Podcast Summary
Podcast: You Are Not Broken
Host: Dr. Kelly Casperson
Episode: 354. Building Companies, Busting Myths, And The Power Of Hormones
Guest: Joanna Strober, CEO of MIDI Health
Date: January 18, 2026
Main Theme & Episode Overview
This episode delves into the intersection of business innovation, women’s empowerment, and hormone health. Dr. Kelly Casperson talks with Joanna Strober, CEO of MIDI Health—a rapidly growing women’s telehealth company focused on providing accessible, insurance-covered menopause and perimenopause care. The conversation highlights the massive care gap for menopausal women, the myths and biases surrounding hormone therapy, and the critical need for better education, research, and health system reform. Throughout, the hosts tackle both the scientific landscape and the real-world impact of proactive, evidence-based hormone care.
Key Discussion Points & Insights
The Genesis of MIDI Health and Its Mission
[00:33–03:34]
- Joanna Strober describes MIDI Health’s rise from a two-provider Facebook pilot (serving 150 patients) to now caring for 25,000 women per week.
- The initial inspiration: both founders struggled to find adequate, insurance-covered menopause care and realized the need for widespread accessible services.
- MIDI’s innovation:
- Focuses on training providers who lacked menopause education (especially post–Women’s Health Initiative era).
- Secured insurance contracts covering 70 million women to expand access.
“Our key differentiator is that we believe women deserve this care covered by insurance.” — Joanna Strober [02:40]
The Unmet Need and "Menopause Math"
[03:34–05:04]
- Only ~5% of eligible women are on hormone therapy, though 80+ million women in the U.S. are over 40.
- Dr. Casperson and Strober stress that training all clinicians won’t be enough; platforms like MIDI Health are essential to bridge the gap.
“I believe about 90% of women over 40 should be on hormone therapy. So the menopause math is actually pretty disconcerting.” — Joanna Strober [04:45]
Provider Training: From “No” to “Yes”
[05:09–05:57]
- Historically, women were almost automatically denied hormone therapy, especially if there were any perceived risks.
- MIDI Health’s philosophy: shift training from “automatic no” to informed, safety-based “yes” when suitable.
“Our goal is to get them to yes as long as it's safe. So we think of it as a getting to yes training system...” — Joanna Strober [05:40]
The Broad Tent of Hormone Therapy
[05:57–06:20]
- Hormone therapy is more than oral estrogen:
- Includes testosterone, progesterone, DHEA, various delivery methods, etc.
- Misconceptions persist about what “hormones” means.
“It's an apothecary. I joke. We have an apothecary.” — Joanna Strober [06:16]
Joanna Strober’s Background & Personal Motivation
[07:55–09:32]
- Previous company: Kerbo Health (digital therapeutic for childhood obesity).
- Experience in digital health showed the potential for remote, impactful care.
- Frustration with slow-moving, conservative organizations (e.g., Weight Watchers) prompted Strober to apply her knowledge to menopause care, recognizing the synergy between hormones and weight.
“What I had realized is that I could take all of that learning and turn it into a menopause company, which was much more interesting...” — Joanna Strober [09:32]
Interconnectedness of Hormones, Weight, and Health in Midlife
[09:44–11:00]
- MIDI was among the first to offer GLP-1 medications alongside hormone therapy, leading to better outcomes in weight and muscle maintenance.
“Women's health between 40 and 60 is essentially hormones and weight...I don't think you can take care of weight without thinking of hormones and vice versa.” — Joanna Strober [09:51]
The Slow March of Research & the Case for Pragmatic Action
[12:15–14:52]
- Many clinicians still cite a lack of gold-standard RCTs for hormones preventing Alzheimer’s.
- Both hosts argue existing mechanistic and epidemiological data are compelling, and awaiting “perfect” trials is impractical.
“If I have to wait for the research that demonstrates 100% that hormone therapy prevents Alzheimer's, I might be dead.” — Joanna Strober [12:34]
Busting Myths:
“You’re Done with Menopause”
[15:27–17:28]
- Many women believe menopause ends with hot flashes or periods, failing to realize that low hormones persist for life.
- MIDI seeks to shift this narrative and show that hormone therapy has benefits even post-menopause.
“You're not done with aging. It's almost like saying you're done with aging, like saying you're done with menopause." — Joanna Strober [16:10]
“You Can’t Start Hormones If You Still Have Periods”
[17:28–18:13]
- Another myth: women believe hormone therapy is only for after periods end.
- The need for nuanced, symptom- and hormone-based care is stressed.
Shifting the Culture & Creating a Grassroots Movement
[18:53–19:28, 25:51–26:26]
- True change will be driven by empowered women demanding better care, not by top-down mandates.
- Millennials and younger women are pushing for proactive approaches, influencing older generations’ expectations.
