

Menopause is a natural component of ageing, where hormonal changes eventually cause periods to stop. UK women reach menopause at age 51 on average, with symptoms lasting 4-12 years\[1\]. 90% of women experience symptoms of which there are 30+\[5\]. Symptoms dramatically impact physical and mental health, including hot flushes, weight gain, joint pain, libido changes, insomnia, depression and anxiety. Symptoms make working, socialising and remaining active extremely challenging, contributing 14mn UK sick days\[3\] and forcing 1mn women to retire prematurely annually, often at their career's peak\[4\]. Additionally to immediate symptoms, menopause has long-term health implications(AppQ4). Dropping oestrogen levels negatively impact bone density and insulin sensitivity, increasing the chance of osteoporosis and diabetes\[15-16\]. Vasomotor symptoms (hot flushes/heart palpitations/blood pressure changes) occur due to constriction/dilation of blood vessels momentarily disrupting blood supply to organs (inc.brain), increasing the likelihood of developing heart disease and dementia\[13-16\]. Two thirds of people with Alzeihmers are women, menopause is a significant trigger\[17\]. Given average life expectancy for UK women is 82.9 years\[18\], women live with the impacts post-menopause for 30+ years. Menopause is a pivotal time, where appropriate treatment can fundamentally change the trajectory of lifelong health, increasing life expectancy. Whilst menopause impacts 20% of the working-age population\[2\], current support is severely lacking. Only 1/5 OB/GYN consultants receive menopause training, 40% of GPs are unaware of options\[35\], and specialist clinics are scarce. As a result, misdiagnosis is frequent and many women are prescribed antidepressants or sleeping pills instead of menopause treatment. Whilst HRT can be effective, it cannot be prescribed in all cases (history of certain cancers, blood clots, high blood pressure\[1\]). The British Menopause Society recognises the need for a "holistic, individualised approach in assessing and advising women, with particular reference to lifestyle advice and dietary modification"\[14\], meaning the solution is more complex than HRT. Andrea Berchowitz and Dr Rebecca Love co-founded ViraHealth in 2019, developing Stella to revolutionise menopause care. Utilising the latest scientific advancements and expert menopause-specialists, Stella provides personalised, holistic and scientifically-validated treatment through the app. Women choose their unique combination of symptoms, how disruptive these symptoms are, and Stella generates a tailored treatment plan, including live interaction with coaches. 80% of women who complete their Stella plan report improved symptoms. This project will engage with a diverse range of women to ensure Stella is relevant and engaging for all, improving programme commitment and supporting long-lasting habit-formation to improve health outcomes in later-life.