TherapeuticsMD (TXMD) 10-K 23 Mar 22 2021 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2021	Mar. 17, 2022	Jun. 30, 2021
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Annual Report	true
Document Transition Report	false
Document Period End Date	Dec. 31, 2021
Document Fiscal Period Focus	FY
Document Fiscal Year Focus	2021
Current Fiscal Year End Date	--12-31
Entity File Number	001-00100
Entity Registrant Name	THERAPEUTICSMD, INC.
Entity Central Index Key	0000025743
Entity Tax Identification Number	87-0233535
Entity Incorporation, State or Country Code	NV
Entity Address, Address Line One	951 Yamato Road,
Entity Address, Address Line Two	Suite 220
Entity Address, City or Town	Boca Raton
Entity Address, State or Province	FL
Entity Address, Postal Zip Code	33431
City Area Code	561
Local Phone Number	961-1900
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	TXMD
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Public Float			$ 444,995,626
Entity Common Stock, Shares Outstanding		433,427,878
ICFR Auditor Attestation Flag	false
Auditor Firm ID	248
Auditor Name	GRANT THORNTON LLP
Auditor Location	Miami, Florida
Documents Incorporated by Reference	Documents Incorporated by Reference Portions of the registrant’s definitive Proxy Statement for its 2022 Annual Meeting of Stockholders are incorporated by reference into Part III of this Annual Report on Form 10-K where indicated. Such Proxy Statement will be filed with the Securities and Exchange Commission no later than 120 days after the end of the registrant’s fiscal year ended December 31, 2021.

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Current assets:
Cash	$ 65,122	$ 80,486
Accounts receivable, net of allowance for credit losses of $1,334 and $1,118 as of December 31, 2021 and 2020, respectively	36,176	32,382
Inventory	7,622	7,993
Prepaid and other current assets	10,548	7,543
Total current assets	119,468	128,404
Fixed assets, net	1,199	1,942
License rights and other intangible assets, net	40,318	41,445
Right of use assets	8,234	9,566
Other non-current assets	253	253
Total assets	169,472	181,610
Current liabilities:
Current maturities of long-term debt	188,269
Accounts payable	20,318	21,068
Accrued expenses and other current liabilities	44,304	38,170
Total current liabilities	252,891	59,238
Long-term debt, net	0	237,698
Operating lease liabilities, non-current	8,063	8,675
Other non-current liabilities	2,139
Total liabilities	263,093	305,611
Commitments and contingencies (Note 9)
Stockholders' deficit:
Preferred stock, par value $0.001; 10,000 shares authorized, none issued
Common stock, par value $0.001; 600,000 shares authorized, 429,886 and 299,765 issued and outstanding as of December 31, 2021 and 2020, respectively	430	300
Additional paid-in capital	957,309	754,644
Accumulated deficit	(1,051,360)	(878,945)
Total stockholders' deficit	(93,621)	(124,001)
Total liabilities and stockholders' deficit	$ 169,472	$ 181,610

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Statement Of Financial Position [Abstract]
Accounts Receivable, Allowance for Credit Loss	$ 1,334	$ 1,118
Preferred Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	10,000,000	10,000,000
Preferred Stock, Shares Issued	0	0
Common Stock, Par or Stated Value Per Share	$ 0.001	$ 0.001
Common Stock, Shares Authorized	600,000,000	600,000,000
Common Stock, Shares, Issued	429,886,000	299,765,000
Common Stock, Shares, Outstanding	429,886,000	299,765,000

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Total revenue, net	$ 86,951	$ 64,872	$ 49,647
Cost of goods sold	18,838	15,975	6,335
Gross profit	68,113	48,897	43,312
Operating expenses:
Selling and marketing	108,195	117,052	114,231
General and administrative	92,602	76,954	60,494
Research and development	7,086	10,432	19,792
Total operating expenses	207,883	204,438	194,517
Loss from operations	(139,770)	(155,541)	(151,205)
Other (expense) income:
Loss on extinguishment of debt			(10,058)
Interest expense and other financing costs	(32,917)	(28,581)	(17,382)
Other income, net	272	598	2,500
Total other expense, net	(32,645)	(27,983)	(24,940)
Loss before income taxes	(172,415)	(183,524)	(176,145)
Net loss	$ (172,415)	$ (183,524)	$ (176,145)
Loss per common share, basic and diluted	$ (0.43)	$ (0.67)	$ (0.72)
Weighted average common shares, basic and diluted	397,992	275,649	246,353
Comprehensive loss:
Net loss	$ (172,415)	$ (183,524)	$ (176,145)
Comprehensive loss	(172,415)	(183,524)	(176,145)
Product [Member]
Total revenue, net	85,780	62,872	34,141
License [Member]
Total revenue, net	$ 1,171	$ 2,000	$ 15,506

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' (DEFICIT) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]
Beginning balance, value at Dec. 31, 2018	$ 97,524	$ 240	$ 616,560	$ (519,276)
Beginning balance, shares at Dec. 31, 2018		240,462,000
Shares issued for sale of common stock, net of cost	77,031	$ 30	77,001
Shares issued for sale of common stock, net of cost (in shares)		29,900,000
Shares issued for exercise of warrants, net of cashless exercises		$ 1	(1)
Shares issued for exercise of warrants, net of cashless exercises (in shares)		471,000
Shares issued for exercise of options	$ 109		109
Shares issued for exercise of options (in shares)	344,000	344,000
Share-based payment award compensation costs	$ 10,682		10,682
Net loss	(176,145)			(176,145)
Ending balance, value at Dec. 31, 2019	9,201	$ 271	704,351	(695,421)
Ending balance, shares at Dec. 31, 2019		271,177,000
Shares issued for sale of common stock, net of cost	31,703	$ 27	31,676
Shares issued for sale of common stock, net of cost (in shares)		26,953,000
Shares issued for exercise of options	$ 272	$ 1	271
Shares issued for exercise of options (in shares)	1,182,000	1,182,000
Shares issued for vested restricted and performance stock units		$ 1	(1)
Shares issued for vested restricted and performance stock units (in shares)		453,000
Warrants issued in relation to debt financing agreement	$ 7,668		7,668
Share-based payment award compensation costs	10,679		10,679
Net loss	(183,524)			(183,524)
Ending balance, value at Dec. 31, 2020	$ (124,001)	$ 300	754,644	(878,945)
Ending balance, shares at Dec. 31, 2020	299,765,000	299,765,000
Shares issued for sale of common stock, net of cost	$ 184,115	$ 122	183,993
Shares issued for sale of common stock, net of cost (in shares)		121,765,000
Shares issued for exercise of warrants, net of cashless exercises	278	$ 1	277
Shares issued for exercise of warrants, net of cashless exercises (in shares)		1,103,000
Shares issued for exercise of options	$ 44		44
Shares issued for exercise of options (in shares)	111,000	111,000
Shares issued for vested restricted and performance stock units		$ 7	(7)
Shares issued for vested restricted and performance stock units (in shares)		6,806,000
Shares issued for sale of common stock related to employee stock purchase plan	$ 233		233
Shares issued for sale of common stock related to employee stock purchase plan (in shares)		336,000
Share-based payment award compensation costs	18,125		18,125
Net loss	(172,415)			(172,415)
Ending balance, value at Dec. 31, 2021	$ (93,621)	$ 430	$ 957,309	$ (1,051,360)
Ending balance, shares at Dec. 31, 2021	429,886,000	429,886,000

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities:
Net loss	$ (172,415,000)	$ (183,524,000)	$ (176,145,000)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	4,093,000	4,067,000	1,392,000
Charges to provision for doubtful accounts	533,000	238,000	318,000
Inventory charge	1,082,000	7,205,000	0
Debt financing fees	5,689,000	2,532,000	856,000
Share-based payment compensation costs	18,125,000	10,679,000	10,682,000
Write-off of patent and trademark	0	1,132,000	79,000
Loss of extinguishment of debt			10,058,000
Other	720,000	1,541,000	1,074,000
Changes in operating assets and liabilities:
Accounts receivable	(4,327,000)	(8,224,000)	(13,651,000)
Inventory	(711,000)	(3,337,000)	(8,593,000)
Prepaid and other current assets	(3,005,000)	3,209,000	(1,734,000)
Accounts payable	(750,000)	1,887,000	(3,563,000)
Accrued expenses and other current liabilities	6,134,000	2,904,000	13,675,000
Other non-current liabilities	2,139,000	220,000	(166,000)
Total adjustments	29,722,000	24,053,000	10,427,000
Net cash used in operating activities	(142,693,000)	(159,471,000)	(165,718,000)
Cash flows from investing activities:
Payment for patent related costs	(2,189,000)	(1,391,000)	(1,442,000)
Payment for intellectual property license			(20,000,000)
Purchase of fixed assets	(34,000)	(207,000)	(2,450,000)
Net cash used in investing activities	(2,223,000)	(1,598,000)	(23,892,000)
Cash flows from financing activities:
Proceeds from sale of common stock, net of costs	184,115,000	31,703,000	77,031,000
Proceeds from exercise of options and warrants	322,000	272,000	109,000
Proceeds from sale of common stock related to employee stock purchase plan	233,000
Repayments of debt	(50,000,000)		(81,661,000)
Borrowings of debt		50,000,000	200,000,000
Payment of debt financing fees	(5,118,000)	(1,250,000)	(6,652,000)
Net cash provided by financing activities	129,552,000	80,725,000	188,827,000
Net decrease in cash	(15,364,000)	(80,344,000)	(783,000)
Cash, beginning of period	80,486,000	160,830,000	161,613,000
Cash, end of period	65,122,000	80,486,000	160,830,000
Supplemental disclosure of cash flow information:
Interest paid	$ 25,068,000	25,849,000	$ 17,788,000
Supplemental disclosure of noncash financing activities:
Warrants issued in relation to debt financing agreement		$ 7,668,000