“It's going to be a movement demanded by women...very much a bottoms up movement of women saying I deserve better care.” — Joanna Strober [18:53]
The Power of Feedback & Transformative Patient Stories
[22:20–24:07]
- MIDI routinely receives stories of “saved” marriages, jobs, and restored wellbeing.
- The impact is frequently immediate and profound.
“Honestly...the reality is once you get someone on the right medication, they feel better very fast. And then they're kind of amazed...” — Joanna Strober [22:54]
Medical Bias Against Addressing Female Suffering
[24:50–25:51]
- Systematic downplaying of women’s symptoms and suffering is called out as both misogynist and illogical.
“When our eyes go bad, we get glasses...But don't replace your ovaries. Like, it becomes this one exclusionary organ.” — Dr. Kelly Casperson [25:33]
Data, Double Standards, and Testosterone
[29:48–33:51]
- There’s extensive, accepted testosterone data in men but huge barriers to women accessing even basic prescriptions.
- MIDI is expanding access state-by-state; research on testosterone’s broader benefits (beyond libido) is emerging and promising.
“There's many more benefits of testosterone...so we are now retraining all of our providers on this new research.” — Joanna Strober [31:42]
Longevity and Women’s Health as a System
[28:47–29:27]
- The goal: not just longer life but better, more independent years—running after grandkids, maintaining energy and function.
- Hormones as a “female longevity” medicine.
“Hormones help healthy cells stay healthy.” — Dr. Kelly Casperson [29:14]
Patient Autonomy and Shared Decision-Making
[36:17–37:28]
- The MIDI philosophy prioritizes access and choice, moving away from a “gatekeeper” approach.
“If women are interested in things...give them access to what they'd like to try, see if they feel better. If it's no downside, why not?” — Joanna Strober [35:30]
Mythbusting: No Age Limit, No Arbitrary Stop
[39:57–41:52]
- The idea that women must eventually stop hormones is unsupported.
- The new guidelines: so long as benefit outweighs risk, continued therapy is appropriate.
“You should never go off of your hormones...I'm gonna die with my patch on, and I don't know why they would ever stop taking it.” — Joanna Strober [40:11]
Business Model & The Role of Telehealth
[46:00–47:34]
- MIDI Health aims for scalability—concierge care alone can’t meet demand; virtual “mass transit” is needed.
- The traditional healthcare system is incentivized towards procedure-heavy specialties, not preventive women’s care.
“The healthcare system pays a lot more for procedures and surgeries...than it does for this type of care. Which means...the healthcare system itself is not going to build more of this care.” — Joanna Strober [46:31]
Notable Quotes & Memorable Moments
-
On the scale of MIDI’s care:
“Mitty takes care of a town of women every single week. That's like a large stadium of women every single week.” — Dr. Kelly Casperson [01:05] -
On patient wins:
“Usually we save their marriage, we enable them to go back to work... They go on and on and on. It's pretty remarkable.” — Joanna Strober [22:20] -
On systemic bias:
“Why is it that we have not thought about the same for women's bodies? And instead we've just been very willing to accept...they are just less important as they get older.” — Joanna Strober [25:21] -
On shared decision making:
“What I learned in medical school...shared decision making. And every time women's health comes up, it's like we forget about shared decision making again.” — Dr. Kelly Casperson [36:17] -
On Telehealth’s impact:
“We need mass transit to solve...We cannot concierge our way out of this problem.” — Dr. Kelly Casperson [46:00] -
On the vision for MIDI:
“What MIDI is building is a healthcare home for women. And we want to make sure that women have a place to go for all of their women oriented things.” — Joanna Strober [44:54]
Key Timestamps for Must-Hear Segments
- [01:02] - MIDI Health in numbers: serving 25,000 women/week
- [03:34] - The post-Women’s Health Initiative education gap
- [05:09] - Training providers: moving from “no” to “yes” in menopause care
- [10:11] - Hormones and weight loss: synergistic benefits
- [12:15] - Limitations of waiting for research “proof” in prevention
- [16:20] - Changing the cultural narrative: “You’re not done with menopause”
- [18:53] - “Bottom up” change: Why empowered women will reshape care
- [22:20] - Real patient impact and gratitude
- [29:14] - Hormones as the foundation of female longevity
- [31:42] - Testosterone: emerging research and access hurdles
- [39:57] - The myth of inevitable hormone discontinuation
- [44:54] - MIDI’s vision for a true healthcare home
- [46:00] - Why telehealth and mass transit models are essential
Conclusion
This engaging, myth-busting episode highlights how determined individuals are tackling one of healthcare’s greatest blind spots: midlife women’s health. Joanna Strober shares a visionary business approach to bridging the menopause care gap, while Dr. Casperson underscores the urgent need to correct longstanding misconceptions and biases around hormones, autonomy, and aging. Both advocate for clinical pragmatism, shared decision-making, and a future where empowered women drive demand for the care they need—and deserve.