Business, basis of presentation

Business, basis of presentation, new accounting standards and summary of significant accounting policies	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Business, basis of presentation, new accounting standards and summary of significant accounting policies	1. Business, basis of presentation, new accounting standards and summary of significant accounting policies General TherapeuticsMD, Inc. (the “Company”), a Nevada corporation, and its consolidated subsidiaries are referred to collectively in this Annual Report on Form 10-K (“2021 10-K Report”) as “TherapeuticsMD,” “we,” “our” and “us.” This 2021 10-K Report includes our trademarks, trade names and service marks, such as TherapeuticsMD ® ® ® TM ® ® ® ® TM SM We are a women’s healthcare company with a mission of creating and commercializing innovative products to support the lifespan of women from pregnancy prevention through menopause. At TherapeuticsMD, we combine entrepreneurial spirit, clinical expertise, and business leadership to develop and commercialize health solutions that enable new standards of care for women. Our solutions range from a patient-controlled, long-lasting contraceptive to advanced hormone therapy pharmaceutical products. We also have a portfolio of branded and generic prescription prenatal vitamins under the vitaMedMD and BocaGreenMD brands. Our portfolio of products focused on women’s health allows us to efficiently leverage our sales and marketing plan to grow our recently approved products. Beginning in 2018, the U.S. Food and Drug Administration (“FDA”) • In July 2018, we launched our FDA-approved product IMVEXXY (estradiol vaginal inserts) for the treatment of moderate-to-severe dyspareunia (vaginal pain associated with sexual activity), a symptom of vulvar and vaginal atrophy, or VVA, due to menopause, which was approved by the FDA in May 2018. • In April 2019, we launched our FDA-approved product BIJUVA (estradiol and progesterone) capsules, our hormone therapy combination of bioidentical 17ß-estradiol and bio-identical progesterone in a single, oral softgel capsule, for the treatment of moderate-to-severe vasomotor symptoms, or VMS, due to menopause in women with a uterus, which was approved by the FDA in October 2018. • In October 2019, we began a “test and learn” market introduction for our FDA-approved product ANNOVERA (segesterone acetate and ethinyl estradiol vaginal system), the first and only annual patient-controlled, procedure-free, reversible prescription contraceptive option for women, which was approved by the FDA in August 2018 and which we have licensed for commercialization in the U.S. pursuant to an exclusive license agreement with the Population Council, Inc. (the “Population Council”), or the Population Council License Agreement. We paused the full commercial launch of ANNOVERA in March 2020 due to the impact of the COVID-19 pandemic and resumed this initiative in July 2020. We have also entered into license agreements with strategic partners to commercialize IMVEXXY and BIJUVA outside of the U.S. • In July 2018, we entered into a license and supply agreement (the “Knight License Agreement”) with Knight Therapeutics Inc. (“Knight”) pursuant to which we granted Knight an exclusive license to commercialize IMVEXXY and BIJUVA in Canada and Israel. • In June 2019, we entered into an exclusive license and supply agreement (the “Theramex License Agreement”) with Theramex HQ UK Limited (“Theramex”) to commercialize IMVEXXY and BIJUVA outside of the U.S., excluding Canada and Israel. In 2021, Theramex secured regulatory approval for BIJUVA in certain European countries and began commercialization efforts in those countries. COVID-19 With multiple variant strains of the SARS-Cov-2 virus and the COVID-19 disease that it causes (collectively, “COVID-19”) still circulating, we continue to be subject to risks and uncertainties in connection with the COVID-19 pandemic. The extent of the future impact of the COVID-19 pandemic on our business continues to be highly uncertain and difficult to predict. The ultimate global recovery from the pandemic will be dependent on, among other things, actions taken by governments and businesses to contain and combat the virus, including any variant strains, the speed and effectiveness of vaccine production and global distribution, as well as how quickly, and to what extent, normal economic and operating conditions can resume on a sustainable basis globally. Since the early phase of the COVID-19 pandemic, we have been using substantial virtual options to ensure business continuity. We have also partnered with independent community pharmacies and multiple third-party online pharmacies and telemedicine providers that focus on contraception or menopause which provide patients real-time access to both diagnosis and treatment. We continue to support prescribers’ needs with samples and product materials through our sales force. If access is restricted, we have mailing options in place for these materials. We also have business continuity plans and infrastructure in place that allows for live virtual e-detailing of our products. As part of our response to the COVID-19 pandemic, we implemented measures to reduce marketing expenses for 2020 and we also implemented cost saving measures in 2020 and 2021, which included negotiating lower fees or suspending services from third-party vendors; implementing a company-wide hiring restriction; delaying or cancelling non-critical information technology projects; and eliminating non-essential travel, entertainment, meeting, and event expenses. In addition, we implemented a significant cost savings initiative that is designed to reduce our annual costs in 2022 by at least $40.0 million. This figure does not include estimated annualized cost savings of approximately $20.0 million from, or the costs associated with the sale of vitaCare for which we signed a definitive agreement on March 6, 2022. See Note 17 – Subsequent events for a description of the vitaCare divestiture. The full impact of the COVID-19 pandemic continues to evolve. However, we remain committed to the execution of our corporate goals, despite the ongoing COVID-19 pandemic, as demonstrated in part by the increase in product revenue throughout 2021. As of the date of issuance of these consolidated financial statements, the future extent to which the COVID-19 pandemic may continue to materially impact our financial condition, liquidity, or results of operations remains uncertain. We are continuing to assess the effect of the COVID-19 pandemic on our operations by monitoring the spread of COVID-19 and the various actions implemented to combat the pandemic throughout the world. Even after the COVID-19 pandemic has subsided, we may continue to experience adverse impacts to our business as a result of any economic recession or depression that has occurred or may occur in the future. While we currently believe that our COVID-19 contingency plan has the ability to mitigate many of the negative effects of the COVID-19 pandemic on our business, the severity of the impact of the COVID-19 pandemic on our business will depend on a number of factors, including, but not limited to, the duration and severity of the pandemic, the duration of “social distancing” orders, the ability of our sales force to access healthcare providers to promote our products, increases in unemployment, which could reduce access to commercial health insurance for our patients, thus limiting payer coverage for our products, and the impact of the pandemic on our global supply chain, all of which remain uncertain. Our future results of operations and liquidity could be materially adversely affected by delays in payments of outstanding receivable amounts beyond normal payment terms, supply chain disruptions, uncertain demand, and the impact of any initiatives or programs that we may undertake to address financial and operations challenges that we may face. Going Concern We incurred a net loss of $172.4 million during the year ended December 31, 2021, and as of that date, our current liabilities exceeded our current assets by $133.4 million and our total liabilities exceeded our total assets by $93.6 million. Along with considering additional financings, we have reviewed numerous potential scenarios in connection with steps that we may take to reduce our operating expenses. Based on our analysis, we believe that our existing cash reserves along with potential proceeds from the sale of certain non-core assets of the Company and proceeds from potential future financings, if available to us, would be sufficient to meet our cash needs arising in the ordinary course of business for the next twelve months from the date of this 2021 10-K Report. If we are unsuccessful with future financings and if the successful commercialization of IMVEXXY, BIJUVA, or ANNOVERA is delayed, or the continued impact of the COVID-19 pandemic or issues in our supply chains related to our third-party contract manufacturers on our business is worse than we anticipate, our existing cash reserves would be insufficient to maintain compliance with the Financing Agreement covenants or satisfy our liquidity. See “Inventory” in Note 3 for additional information regarding risks associated with our contract manufacturers, particularly for ANNOVERA. The presence of these projected factors in conjunction with the uncertainty of the capital markets raises substantial doubt about the Company's ability to continue as a going concern for the next twelve months from the issuance of these financial statements. The accompanying consolidated financial statements do not include any adjustments that might be necessary if the Company is unable to continue as a going concern. A. Basis of presentation The consolidated financial statements and related notes include our parent company and all wholly-owned subsidiaries. The consolidated financial statements are prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). Our fiscal year-end is as of and for the year ended December 31st for each year presented. All intercompany transactions among our businesses have been eliminated. Certain amounts in the n otes to the consolidated financial statements B. New accounting standards Adoption of new accounting standards New accounting standards or accounting standards updates were assessed and determined to be either not applicable or did not have a material impact on the Company’s consolidated financial statements or processes. Accounting standards issued but not yet adopted Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting and Scope. In March 2020 and January 2021, Accounting Standards Update (“ASU”) 2020-04 and ASU 2021-01 were issued, respectively. These ASUs provide optional guidance for a limited period of time to ease potential accounting impacts associated with transitioning away from reference rates that are expected to be discontinued, such as London Interbank Offered Rate (LIBOR). These ASUs include practical expedients for contract modifications due to reference rate reform. Generally, contract modifications related to reference rate reform may be considered an event that does not require remeasurement or reassessment of a previous accounting determination at the modification date. These ASUs were effective upon issuance and may be applied prospectively to contract modifications made or evaluated on or before December 31, 2022. Our debt agreements currently include the use of alternate rates when LIBOR is not available. We do not expect the change from LIBOR to an alternate rate will have a material impact to our financial statements and, to the extent we enter into modifications of agreements that are impacted by the LIBOR phase-out, we will apply such guidance to those contract modifications. Other recently issued accounting standards not yet adopted by us are not expected, upon adoption, to have a material impact on the Company’s consolidated financial statements or processes. C. Estimates and assumptions The preparation of consolidated financial statements in conformity to U.S. GAAP requires us to make certain estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. We evaluate our estimated assumptions based on historical experience and on various other assumptions that are believed to be reasonable, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ, at times in material amounts, from these estimates under different assumptions or conditions. D . Cash We maintain cash at financial institutions that at times may exceed the Federal Deposit Insurance Corporation (“FDIC”) insured limits of $0.25 million per bank. We have never experienced any losses related to these funds. E . Accounts receivable and allowance for doubtful accounts Accounts receivable are customer obligations due under normal trade terms and are measured at amortized cost. We extend credit on an unsecured basis to most of our customers based on an evaluation of a customer’s financial condition, and collateral is not required. Our accounts receivable concentration of credit risk is primarily limited customers who are drug wholesalers and retail pharmacy distributors. We review accounts receivable for uncollectible and delinquent accounts and credit card chargebacks, and we provide an allowance for doubtful accounts, which is based upon a review of outstanding receivables, historical collection information, reasonable supportable forecasts, and existing economic conditions , and we record an allowance that presents the net amount expected to be collected. We write off uncollectible and delinquent receivables against our allowance for doubtful accounts based on individual credit evaluations, the results of collection efforts, and specific circumstances of customers. We record recoveries of accounts previously written off when received as an increase in the allowance for doubtful accounts. To the extent data we use to calculate these estimates does not accurately reflect bad debts, adjustments to these reserves may be required. Our exposure to credit losses may increase if our customers are adversely affected by changes in healthcare laws, coverage, and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, disruption associated with the current COVID-19 pandemic, or other customer-specific factors. Although we have historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of trade receivables in the future. F . Inventories Inventories represent pharmaceutical products, packaged vitamins and raw materials which are valued at the lower of cost or net realizable value. Our pharmaceutical products are valued using first in first out method and our vitamins are valued using the average-cost method. We review inventories for excess and obsolescence, and we write-down obsolete or otherwise unmarketable inventory to its estimated net realizable value. Obsolescence may occur due to product expiring, product improvements rendering previous versions obsolete, or decreases in demand for our products. G . Fair Value Measurements Fair value is the price to sell an asset or transfer a liability and therefore represents an exit price in the principal market (or in the absence of a principal market, the most advantageous market). It represents a market-based measurement that contemplates a hypothetical transaction between market participants at the measurement date. The unique characteristics of an asset or liability and the availability of observable prices affect the number of valuation approaches and/or techniques used in a fair value analysis. We measure fair value using observable and unobservable inputs. We give the highest priority to quoted prices (unadjusted) in active markets for identical assets or liabilities (Level 1 inputs) and the lowest priority to unobservable inputs (Level 3 inputs). We apply the following fair value hierarchy: • Level 1 - Quoted prices (unadjusted) in active markets for identical assets and liabilities. • Level 2 - Quoted prices in non-active markets or in active markets for similar assets or liabilities, observable inputs other than quoted prices; and inputs that are not directly observable but are corroborated by observable market data. • Level 3 - Inputs that are unobservable. The carrying amount of our cash, accounts receivable, accounts payable and accrued expenses approximate their fair value because of the short-term maturity of such instruments, which are considered Level 1 under the fair value hierarchy. The carrying amount of our debt approximates fair value since it bears interest either at variable rates or fixed rates which are not significantly different from market rates, which are considered Level 2 under the fair value hierarchy. H . Fixed assets Fixed assets are carried at cost less accumulated depreciation and amortization. We charge maintenance costs, which do not significantly extend the useful lives of the respective assets, and repair costs to operating expenses as incurred. We compute depreciation using the straight-line method over the estimated useful lives of the related assets, which range from three to seven years. Leasehold improvements are depreciated over the shorter of their useful life or the term of the lease. Long-lived assets held and used by us, including fixed assets, are assessed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. We capitalize software and software development costs incurred to create and acquire computer software for internal use, principally related to software coding and application development. We begin to capitalize software development costs when both the preliminary project stage is completed, and it is probable that the software will be used as intended. Capitalized software costs include only external direct costs and services utilized in developing or obtaining computer software. Capitalized software costs are amortized on a straight-line basis when placed into service over the estimated useful life, generally five to seven years. I. License rights and other intangibles assets We record license rights and other intangible assets at cost, which includes external costs, consisting primary of legal costs, incurred in securing our patents and trademarks. We started amortizing license rights cost once ANNOVERA became commercially available for use. License rights cost is amortized over the useful life over which the license rights will contribute directly or indirectly to our cash flows, which is estimated to be the remaining patent life of ANNOVERA, expiring in June 2039. The cost is amortized using the straight-line method as the pattern of economic benefit cannot be reliably determined. Intangible assets subject to amortization, such as patents, are amortized over the useful life of the patent using the straight-line method. If the patent is not granted, we write-off any capitalized patent costs at that time. Intangible assets not subject to amortization, such as trademarks, are perpetual and have indefinite lives. We review license rights and other intangible assets subject to amortization on a periodic basis to determine whether events and circumstances would indicate impairment or warrant a revision to their remaining useful lives. We assess other intangible assets not subject to amortization for potential impairment at least annually during the fourth quarter of each year, J. Segment reporting We manage and operate as one business, which is focused on creating and commercializing products targeted exclusively for women. Our business operations are managed by a single executive leadership team, which is led by our chief executive officer. We do not operate separate lines of business with respect to any of our products, and we do not prepare discrete financial information with respect to separate products. All product sales are derived from sales within the United States. Accordingly, we view our business as one reportable operating segment. With one geographic location. K. Revenue recognition We determine the amount of revenue to be recognized through application of the following steps: • Identification of the contract with a customer; • Identification of the performance obligations in the contract; • Determination of the transaction price; • Allocation of the transaction price to the performance obligations in the contract; and • Recognition of revenue when or as we satisfy the performance obligations. Essentially all of our revenue is generated through contracts with our customers, who are primarily wholesale distributors and retail pharmacies. A performance obligation is a promise in a contract to transfer a product or service to a customer. A good or service is considered to be transferred when the customer receives the goods or service or obtains control, and we treat shipping as a fulfillment activity rather than as a separate obligation. We generally recognize revenue at a point in time when all of our performance obligations under the terms of a contract are satisfied. Revenue is recognized upon transfer of control of promised products or services in an amount that reflects the consideration we expect to receive in exchange for those products or services. The collectability of consideration on the contract is reasonably assured before revenue is recognized. To the extent that customer payment has been received before all recognition criteria are met, these revenues are initially deferred in other accruals on the balance sheet and the revenue is recognized in the period that all recognition criteria have been met. Prescription products Prescription products are sold at fixed wholesale acquisition cost, or WAC, determined based on our list price. However, the total transaction price is variable as it is calculated net of estimated product returns, chargebacks, rebates, coupons, discounts and wholesaler fees. These estimates are based on the amounts earned or to be claimed on the related sales and are classified as reductions of accounts receivable (if the amount is payable to the customer) or a current liability (if the amount is payable to a party other than a customer). To determine the transaction price, we estimate the amount of variable consideration at the outset of the contract either utilizing the expected value or most likely amount method, depending on the facts and circumstances relative to the contract or each variable consideration. The estimated amount of variable consideration is included in the transaction price only to the extent that it is probable that a significant reversal in the amount of cumulative product revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved. In determining amounts of variable consideration to include in a contract’s transaction price, we rely on our historical experience and other evidence that supports our qualitative assessment of whether product revenue would be subject to a significant reversal. We consider all the facts and circumstances associated with both the risk of a product revenue reversal arising from an uncertain future event and the magnitude of the reversal if that uncertain event were to occur. Actual amounts of consideration ultimately received may differ from our estimates. If actual results in the future vary from our original estimates, we will adjust these estimates, which would affect net product revenue and earnings in the period such changes in estimates become known. We accept returns of unsalable prescription products sold through wholesale distributors within a return period of six months prior to and up to 12 months following product expiration. ANNOVERA cannot be returned before the expiration date and expired ANNOVERA can be returned up to 12 months past the expiration date. Our prescription vitamins, IMVEXXY and BIJUVA currently have a shelf life of 24 months from the date of manufacture and ANNOVERA currently has a shelf life of 18 months from the date of manufacture. We do not allow product returns for prescription products that have been dispensed to a patient. We estimate the amount of our product sales that may be returned by our customers and record this estimate as a reduction of product revenue in the period the related product revenue is recognized. Where historical rates of return exist, we use history as a basis to establish a returns reserve for products shipped to wholesalers. For our newly launched products, for which the right of return exists but for which we currently do not have history of product returns, we estimate returns based on available industry data, our own sales information and our visibility into the inventory remaining in the distribution channel. At the end of each reporting period, we may decide to constrain product revenue for product returns based on information from various sources, including channel inventory levels and dating and sell-through data, the expiration dates of products currently being shipped, price changes of competitive products and any introductions of generic products. We recognize the amount of expected returns as a refund liability, representing the obligation to return the customer’s consideration. Since our returns primarily consist of expired and short dated products that will not be resold, we do not record a return asset for the right to recover the goods returned by the customer at the time of the initial sale (when recognition of product revenue is deferred due to the anticipated return). We offer various rebate and discount programs in an effort to maintain a competitive position in the marketplace and to promote sales and customer loyalty. We estimate the allowance for consumer rebates and coupons that we have offered based on our experience and industry averages, which is reviewed and adjusted, if necessary, on a quarterly basis. We record distributor fees based on amounts stated in contracts. We estimate chargebacks based on number of units sold during the period taking into account prices stated in contracts and our historical experience. We provide discounts to our customers for prompt payment. Consumer rebates and coupons costs, distribution fees, chargebacks and discounts are deducted from gross product revenue at the time the product revenue is recognized. For our prescription products, we offer a co-pay assistance program for eligible enrolled patients whose out of pocket costs are reduced to a more affordable price. This allows patients to access the product at a reasonable cost and is in line with our responsible pricing approach. We reimburse pharmacies for this discount through third-party vendors. The variable consideration is estimated based on contract prices, the estimated percentage of patients that will utilize the copay assistance, the average assistance paid, the estimated levels of inventory in the distribution channel and the current level of prescriptions covered by patients’ insurance. Payers may change coverage levels for our prescription products positively or negatively, at any time up to the time that we have formally contracted coverage with the payer. As such, the net transaction price of our prescription products is susceptible to such changes in coverage levels, which are outside the influence of the Company. As a result, we constrain variable consideration for our prescription products to an amount that will not result in a significant product revenue reversal in future periods. Our ability to estimate the net transaction price for our prescription products is constrained by our estimates of the amount to be paid for the co-pay assistance program which is directly related to the level of prescriptions paid for by insurance. As such, we record an accrual to reduce gross sales for the estimated co-pay and other patient assistance based on currently available third-party data and our internal analyses. We re-evaluate variable consideration each reporting period. License revenue License arrangements may consist of non-refundable upfront license fees, exclusive licensed rights to patented or patent pending technology, and various performance or sales milestones and future product royalty payments. Some of these arrangements may include multiple performance obligations. Non-refundable up-front fees that are not contingent on any future performance by us, and do not require continuing involvement on our part, are recognized as revenue when the right to use functional intellectual property is transferred to the customer. L. Cost of sales Cost of sales includes the cost of inventory, manufacturing, manufacturing overhead and supply chain costs and product shipping and handling costs. The Population Council License Agreement requires royalty payments based on our net sales of ANNOVERA, which are recorded as a component of cost of sales. Additionally, the amortization costs of license rights are recorded as a component of cost of sales. M. Research and development Research and development expenses include internal R&D activities, costs of services of third-party contract research organizations (“CROs”) and usage of their clinical research sites, manufacturing, scale-up and validation costs, and other activities. Internal R&D activity expenses include laboratory supplies, salaries, benefits, and share-based payment award compensation costs. CRO activity expenses include preclinical laboratory experiments and clinical trial studies. Other activity expenses include regulatory consulting and other costs. The activities undertaken by our regulatory consultants that were classified as R&D expenses include assisting, consulting with, and advising our in-house staff with respect to various FDA submission processes, clinical trial processes, and scientific writing matters, including preparing protocols and FDA submissions. These consulting expenses were direct costs associated with preparing, reviewing, and undertaking work for our clinical trials and investigative drugs. We charge internal R&D activities and other activity expenses to operations as incurred. We make payments to CROs based on agreed-upon terms, which may include payments in advance of a study starting date. We expense nonrefundable advance payments for goods and services that will be used in future R&D activities when the activity has been performed or when the goods have been received rather than when the payment is made. We review and accrue CRO expenses and clinical trial study expenses based on services performed and rely on estimates of those costs applicable to the completion stage of a study as provided by CROs. Estimated accrued CRO costs are subject to revisions as such studies progress to completion. We charge revisions to expenses in the period in which the facts that give rise to the revision become known. N. Share-based payment awards We account for share-based payment awards on a fair value basis of the equity instrument issued. Under fair value accounting, the grant-date fair value of the share-based payment award is amortized as compensation expense, on a straight-line basis, over the service period (generally, the vesting period) for both graded and cliff vesting awards. We have elected to account for forfeitures as they occur. O. Income taxes Income taxes are accounted for under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases, and operating loss and income tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted income tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in income tax rates is recorded as a component of the income tax provision in the period that includes the enactment date. Regular assessments are made on the likelihood that our deferred tax assets will be recovered from our future taxable income. Our evaluation is based on estimates, assumptions, and includes an analysis of available positive and negative evidence, givi

Accounts receivable

Accounts receivable	12 Months Ended
	Dec. 31, 2021
Receivables [Abstract]
Accounts receivable	2. Accounts receivable The following sets forth activities in our allowance for credit losses (in thousands): 2021 2020 2019 Balance as of beginning of period $ 1,118 $ 904 $ 597 Charges to provision for credit losses 533 238 318 Write-off of uncollectible receivables (317 ) (24 ) (11 ) Balance as of end of period $ 1,334 $ 1,118 $ 904

Inventory

Inventory	12 Months Ended
	Dec. 31, 2021
Inventory Disclosure [Abstract]
Inventory	3. Inventory We rely on third parties to manufacture our finished products, and we have entered into long-term supply agreements for the manufacture of ANNOVERA, IMVEXXY, and BIJUVA. We do not have a long-term supply agreement for the manufacture of our prescription vitamins. Additionally, we do not have long-term contracts for the supply of all the active pharmaceutical ingredient (“API”) used in ANNOVERA and BIJUVA. One of our third-party contract manufacturers that manufactures ANNOVERA has recently experienced an increase in difficulties with manufacturing of ANNOVERA, which has resulted in intermittent supply of ANNOVERA for commercial distribution. The challenges are multifactorial and include variability in raw material supply and normal manufacturing variation due to a semi-manual process. This has recently resulted in challenges to supply ANNOVERA consistently within the approved specification at a rate that meets the projected demand for ANNOVERA. To mitigate the manufacturing challenges, in August 2021, we filed a supplemental New Drug Application (“NDA”) with the FDA to modify the testing specifications for ANNOVERA to allow increased consistency of supply of ANNOVERA. In December 2021, FDA determined that it could not approve supplemental NDA without additional information. In its complete response letter (“CRL”), the FDA provided recommendations and requested additional information that could support approval of revisions to certain testing specifications. In January 2022, we responded to the CRL, and provided the requested additional information to the FDA and modified the request for the manufacturing testing limits based on the FDA recommendations. We expect a response from the FDA by the end of second quarter of 2022. We will continue to manufacture and supply ANNOVERA under the existing specifications. In the meantime, our third-party contract manufacturer may not be able to supply us with sufficient ANNOVERA to adequately supply the market, which would have an adverse effect on our business, results of operations and financial condition. We have also experienced a greater than expected amount of raw materials for ANNOVERA being out of specification. If any of our third-party contract manufacturers or any suppliers of raw materials or API experience further difficulties, do not comply with the terms of an agreement between us, or do not devote sufficient time, energy, and care to providing our manufacturing needs, or if the manufacturing specification modifications that we have requested are not approved by the FDA, we could experience additional interruptions in the supply of our products, which may have a material adverse impact on our revenue, results of operations and financial position. Our inventory consisted of the following (in thousands): As of December 31, 2021 2020 Raw materials $ 3,042 $ 3,748 Work in process 1,642 895 Finished products 2,938 3,350 Inventory $ 7,622 $ 7,993 During 2021 and 2020, we recorded inventory charges of $1.1 million and $7.2 million, respectively. The charge recorded for 2020 was primarily a result of the impact of the COVID-19 pandemic on our business, which decreased demand for our products. No inventory charge was recorded for 2019.

Prepaid and other current asset

Prepaid and other current assets	12 Months Ended
	Dec. 31, 2021
Prepaid Expense And Other Assets Current [Abstract]
Prepaid and other current assets	4. Prepaid and other current assets Our prepaid and other current assets consisted of the following (in thousands): As of December 31, 2021 2020 Insurance $ 2,731 $ 2,568 Paragraph IV legal proceeding costs 2,304 — Other 5,513 4,975 Prepaid and other current assets $ 10,548 $ 7,543

Fixed assets

Fixed assets	12 Months Ended
	Dec. 31, 2021
Property Plant And Equipment [Abstract]
Fixed assets	5. Fixed assets Our fixed assets, net consisted of the following (in thousands): As of December 31, 2021 2020 Furniture and fixtures $ 1,407 $ 1,407 Computer and office equipment 1,855 1,784 Computer software 375 412 Leasehold improvements 80 80 Fixed assets 3,717 3,683 Less: accumulated depreciation and amortization 2,518 1,741 Fixed assets, net $ 1,199 $ 1,942 We recorded depreciation expense of $0.8 million for 2021 and 2020, and $0.4 million for 2019.

Licensed rights and other intan

Licensed rights and other intangible assets	12 Months Ended
	Dec. 31, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Licensed rights and other intangible assets	6. Licensed rights and other intangible assets The following provides information about our license rights and other intangible assets, net (in thousands): As of December 31, 2021 As of December 31, 2020 Gross Gross Carrying Accumulated Carrying Accumulated Amount Amortization Net Amount Amortization Net License rights and other intangible assets subject to amortization: License rights $ 40,000 $ 6,826 $ 33,174 $ 40,000 $ 3,803 $ 36,197 Hormone therapy drug patents 5,834 1,042 4,792 4,045 749 3,296 Hormone therapy drug patents applied and pending approval 2,020 — 2,020 1,629 — 1,629 License rights and other intangible assets subject to amortization 47,854 7,868 39,986 45,674 4,552 41,122 Intangible assets not subject to amortization: Trademarks/trade name rights 332 — 332 323 — 323 License rights and other intangible assets, net $ 48,186 $ 7,868 $ 40,318 $ 45,997 $ 4,552 $ 41,445 We recorded amortization expense related to the exclusive license rights agreement with Population Council of $3.0 million for 2021 and 2020, and $0.8 million for 2019. We recorded amortization expense related to patents of $0.3 million for 2021 and 2020, and $0.2 million for 2019. Our license rights and other intangible assets subject to amortization is expected to be amortized as follows (in thousands): Year ending December 31, 2022 $ 3,451 2023 3,445 2024 3,447 2025 3,445 2026 3,445 Thereafter 20,733 Total $ 37,966 We use a combination of qualitative and quantitative factors to assess licensed rights and intangible assets for impairment. As a result of performing these assessments, we determined that no impairment existed as of December 31, 2021, therefore, no write downs were recorded to our licensed rights and other intangible assets for 2021. For 2020 and 2019, we wrote off $1.1 million and $0.1 million, respectively, in costs related to patents and trademarks , which

Accrued expenses and other curr

Accrued expenses and other current liabilities	12 Months Ended
	Dec. 31, 2021
Payables And Accruals [Abstract]
Accrued expenses and other current liabilities	7. Accrued expenses and other current liabilities Other accrued expenses and other current liabilities consisted of the following (in thousands): As of December 31, 2021 2020 Payroll and related costs $ 13,764 $ 11,179 Rebates 11,010 11,011 Sales returns and coupons 2,422 7,057 Selling and marketing expenses 2,850 228 Research and development expenses 1,995 925 Wholesale distributor fees 3,614 2,632 Professional fees 2,571 925 Operating lease liabilities 1,361 2,254 Other 4,717 1,959 Accrued expenses and other current liabilities $ 44,304 $ 38,170 We expense advertising costs when incurred, which amounted to $39.7 million, $35.8 million and $9.0 million for 2021, 2020 and 2019, respectively.

Debt

Debt	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Debt	8. Debt Our debt consisted of the following (in thousands): As of December 31, 2021 2020 Financing Agreement $ 200,000 $ 250,000 Less: deferred financing fees 11,731 12,302 Debt, net 188,269 237,698 Current maturities of long-term debt 188,269 — Long-term debt $ - $ 237,698 Financing agreement We are party to a Financing Agreement with Sixth Street Specialty Lending, Inc., as administrative agent (the “Administrative Agent”), various lenders from time-to-time party thereto, and certain of our subsidiaries party thereto from time to time as guarantors. In connection with the initial borrowing under the Financing Agreement, we paid, for the benefit of the lenders, a facility fee equal to 2.5% of the initial amount borrowed and were required to pay such a facility fee in connection with subsequent borrowings under the Financing Agreement. Borrowings under the Financing Agreement accrue interest at either (i) 3-month LIBOR plus 7.75%, subject to a LIBOR floor of 2.70% or (ii) the prime rate plus 6.75%, subject to a prime rate floor of 5.2% as selected by us. As of December 31, 2021, our interest rate was 10.45%. Interest on amounts borrowed under the Financing Agreement is due and payable quarterly in arrears. In addition, we are required to pay an annual administrative fee, and other fees and expense. We have the right to prepay borrowings under the Financing Agreement in whole or in part at any time, subject to a prepayment fee on the principal amount being prepaid. The Financing Agreement was entered into in April 2019, and it provided us with up to a $300.0 million first lien secured term loan credit facility. The credit facility provided for availability to us in three tranches: (i) $200.0 million was drawn upon entering into the Financing Agreement; (ii) $50.0 million was drawn in February 2020 and (iii) $50.0 million was previously available to us in the Administrative Agent’s sole and absolute discretion either contemporaneously with the delivery of our financial statements for the quarterly period ended June 30, 2020 or at such earlier date as the Administrative Agent may have consented to. In the third quarter of 2020, the Administrative terminated the undrawn $50.0 million tranche under the Financing Agreement, therefore, such amount was no longer available to us to borrow. In August 2020, we entered into Amendment No. 5 to the Financing Agreement (“Amendment No. 5”) pursuant to which, among other amendments, the covenant in the Financing Agreement regarding our achievement of minimum consolidated net revenue attributable to commercial sales of our IMVEXXY, BIJUVA and ANNOVERA products were adjusted in order to reflect the impact of COVID-19 on our business. In lieu of a cash amendment fee, we issued to the Administrative Agent and the lenders under the Financing Agreement warrants to purchase an aggregate of 4,752,116 shares of our common stock with an exercise price of $1.58 per share and a ten-year term (the “Lender Warrants”). The Lender Warrants were issued pursuant to an exemption from registration under the Securities Act of 1933, as amended, and no registration rights were issued. The estimated fair value of the Lender Warrants was $ 7.4 million, and was recorded as deferred financing cost since Amendment No. 5 was accounted for a s a debt modification . In November 2020, in connection with Amendment No. 6 to the Financing Agreement (“Amendment No. 6”), we amended the Lender Warrants to provide for an adjustment to the exercise price if we conduct certain dilutive issuances prior to December 31, 2020, or if the volume-weighted average price of our common stock for the fifteen trading days ending December 31, 2020 is lower than the then current exercise price. Also, in November 2020, we concluded an underwritten public offering of our common stock and received consideration of $1.19 per share, after deducting for underwriting discounts and commissions. This offering of our common stock automatically triggered the down round provision to the exercise price of the Lender Warrants, which lowered the exercise price from $1.58 to $1.19 per share. The estimated fair value of the adjustment to the exercise price of Lender Warrants was $0.2 million and was recorded as deferred financing cost since Amendment No. 6 was accounted for as a debt modification. No other amendment financing fees were paid. In January 2021, we entered into Amendment No. 7 to the Financing Agreement (“Amendment No. 7”) pursuant to which, among other amendments, the minimum quarterly product net revenue requirements attributable to commercial sales of IMVEXXY, BIJUVA, and ANNOVERA for the fiscal quarters ending March 31, 2021 and June 30, 2021 were reduced, and we paid amendment financing fees of $5.0 million, which was recorded as deferred financing fees since Amendment No 7 was accounted for as debt modification. Additionally, in connection with entering into Amendment No. 7, the warrants issued to the Administrative Agent and the lenders under the Financing Agreement in August 2020 were further amended to provide for an additional adjustment to the exercise price if we conducted certain dilutive issuances prior to March 31, 2021. No adjustments were made to the exercise price of these warrants prior to the expiration of such period. In March 2021, we entered into Amendment No. 8 to the Financing Agreement (“Amendment No. 8”) pursuant to which, among other amendments, the minimum quarterly product net revenue requirements attributable to commercial sales of IMVEXXY, BIJUVA, and ANNOVERA were revised, the amortization and prepayment terms of the borrowings under the Financing Agreement were revised, and the Administrative Agent consented to a framework for our potential disposition of our vitaCare business. In connection with Amendment No. 8, we (i) repaid $50.0 million in principal under the Financing Agreement during the three months ended March 31, 2021, plus a 5.0% prepayment fee and (ii) agreed to make additional quarterly principal repayments plus the prepayment fees as follows: (a) $5.0 million due in March 2022, June 2022 and September 2022; (b) $10.0 million due in December 2022 and March 2023; and (c) $41.25 million due in June 2023, September 2023, December 2023 and March 2024. Additionally, the prepayment fees on principal amounts being prepaid under the Financing Agreement were revised as follows: (i) 30.0% of the principal amount being repaid through March 31, 2022 (excluding the scheduled $5.0 million principal repayment on such date, which is subject to a 5.0% prepayment fee); (ii) 5.0% of the principal amount being repaid from April 2022 through March 2023; (iii) 3.0% of the principal amount being repaid from April 2023 through March 2024; and (iv) thereafter, none, in each case subject to certain limited exceptions, including with respect to a repayment in full of the obligations under the Financing Agreement. Based on the contractual quarterly principal repayments in Amendment No. 8, as of December 31, 2021, we recorded an accrual of $2.2 million related to future prepayment fee obligations, of which $1.3 million is included in accrued expenses and other current liabilities and $0.9 million is included in other non-current liabilities in the accompanying consolidated balance sheets. In March 2022, we entered into Amendment No. 9 to the Financing Agreement (“Amendment No. 9”). See Note 17 – Subsequent events. In accordance with Amendment No. 9, the maturity date of the Financing Agreement was amended to June 1, 2022. Accordingly, the entire debt balance of $200.0 million as of December 31, 2021 will be due and payable in June 2022. The Financing Agreement also includes other representations, warranties, indemnities, restrictions on the payment of dividends, and events of default that are customary for financings of this type, including an event of default relating to a change of control of the Company. Upon or after an event of default, the Administrative Agent and the lenders may declare all or a portion of our obligations under the Financing Agreement to be immediately due and payable and exercise other rights and remedies provided for under the Financing Agreement. The obligations of our company and its subsidiaries under the Financing Agreement are secured, subject to customary permitted liens and other agreed upon exceptions, by a first priority perfected security interest in all existing and after acquired assets of our company and its subsidiaries. The obligations under the Financing Agreement will be guaranteed by each of our future direct and indirect subsidiaries, subject to certain exceptions. Since the inception of the Financing Agreement, we have incurred a total of $18.8 million in deferred financing fees related to the Financing Agreement. As of December 31, 2021, our unamortized deferred financing fees was $11.7 million, which will be entirely amortized upon the maturity of the Financing Agreement in 2022. Additionally, in connection with Amendment No. 9, we will pay financing fees of $30.0 million, which will be paid in kind (“PIK”) by being added to the principal balance of the Financing Agreement, and future prepayment fees were waived. Of the total PIK financing fees, $16.0 million will be waived if one of the two milestones specified in Amendment No. 9 is achieved. Debt covenants The Financing Agreement contains customary restrictions and covenants applicable to us that are customary for financings of this type. Among other requirements, prior to execution of Amendment No. 9 in March 2022, we were required to achieve certain minimum quarterly consolidated net revenue amounts attributable to commercial sales of our IMVEXXY, BIJUVA and ANNOVERA products. We were not in compliance with our covenant to achieve certain minimum quarterly product net revenue requirements for the quarterly period ended December 31, 2021 of $26.5 million. In connection with Amendment No 9, this event of default was waived by the Administrative Agent and lenders, and the minimum product net revenue requirement for the quarterly period ending March 31, 2022, which is the final quarterly reporting period, was removed. Credit agreement In April 2019, we terminated and repaid all amounts outstanding under a Credit and Security Agreement (the “Credit Agreement”), as amended, with MidCap Financial Trust, as agent and as lender and the additional lenders party thereto using a portion of the initial tranche of borrowing under the Financing Agreement. The aggregate amount paid of $81.7 million included a prepayment fee of 4%, a repayment fee of 4% and other fees and expenses payable to the lenders under the Credit Agreement. As a result of the termination of the Credit Agreement, we recorded a $10.1 million loss on extinguishment of debt in 2019. Interest and financing costs Interest expense and other financing costs consisted of the following (in thousands): 2021 2020 2019 Interest expense $ 22,568 $ 26,049 $ 16,526 Prepayment fees 4,660 — — Financing fees amortization 5,689 2,532 856 Interest expense and other financing costs $ 32,917 $ 28,581 $ 17,382

Commitments and contingencies

Commitments and contingencies	12 Months Ended
	Dec. 31, 2021
Commitments And Contingencies Disclosure [Abstract]
Commitments and contingencies	9. Commitments and contingencies Leases Substantially all of our leases are for rental of office space used to conduct our business. In October 2018, we entered into a lease for e xecutive, administrative, operations and sales offices pursuant to an addendum to such lease, which commenced in May 2020. For 2021, operating lease expense related to our real estate leases was $2.1 million and variable lease expense was $0.7 million. For 2020, operating lease expense related to our real estate leases was $2.3 million and variable lease expense was $0.4 million. For 2019, operating lease expense related to our real estate leases was $1.6 million and variable lease expense was insignificant. As of December 31, 2021, our remaining lease payments were as follows (in thousands): Year ending December 31, 2022 $ 1,413 2023 1,443 2024 1,477 2025 1,513 2026 1,551 Thereafter 5,883 Total undiscounted lease payments 13,280 Less: imputed interest 3,856 Present value of lease payments $ 9,424 The following table sets forth supplemental balance sheet information related to leases (in thousands): As of December 31, 2021 2020 Assets: Operating lease right-of-use assets $ 8,234 $ 9,566 Liabilities: Operating lease liabilities current (included in accrued expenses and other current liabilities) $ 1,361 $ 2,254 Operating lease liabilities, non-current 8,063 8,675 Total operating lease liabilities $ 9,424 $ 10,929 The following table presents other information related to leases: 2021 2020 Weighted average remaining term (years) - operating leases 8.7 9.0 Weighted average discount rate - operating leases 8.3 % 8.3 % Cash paid for amounts included in the measurement of lease liabilities from operating lease (in thousands) $ 2,335 $ 1,618 Right-of-use assets obtained in exchange for new operating lease obligations (non-cash in thousands) $ — $ 999 Population Council license agreement Under the terms of the Population Council License Agreement, we paid the Population Council a milestone payment of $20.0 million in 2018, which was within 30 days following the approval by the FDA of the NDA for ANNOVERA, and $20.0 million in 2019 following the first commercial batch release of ANNOVERA. The aggregate $40.0 million of milestone payments were recorded as license rights, see “Note 6. License rights and other intangible assets” for additional information. The Population Council is also eligible to receive future payments upon the achievement of certain commercial sales milestones of ANNOVERA. We are required to pay the Population Council additional milestone payments of $40.0 million upon cumulative net sales of ANNOVERA in the U.S. by us and our affiliated and permitted sublicensees of each of $200.0 million, $400.0 million and $1.0 billion. We will record any future milestone payment as incremental license rights cost when incurred, and amortize such costs over the remaining useful life over which the license rights will contribute directly or indirectly to our cash flows based on when ANNOVERA became commercially available for use. Accordingly, if and when we incur the incremental license rights cost, we will immediately record an additional amortization amount that assumed the incremental cost was incurred when the first commercial batch of ANNOVERA was released in 2019. The Population Council has agreed to perform and pay the costs and expenses associated with four post-approval studies required by the FDA for ANNOVERA, and we have agreed to perform and pay the costs and expenses associated with a post approval study required by the FDA to measure risk for venous thromboembolism, provided that if the costs and expenses associated with such post-approval study exceed $20.0 million, half of such excess will be offset against royalties or other payments owed by us to the Population Council under the Population Council License Agreement. To the extent that the Population Council does not fulfil these studies to FDA’s satisfaction, FDA may impose additional requirements and penalties against us, as we hold the NDA for ANNOVERA. In July 2021, we received a letter from FDA indicating that the post-marketing commitment study being conducted by the Population Council for ANNOVERA to characterize the in vivo release rate of ANNOVERA was not fulfilled to FDA’s satisfaction. In addition, the final reports for the two post-marketing requirement studies being performed by the Population Council for ANNOVERA were not submitted by the initial listed submission deadline, which deadlines have since been extended by FDA. We are working with Population Council to complete the post-marketing commitment study to FDA’s satisfaction and reduce the delay in submitting the post-marketing requirement final reports. To the extent that the Population Council does not fulfil these studies to FDA’s satisfaction, FDA may impose additional requirements and penalties against us, as we hold the NDA for ANNOVERA. We and the Population Council have agreed to form a joint product committee responsible for overseeing activities under the Population Council License Agreement. We are responsible for all aspects of marketing, promotion, product positioning, pricing, education programs, publications, sales messages and any additional desired clinical studies for the one-year vaginal contraceptive system, subject to oversight and decisions made by the joint product committee. We are also required to pay the Population Council, on a quarterly basis, step-based royalty payments based on our annual net sales of ANNOVERA as follows: (i) if annual net sales are less than or equal to $50.0 million, a royalty of 5% of net sales; (ii) for annual net sales greater than $50.0 million and less than or equal to $150.0 million, a royalty of 10% of such net sales; and (iii) for net sales greater than $150.0, a royalty of 15% of such net sales. The annual royalty rate will be reduced to 50% of the initial rate during the six-month period beginning on the date of the first arms-length commercial sale of a generic equivalent of the one-year vaginal contraceptive system that is launched by a third-party in the U.S., and thereafter will be reduced to 20% of the initial rate. Unless earlier terminated, the Population Council License Agreement will remain in effect until the later of the expiration of the last-to-expire of the Population Council’s U.S. patents that are licensed to us, or the date following such expiration that follows a continuous period of six months during which we and our affiliates have not made a commercial sale of ANNOVERA in the U.S. The Population Council License Agreement may also be terminated for certain breach and bankruptcy-related events and by us on 180 days’ prior notice to the Population Council. Purchase commitments We have manufacturing and supply agreements whereby we are required to purchase from Catalent, Inc. (“Catalent”) a minimum number of units of BIJUVA and IMVEXXY softgels during each respective annual contract year. The annual contract period for BIJUVA and IMVEXXY ends each April and July, respectively. If the minimum order quantities of BIJUVA or IMVEXXY are not met, we are required to pay a minimum commitment fee equal to 50% or 60%, respectively, of the difference between the total amount we would have paid if the minimum requirement had been fulfilled and the total amount of purchases of BIJUVA or IMVEXXY during each product’s respective contract year. Our estimated minimum commitments for Catalent are as follows: $5.2 million for 2022, $3.9 million for 2023, $4.3 million for 2024, $4.7 million for 2025, $4.8 million for 2026, and $11.5 million thereafter. Additionally, with another third-party manufacturer, we have a manufacturing and supply agreement, renewable annually, whereby we are required to purchase a minimum number of units of ANNOVERA during a contract year. The annual contract period for ANNOVERA ends each August. If the minimum order quantities of ANNOVERA are not met, we are required to pay a minimum commitment fee equal to the difference between the total amount we would have paid if the minimum requirement had been fulfilled and the total amount of purchases of ANNOVERA during the contract year. Our estimated minimum commitment for ANNOVERA is $2.1 million for 2022. For each of the three annual contract years ending in 2021, we have met our minimum purchase number of units in all material respects. For annual contract years ending in 2022 and thereafter, we will continue to evaluate whether we will be able to meet each annual contract year’s respective minimum purchase commitment and will record a liability for estimated minimum commitment fees if we believe that we will not be able to reasonably meet the minimum purchase commitment. We believe that minimum commitment fees that we may pay, if any, will not have a material impact to our financial position and operating results. Legal proceedings In February 2020, we received a Paragraph IV certification notice letter (the “IMVEXXY Notice Letter”) regarding an Abbreviated New Drug Application (“ANDA”) submitted to FDA by Teva Pharmaceuticals USA, Inc. (“Teva”). The ANDA seeks approval from FDA to commercially manufacture, use, or sell a generic version of the 4 mcg and 10 mcg doses of IMVEXXY. In the IMVEXXY Notice Letter, Teva alleges that TherapeuticsMD patents listed in FDA’s Orange Book that claim compositions and methods of IMVEXXY (the “IMVEXXY Patents”), are invalid, unenforceable, and/or will not be infringed by Teva’s commercial manufacture, use, or sale of its proposed generic drug product. The IMVEXXY Patents identified in the IMVEXXY Notice Letter expire in 2032 or 2033. In April 2020, we filed a complaint for patent infringement against Teva in the United States District Court for the District of New Jersey arising from Teva’s ANDA filing with the FDA. We are seeking, among other relief, an order that the effective date of any FDA approval of Teva’s ANDA would be a date no earlier than the expiration of the IMVEXXY Patents and equitable relief enjoining Teva from infringing the IMVEXXY Patents. Teva has filed its answer and counterclaim to the complaint, alleging that the IMVEXXY Patents are invalid and not infringed. In July 2021, following a proposal by Teva, the District Court entered an order temporarily staying all proceedings in the IMVEXXY litigation, which order was filed under seal. In September 2021, the District Court made available a public version of the order following the parties’ agreement to a consent motion to redact information Teva contended was confidential. The order provides that the statutory stay that prevents FDA from granting final approval of the ANDA for 30 months from the date of the Notice Letter will be extended for the number of days that the stay of the IMVEXXY litigation is in place. The length of the stay of the IMVEXXY litigation is dependent on further action by Teva. In March 2020, we received a Paragraph IV certification notice letter (the “BIJUVA Notice Letter”) regarding an ANDA submitted to FDA by Amneal Pharmaceuticals (“Amneal”). In April 2020, we filed a complaint for patent infringement against Amneal in the United States District Court for the District of New Jersey arising from Amneal’s ANDA filing with FDA. In December 2021, we entered into a settlement agreement (the “Settlement Agreement”) with Amneal Pharmaceuticals, Inc., Amneal Pharmaceuticals, LLC and Amneal Pharmaceuticals of New York LLC (collectively “Amneal”) to resolve the litigation over our Under the terms of the Settlement Agreement, the parties filed a consent judgment with the U.S. District Court for the District of New Jersey that enjoins Amneal from marketing a generic version of BIJUVA (1 mg estradiol and 100 mg progesterone) before the expiration of the patents-in-suit, except as provided in the Settlement Agreement, and the Company granted Amneal a non-exclusive, non-transferable, royalty-free license to commercialize Amneal’s generic formulation of BIJUVA in the U.S. commencing in May 2032 (180 days before the current expiration date in November 2032 for the last to expire of our BIJUVA Patents), or earlier under certain circumstances customary for settlement agreements of this nature. As of December 31, 2021, for the IMVEXXY paragraph IV legal proceeding, we have incurred and recorded legal costs amounting to $2.3 million in prepaid expenses and other current assets since we believe that we will successfully prevail in this legal proceeding. Upon the successful conclusion of the legal proceeding, the related capitalized legal costs will be reclassified to patents, in license rights and other intangible assets, net, in the accompanying consolidated balance sheets, and such costs will be amortized over the remaining useful of the patent. If we are unsuccessful in this legal proceeding, then the related capitalized legal costs for this legal preceding and any unamortized IMVEXXY patent costs that were previously capitalized will be immediately expensed in the period in which we become aware of unsuccessful legal proceeding. From time to time, we are involved in other litigations and proceedings in the ordinary course of business. We are currently not involved in any other litigations and proceedings that we believe would have a material effect on our consolidated financial condition, results of operations, or cash flows. Off-balance sheet arrangements As of December 31, 2021, 2020 and 2019, we had no off-balance sheet arrangements that have had or are reasonably likely to have current or future effects on our financial condition, changes in financial condition, revenues or expenses, results of operations, liquidity, capital expenditures or capital resources that are material to investors. Employment agreements We have entered into employment agreements with certain of our executives that provide for compensation and certain other benefits. Under certain circumstances, including a change in control, some of these agreements provide for severance or other payments, if those circumstances occur during the term of the employment agreement. In September 2021, our former Executive Vice President of Operations (“EVP of Operations”) and us mutually agreed that the EVP of Operations would separate from the company. The separation was for “Good Reason” under the employment agreement of the EVP of Operations; accordingly, he received the separation benefits provided therein. Then, i (the “Board”) appointed our current Chief Executive Officer (“CEO”). Our former CEO’s separation as CEO was a termination without “Cause,” as defined in his employment agreement. Accordingly, our former CEO received the separation benefits provided therein. Additionally, in 2021, three other senior executives separated from the Company, and they received separation benefits provided by their respective employment agreements. In the aggregate, for 2021, we recorded executive officer severance expenses of $12.4 million, of which $8.0 million was related to share-based compensation recorded in connection with accelerated vesting of certain share-based payment awards for the former senior executives. Employee benefit plan We maintain a voluntary defined contribution 401(k) plan covering all eligible employees as defined in the plan documents. The plan provides for discretionary matching contribution, which is equal to up to four percent of each eligible contributing participant’s elective deferral not to exceed two thousand per year. Employees who elect to participate in the plan are generally fully vested in any existing matching contribution after five years of service with the Company. Contributions by the Company under the plan amounted to $ 0.6 million for 2021, and $ 0.5 million for each of 2020 and 2019.

Stockholders_ Deficit

Stockholders’ Deficit	12 Months Ended
	Dec. 31, 2021
Equity [Abstract]
Stockholders’ Deficit	10. Stockholders’ deficit Common stock In March 2021, we entered into an at-the-market equity offering program (the “2021 ATM Program”) relating to shares of our common stock. The 2021 ATM Program permits us to offer and sell shares of our common stock having an aggregate offering price of up to $100.0 million from time to time through or to the sales agent under the 2021 ATM Program. Sales of our common stock may be made from time to time in at-the-market offerings as defined in Rule 415 of the Securities Act, including by means of ordinary broker’s transactions on The Nasdaq Stock Market LLC (“Nasdaq”) Subsequently, through the date of this 2021 10-K Report, we have not sold any additional shares of our common stock under the 2021 ATM Program . Future sales, if any, under the 2021 ATM Program will depend on a variety of factors, including among others, market conditions, the trading price of our common stock, determinations by us of the appropriate sources of funding, and potential uses of funding available to us. In February 2021, we closed on an underwritten public offering of our common stock, pursuant to which we issued 59,459,460 shares of our common stock at an offering price of $1.85 per share, and we received net proceeds of $96.6 million, after deducting the underwriting discounts and commissions and estimated offering expenses. In November 2020, we entered into an at-the-market offering program (the “2020 ATM Program”) relating to shares of our common stock. The 2020 ATM Program permitted us to offer and sell shares of our common stock having an aggregate offering price of up to $50.0 million from time to time through or to the sales agent under the 2020 ATM Program. Sales of our common stock were permitted to be made from time to time in at-the-market offerings as defined in Rule 415 of the Securities Act of 1933, as amended (the “Securities Act”), including by means of ordinary broker’s transactions on Nasdaq or otherwise at market prices prevailing at the time of sale, at prices related to prevailing market prices, or as otherwise agreed to with the sales agent. The sales agent was entitled to compensation at a fixed commission rate of 3.0% of the aggregate gross sales price per share sold. As of February 8, 2021, sales of shares of our common stock under the 2020 ATM Program were completed when we sold an aggregate total of 28,600,689 shares of our common stock at an average sale price of $1.75 per share. For the 2020 ATM Program, we received net proceeds of $48.1 million, after deducting the discounts and commissions to the sales agent and estimated offering expenses Also, in November 2020, we closed on an underwritten public offering of our common stock, pursuant to which we issued 26,953,125 shares of our common stock, which includes 3,515,625 shares issued for the exercise of an underwriter option, at an offering price of $1.28 per share, and we received net proceeds of $31.7 million, after deducting the underwriting discounts and commissions and estimated offering expenses. Also, in October 2019, we closed on an underwritten public offering of our common stock, pursuant to which we issued 29,900,000 shares of our common stock, which includes 3,900,000 shares issued for the exercise of an underwriter option, at an offering price of $2.75 per share, and we received net proceeds of $77.0 million, after deducting the underwriting discounts and commissions and estimated offering expenses. Warrants As disclosed in “Note 8. Debt”, in 2020, we issued to the Administrative Agent and the lenders under the Financing Agreement warrants to purchase an aggregate of 4,752,116 shares of our common stock. In 2019, we granted warrants to purchase an aggregate of 75,000 shares of our common stock to outside consultants. The following table summarizes the status of our outstanding and exercisable warrants and related for each of the following years (in thousands, except weighed average exercise price and weighted average remaining contractual life data): Warrants outstanding and exercisable Warrants Weighted Average Exercise Price Aggregate Intrinsic Value Weighted Average Remaining Contractual Life (in Years) Balance, January 1, 2019 3,008 $ 2.78 $ 4,826 1.6 Issued/granted 75 5.63 Exercised (1,250 ) 3.20 2,263 Balance, December 31, 2019 1,833 2.62 2,448 2.0 Issued/granted 4,752 1.19 Cancelled/Forfeited (50 ) 6.35 Balance, December 31, 2020 6,535 1.55 1,041 7.3 Exercised (1,163 ) 0.31 1,146 Expired (245 ) 7.90 Balance, December 31, 2021 5,127 $ 1.52 $ — 8.3 We used the Black Scholes option pricing model to estimate the fair value of warrants issued. The weighted average fair value of the warrants issued in 2020 was $1.56 per warrant and the assumptions used to determine such fair value were as follows: expected term of 10 years, volatility of 68.8%, dividend yields of 0% and risk-free interest rates of 0.3%. The weighted average fair value of the warrants granted in 2019 was $3.00 per warrant and the assumptions used to determine such fair value were as follows: expected term of 5 years, volatility of 60.8%, dividend yields of 0% and risk-free interest rates of 2.5%. Share-based payment award plans Plan summary and description In June 2019, our stockholders approved the TherapeuticsMD, Inc. 2019 Stock Incentive Plan, as amended (the “2019 Plan”), which replaced our previously adopted 2012 Stock Incentive Plan, as amended, and the 2009 Long-Term Incentive Compensation Plan ( referred to collectively as the “ Prior Plans”). The 2019 Plan is administered by the Compensation Committee of the Board. The purpose of the 2019 Plan is to provide a means for us and our subsidiaries and other designated affiliates (the “Related Entities”) to attract key personnel to provide services to us and the Related Entities, as well as to provide a means by which those key persons can acquire and maintain stock ownership, resulting in a strengthening of their commitment to our welfare and the welfare of the Related Entities and promoting the mutuality of interests between participants and our stockholders. A further purpose of the 2019 Stock Incentive Plan is to provide participants with additional incentive and reward opportunities designed to enhance our profitable growth and the profitable growth of the Related Entities, and provide participants with annual and long-term performance incentives to expend their maximum efforts in the creation of stockholder value. The persons eligible to receive awards under the 2019 Plan are our employees, officers, members of the Board, and consultants who provide services to us or any subsidiary. The provisions of the 2019 Plan authorize the grant of (i) stock options, which can be “qualified” or “nonqualified” under the Internal Revenue Code of Under the 2019 Plan, 37,475,000 shares of common stock are authorized for issuance, which includes 22,475,000 shares from the First Amendment to the 2019 Plan, which was approved by our stockholders in May 2021 plus any unallocated shares previously available for issuance under the Prior Plans that were not then subject to outstanding awards. Any shares subject to outstanding share-based payment awards under the 2019 Plan and Prior Plans that are forfeited, expire or otherwise terminate without issuance of the underlying shares, or if any such award is settled for cash or otherwise does not result in the issuance of all or a portion of the shares subject to such award (other than shares tendered or withheld in connection with the exercise of an award or the satisfaction of withholding tax liabilities), the shares to which those awards were subject, shall, to the extent of such forfeiture, expiration, termination, cash settlement or non-issuance, again be available for delivery with respect to awards under the 2019 Plan. In August 2021, the Company hired a new President, who became our CEO in December 2021, and granted an “inducement grant” under Listing Rule 5635(c)(4) of Nasdaq of 2,750,000 RSUs (designated as “Time-Based Units”) and 2,750,000 PSUs (designated as “Performance Units”). In October 2021, the Company appointed a new Chief Business Officer and granted an “inducement grant” under Listing Rule 5635(c)(4) of Nasdaq of 660,000 RSUs (designated as “Time-Based Units”) and 260,000 PSUs (designated as “Performance Units”) . As of December 31, 2021, 39,440,678 shares of common stock were subject to outstanding awards under our share-based payment award plans and inducement grants (calculated using the base number of PSUs that may vest). If we assume the maximum achievement of performance goals for PSUs, then 42,925,277 outstanding awards under our share-based payment award plans and inducement grants. The following table summarizes the outstanding awards issued pursuant to our share-based payment award plans and inducement grants as of December 31, 2021 and the remaining shares of common stock available for future issuance (in thousands): Plan Name Options RSUs PSUs (1) Remaining shares of common stock available for future issuance (2) 2019 Plan (3) 3,332 10,174 5,193 13,054 2012 Plan (4) 4,601 — — — 2009 Plan (5) 9,722 — — — 2021 Inducement Grants (6) — 3,410 3,010 — (1) The number of PSUs represents the base number of PSUs that may vest. The actual number of PSUs that will vest will be between zero and 11,687,530 depending on the Company’s achievement of certain performance goals. (2) The number of remaining shares of common stock available for future issuance is based on an assumption that the maximu m performance goals for PSUs were achieved, where applicable. (3) As of December 31, 2021, outstanding options have exercise prices ranging from $1.07 to $2.73 and will expire between January 2022 and June 2030. Unvested RSUs will vest between January 2022 and December 2024. If and when certain performance goals are achieved, then unvested PSUs will vest between June 2022 and March 2024. (4) As of December 31, 2021, outstanding options have exercise prices ranging from $2.55 to $8.92 and will expire between March 2022 and February 2029. (5) As of December 31, 2021, outstanding options have exercise prices ranging from $1.80 to $8.92 and will expire between January 2022 and February 2029. (6) As of December 31, 2021, unvested RSUs will vest between August 2022 and October 2024 and unvested PSUs upon achievement of certain performance goals will vest between October 15, 2022 and August 2024. 2021 Exchange of eligible options for RSUs In May 2021, our stockholders approved an Offer to Exchange Eligible Options for Restricted Stock Units (the “Exchange Offer”). The Exchange Offer allowed certain employee option holders, excluding the Company’s named executive officers, advisers, consultants, contractors, or present or past non-employee directors, to exchange some or all of their outstanding options to purchase shares of common stock that were granted before August 26, 2019, and had a per share exercise price equal to or greater than $5.01 (“Eligible Options”), for an award of RSUs of the Company (“New RSUs”), subject to specified conditions. In September 2021, following the expiration of the Exchange Offer, 69 eligible employees elected to exchange Eligible Options, and the Company accepted for cancellation Eligible Options to purchase an aggregate of 4,493,000 shares of common stock, representing approximately 91.5% of the total shares of common stock underlying the Eligible Options. Also, in September 2021, promptly following the expiration of the Exchange Offer, the Company granted 700,264 New RSUs in exchange for the cancellation of the tendered Eligible Options. The New RSUs vest in three equal annual installments beginning in September 2022, subject to the terms and conditions of the 2019 Plan. Options The following table summarizes the status of our outstanding and exercisable options and related transactions, including the Exchange Offer, for each for the following years (in thousands, except weighed average exercise price and weighted average remaining contractual life data): Options awards outstanding Options awards exercisable Options Awards Weighted Average Exercise Price Aggregate Intrinsic Value Weighted Average Remaining Contractual Life (in Years) Options Awards Weighted Average Exercise Price Aggregate Intrinsic Value Weighted Average Remaining Contractual Life (in Years) Balance, January 1, 2019 20,873 $ 4.93 $ 12,240 5.9 16,069 $ 4.61 $ 12,240 5.1 Granted 4,620 3.10 Exercised (344 ) 0.32 1,427 Cancelled/Forfeited (93 ) 5.16 Expired (26 ) 5.57 Balance, December 31, 2019 25,030 4.65 3,668 5.8 18,026 4.88 3,320 4.6 Granted 737 1.58 Exercised (1,182 ) 0.23 1,739 Cancelled/Forfeited (416 ) 3.80 Expired (387 ) 3.76 Balance, December 31, 2020 23,782 4.80 152 5.2 19,863 5.06 117 4.6 Granted 60 1.21 Exercised (111 ) 0.03 61 Cancelled/Forfeited (5,048 ) 6.01 Expired (1,028 ) 4.02 Balance, December 31, 2021 17,655 $ 4.52 $ — 3.8 16,776 $ 4.62 $ — 3.6 We used the Black Scholes option pricing model to estimate the fair value of options granted. The weighted average fair value of the options granted in 2021 was $0.77 per option, and the assumptions used to determine such fair value were as follows: expected term of 6.9 years, volatility of 67.6%, dividend yields of 0% and risk-free interest rates of 1.1%. The weighted average fair value of the options granted in 2020 was $1.58 per option and the assumptions used to determine such fair value were as follows: expected term of 6.0 to 6.8 years 5.5 to 6.5 years Restricted stock units The following table summarizes the status of our RSUs and related transactions, including the Exchange Offer, for each for the following years (in thousands, except weighed average grant date fair value): RSUs awards outstanding RSUs awards vested and not settled RSUs Weighted Average Grant Date Fair Value Aggregate Intrinsic Value RSUs Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Balance, January 1, 2019 1,040 $ 4.06 $ 3,962 — $ — $ — Granted 200 2.18 Balance, December 31, 2019 1,240 3.56 3,001 150 4.06 363 Granted 6,153 1.39 Vested and settled (301 ) 1.78 479 Cancelled/Forfeited (31 ) 1.07 Balance, December 31, 2020 7,061 1.76 8,544 — — — Granted 12,977 1.05 Vested and settled (5,126 ) 1.57 4,021 Cancelled/Forfeited (1,328 ) 1.47 Balance, December 31, 2021 13,584 $ 1.16 $ 4,890 1,573 $ 2.11 $ 566 Performance stock units The following table summarizes the status of our PSUs and related transactions for each for the following years (in thousands, except weighed average grant date fair value): PSUs awards outstanding PSUs awards vested and not settled PSUs Weighted Average Grant Date Fair Value Aggregate Intrinsic Value PSUs Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Balance, January 1, 2019 — $ — $ — — $ — $ — Granted 2,586 1.08 Vested and settled (152 ) 1.14 226 Cancelled/Forfeited (30 ) 1.07 Balance, December 31, 2020 2,404 1.08 2,909 — — — Granted 7,597 1.04 Vested and settled (1,680 ) 1.16 1,057 Cancelled/Forfeited (118 ) 1.07 Balance, December 31, 2021 8,203 (1) $ 1.03 $ 2,953 1,968 $ 1.18 $ 709 (1) The number of PSUs represents the base number of PSUs that may vest. The actual number of PSUs that will vest will be between zero and 11,687,530 depending on the Company’s achievement of certain performance goals. Employee stock purchase plan In June 2020, our stockholders approved the TherapeuticsMD, Inc. 2020 Employee Stock Purchase Plan (“ESPP”), which reserved 5,400,000 shares of our common stock for purchase by eligible employees. The ESPP permits eligible employees to purchase our common stock at a price per share which is equal to 85% of the lesser of (i) the fair market value of the shares on the offering date of the offering period or (ii) the fair market value of the shares on the purchase date. In 2021, 336,056 shares were sold under the ESPP at an average sale price of $0.69 per share and we received proceeds of $0.2 million. Share-based payment compensation cost Share-based payment compensation expense for PSUs is based on our current assessment of the most likely probability of the Company’s achievement of certain performance goals. We recorded share-based payment award compensation costs related to previously issued options, RSU and PSUs, as well as shares of common stock issued under the ESPP totaling $18.1 million for 2021, and $10.7 million for 2020 and 2019. As of December 31, 2021, we had $16.2 million of unrecognized share-based payment award compensation cost related to unvested options, RSUs and PSUs as well as shares issuable under the ESPP, which may be adjusted if certain performance targets are achieved and for future changes in forfeitures and is included as additional paid-in capital in the accompanying consolidated balance sheets. No tax benefit was realized due to a continued pattern of net losses. The unrecognized compensation cost as of December 31, 2021is expected to be recognized as share-based payment award compensation over a weighted average period of 2.1 years as follows (in thousands): Year ending December 31, 2022 $ 8,646 2023 5,199 2024 2,355 $ 16,200

Revenue

Revenue	12 Months Ended
	Dec. 31, 2021
Disaggregation Of Revenue [Abstract]
Revenue	11. Revenue Disaggregated revenue The following table provides information about disaggregated revenue by product mix and service (in thousands): 2021 2020 2019 Product revenue: ANNOVERA $ 37,943 $ 19,611 $ 6,167 IMVEXXY 31,533 27,139 16,252 BIJUVA 10,579 6,354 1,836 Prescription vitamin 5,725 9,768 9,886 Product revenue, net 85,780 62,872 34,141 License revenue 1,171 2,000 15,506 Total revenue, net $ 86,951 $ 64,872 $ 49,647 License agreements with customers Knight license agreement Pursuant to the terms of the Knight License Agreement, in 2020, Knight paid us $2.0 million in milestone fees upon the first regulatory approval in Canada for IMVEXXY and BIJUVA, and is required to pay us sales milestone fees based upon certain aggregate annual sales in Canada and Israel of each of IMVEXXY and BIJUVA and royalties based on aggregate annual sales of each of IMVEXXY and BIJUVA in Canada and Israel. We may terminate the Knight License Agreement if Knight does not submit all regulatory applications, submissions and/or registrations required for regulatory approval to use and commercialize IMVEXXY and BIJUVA in Canada within certain specified time periods. We also may terminate the Knight License Agreement if Knight challenges our patents. Either party may terminate the Knight License Agreement for any material breach by the other party that is not cured within certain specified time periods or if the other party files for bankruptcy or other related matters. As part of the Knight License Agreement, Knight is prohibited from exporting IMVEXXY and BIJUVA to the United States. As of December 31, 2021, no IMVEXXY or BIJUVA sales have been made through the Knight License Agreement. Theramex license agreement Under the terms of the Theramex License Agreement, Theramex paid us EUR 14 million, or $15.5 million, in cash as an upfront fee in August 2019. Within thirty days of signing the Theramex License Agreement, we provided Theramex the regulatory materials and clinical data that were necessary for Theramex to obtain marketing authorizations and other applicable regulatory approvals for commercializing BIJUVA and IMVEXXY. In 2019, at a point in time when Theramex was able to use and benefit from the license which was when the knowledge transfer of regulatory documents occurred, we recognized the revenue related to the upfront fee, which was a non-refundable payment. In 2021, we received additional milestone payments comprised of an aggregate of EUR 1.0 million, or $1.2 million, in regulatory milestone payments based on regulatory approvals for BIJUVA in certain specified markets. Additionally, in December 2021, we received EUR 0.5 million, or $0.6 million, in additional upfront payments for the license grants of IMVEXXY in Brazil and Mexico. The additional upfront payment for the license grants of IMVEXXY in Brazil and Mexico may be returned to Theramex under certain conditions if IMVEXXY fails to obtain marketing authorization in one of Brazil or Mexico within a prespecified period. Accordingly, the additional upfront payment for the license grants of IMVEXXY in Brazil and Mexico was recorded as other non-current liabilities as of December 31, 2021 in the accompanying balance sheets. We are eligible to receive additional sales milestone payments up to an aggregate of EUR 27.5 million in sales milestone payments to be paid in escalating tranches based on Theramex first attaining certain aggregate annual net sales milestones of BIJUVA and IMVEXXY outside of the U.S., excluding Canada and Israel (collectively the “Theramex Territory”) ranging from EUR 25 million to EUR 100 million. We are also entitled to receive quarterly royalty payments at a rate of 5% on net sales of BIJUVA and IMVEXXY in the Theramex Territory. Theramex is responsible for all regulatory and commercial activities for BIJUVA and IMVEXXY in the Theramex Territory. Theramex Theramex and/or registrations required for regulatory approval to use and commercialize BIJUVA and IMVEXXY within certain specified time periods. We also may terminate the Theramex License Agreement if Theramex challenges our patents. Either party may terminate the Theramex License Agreement for any material breach by the other party that is not cured within certain specified time periods or if the other party files for bankruptcy or other related matters. In 2021, we recorded BIJUVA sales of $1.4 million made through the Theramex License Agreement. As of December 31, 2021, no IMVEXXY sales have been made through the either of the licensing agreements.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	12. Income taxes Our loss before income taxes is as follows (in thousands): 2021 2020 2019 United States $ (172,415 ) $ (183,524 ) $ (176,145 ) For 2021, 2020 and 2019, there was no current or deferred provision for income taxes, current or deferred. As of December 31, 2021, we had a federal net operating loss (“NOL”) carryforwards of $885.1 million, which is available to offset future taxable income. Of the total NOL, $338.8 million can be carried forward for 20 years and will begin to expire in 2031. The remaining $546.3 million can be carried forward indefinitely. In the event of future income, the NOL deduction arising from NOL generated in taxable years beginning in 2021 will be limited to 80% of the excess taxable income. A reconciliation between taxes computed at the federal statutory rate and the consolidated effective tax rate is as follows: 2021 2020 2019 Federal statutory tax rate 21.0 % 21.0 % 21.0 % State tax rate, net of federal tax benefit 4.7 % 5.1 % 4.0 % Adjustment in valuation allowances (22.1 %) (27.0 %) (22.5 %) Excess stock benefits (1.5 %) 0.1 % 0.2 % Permanent and other differences (2.1 %) 0.8 % (2.7 %) Provision (benefit) for income taxes 0.0 % 0.0 % 0.0 % The components of the net deferred income tax asset as of December 31, 2021 and 2020 are as follows (in thousands): As of December 31, 2021 2020 Deferred income tax assets: Net operating loss $ 224,660 $ 195,008 Share-based payment compensation 17,698 17,252 Interest expense limitation 20,391 12,992 Accrual for sales returns and coupons 3,779 5,060 R&D credit 186 186 Other, net 1,674 (241 ) Deferred income tax asset 268,388 230,257 Valuation allowance (268,388 ) (230,257 ) Deferred income tax assets, net $ — $ — We believe that it is more likely than not that we will not generate sufficient future taxable income to realize the tax benefits related to the deferred tax assets on our balance sheet. Accordingly, a valuation allowance has been established against the deferred tax assets as of December 31, 2021 and 2020. Since our first year of operations in 2011, we generated net operating losses, and our U.S. federal and state tax returns remain open to examination. As of December 31, 2021 and 2020, we had no tax positions relating to open tax returns that were considered to be uncertain, and we had no unrecognized tax benefits.

Loss per common share

Loss per common share	12 Months Ended
	Dec. 31, 2021
Earnings Per Share [Abstract]
Loss per common share	13. Loss per common share The following table sets forth the computation of basic and diluted loss per common share for the periods presented (in thousands, except per share amounts): 2021 2020 2019 Numerator: Net loss $ (172,415 ) $ (183,524 ) $ (176,145 ) Denominator: Weighted average common shares for basic loss per common share 397,992 275,649 246,353 Effect of dilutive securities — — — Weighted average common shares for diluted loss per common share 397,992 275,649 246,353 Loss per common share, basic and diluted $ (0.43 ) $ (0.67 ) $ (0.72 ) Since we reported a net loss for 2021, 2020 and 2019, our potentially dilutive securities are deemed to be anti-dilutive, accordingly, there was no effect of dilutive securities. Therefore, our basic and diluted loss per common share and our basic and diluted weighted average common share are the same for 2021, 2020 and 2019. The following table sets forth the outstanding securities as of the periods presented which were not included in the calculation of diluted earnings per common share during 2021, 2020 and 2019 (in thousands): As of December 31, 2021 2020 2019 Stock options 17,655 23,782 25,030 RSUs 13,584 7,061 1,240 PSUs 8,203 2,404 — Warrants 5,127 6,535 1,833 44,569 39,782 28,103

Related parties

Related parties	12 Months Ended
	Dec. 31, 2021
Related Party Transactions [Abstract]
Related Parties	14. Related parties A former member of our Board, J. Martin Carrol, who resigned in December 2021, is also a director of Catalent. From time to time, we have entered into agreements with Catalent and its affiliates in the normal course of business. From July 2015 to December 2021, agreements with Catalent have been reviewed by independent directors of our Company, or a committee consisting of independent directors of our Company. For manufacturing activities, Catalent billed us $4.1 million, $3.0 million and $6.1 million for 2021, 2020 and 2019, respectively. As of December 31, 2021 and 2020, estimated amounts payable to Catalent was $0.9 million and $0.3 million, respectively. In addition, we have minimum purchase requirements in place with Catalent as disclosed in Note 9, Commitments and contingencies. In April 2020, Karen L. Ling was appointed to our Board, who was an executive vice president and chief human resources officer of American International Group, Inc. (“AIG”) until May 2021. From time to time, we have entered into agreements with AIG in the normal course of business. From April 2020 to May 2021, agreements with AIG have been reviewed by independent directors of our Company, or a committee consisting of independent directors of our Company. For various insurance premiums, AIG billed us less than $0.1 million and $0.2 million for 2021 and 2020, respectively. As of December 31, 2021 and 2020, we have no amounts payable to AIG.

Business concentrations

Business concentrations	12 Months Ended
	Dec. 31, 2021
Risks And Uncertainties [Abstract]
Business concentrations	15. Business concentrations We sell our products to wholesale distributors, specialty pharmacies, specialty distributors, and chain drug stores that generally sell products to retail pharmacies, hospitals, and other institutional customers. Customers with product revenue equal to or greater than 10% 2021 2020 2019 Customer A 11% 21% 37% Customer B 15% 16% 11% Customer C 17% 28% 13% Customer E 12% * * Customer F * * 12% * Less than 10% of total product revenue Customers that accounted for 10% As of December 31, 2021 2020 Customer A * 17% Customer B 21% 19% Customer C 35% 25% Customer D 11% 11% * Balance was less than 10% of accounts receivable, gross We rely on third parties for the manufacture and supply of our products, as well as third-party logistics providers. In instances where these parties fail to perform their obligations, we may be unable to find alternatives suppliers or satisfactorily deliver our products to our customers on time, if at all. Vendors with product purchases equal to or greater than 10% 2021 2020 2019 Catalent 33% 30% 24% Vendor A 36% 25% * Vendor B 27% 36% 27% Vendor I * * 35% * Less than 10% of total product purchases Vendors that accounted for 10% As of December 31, 2021 2020 Vendor E 19% 17% Vendor F 20% 16% Vendor G * 10% * Balance was less than 10% of total accounts payable

Summary quarterly information (

Summary quarterly information (unaudited)	12 Months Ended
	Dec. 31, 2021
Quarterly Financial Information Disclosure [Abstract]
Summary quarterly information (unaudited)	16. Summary quarterly information (unaudited) The following table sets forth a summary of the unaudited quarterly results for 2021 and 2020 (in thousands, except per share amounts): March 31, June 30, September 30, December 31, 2021 2021 2021 (2) 2021 (3) Revenue, net $ 19,866 $ 23,001 $ 25,406 $ 18,678 Gross profit $ 15,179 $ 18,869 $ 20,124 $ 13,941 Loss from operations $ (29,278 ) $ (35,179 ) $ (39,921 ) $ (35,392 ) Net loss $ (39,383 ) $ (42,652 ) $ (47,420 ) $ (42,960 ) Loss per common share, basic and diluted (1) $ (0.11 ) $ (0.11 ) $ (0.11 ) $ (0.10 ) March 31, June 30, September 30, December 31, 2020 2020 2020 (4) 2020 (5) Revenue, net $ 12,251 $ 10,701 $ 19,342 $ 22,578 Gross profit $ 9,536 $ 6,301 $ 16,063 $ 16,997 Loss from operations $ (50,922 ) $ (45,038 ) $ (24,974 ) $ (34,607 ) Net loss $ (56,849 ) $ (51,976 ) $ (32,612 ) $ (42,087 ) Loss per common share, basic and diluted (1) $ (0.21 ) $ (0.19 ) $ (0.12 ) $ (0.15 ) (1) Basic and diluted loss per common share are computed independently for each quarter and the full year based upon respective weighted average shares outstanding. Therefore, the sum of the quarterly basic and diluted earnings per share amounts may not equal the annual basic and diluted earnings per share amounts reported. (2) Included $7.3 million in senior executive severances, which included our former EVP of Operations. (3) Included $5.1 million in senior executive severances, which included our former CEO. (4) Included (i) $2.0 million in license revenue related to the Knight License Agreement, (ii) $5.7 million in inventory charge, primarily related to BIJUVA, and (iii) $0.6 million in write off of certain costs related to trademarks and patents. (5) Included $0.5 million in write off of certain costs related to trademarks and patents.

Subsequent events

Subsequent events	12 Months Ended
	Dec. 31, 2021
Subsequent Events [Abstract]
Subsequent events	17. Subsequent events vitaCare divestiture On March 6, 2022, we entered into a stock purchase agreement (the “Purchase Agreement”) with GoodRx, Inc. (“GoodRx”). which provides for the sale of all of the issued and outstanding capital stock of vitaCare to GoodRx (the “vitaCare Divestiture”). adjustment as provided in the Purchase Agreement and customary holdbacks. In addition, we may receive up to an additional of $ contingent upon vitaCare’s financial performance through 2023 as determined in accordance with the terms of the Purchase Agreement. The Purchase Agreement contains customary representations and warranties, covenants and indemnities of the parties thereto. In addition, the Purchase Agreement provides that at the Closing: (i) we will enter into a long-term services agreement with vitaCare to continue utilization of the vitaCare platform with respect to our products; (ii) we and vitaCare will enter into a transition services agreement for us to provide certain transition services to vitaCare for up to 12 months following the Closing; and (iii) certain employees of ours and/or vitaCare will enter into employment agreements with GoodRx. The vitaCare Divestiture is expected to close in the second quarter of 2022, subject to the satisfaction or waiver of certain customary conditions, including the receipt of certain regulatory approvals Amendment No. 9 to the Financing Agreement In March 2022, we entered into Amendment No. 9 pursuant to which, among other things, (i) the lenders waived various Company breaches of the Financing Agreement, including breaches of the $60.0 million minimum cash covenant and the minimum net revenue covenants for the fourth quarter of 2021; (ii) the Company and the lenders agreed to reduced minimum cash covenant and to the removal of the minimum net revenue covenant for the first quarter of 2022; (iii) the lenders waived the existing $60.0 million prepayment penalty under the Financing Agreement and the Company agreed to a paid in kind amendment fee of $30.0 million, which fee was added to the principal amount of the loans under the Financing Agreement, $16.0 million of which fee is waivable in certain conditions; and (iv) the maturity date of the Financing Agreement was am ended to June 1, 2022

Business, basis of presentati_2

Business, basis of presentation, new accounting standards and summary of significant accounting policies (Policies)	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
General	General TherapeuticsMD, Inc. (the “Company”), a Nevada corporation, and its consolidated subsidiaries are referred to collectively in this Annual Report on Form 10-K (“2021 10-K Report”) as “TherapeuticsMD,” “we,” “our” and “us.” This 2021 10-K Report includes our trademarks, trade names and service marks, such as TherapeuticsMD ® ® ® TM ® ® ® ® TM SM We are a women’s healthcare company with a mission of creating and commercializing innovative products to support the lifespan of women from pregnancy prevention through menopause. At TherapeuticsMD, we combine entrepreneurial spirit, clinical expertise, and business leadership to develop and commercialize health solutions that enable new standards of care for women. Our solutions range from a patient-controlled, long-lasting contraceptive to advanced hormone therapy pharmaceutical products. We also have a portfolio of branded and generic prescription prenatal vitamins under the vitaMedMD and BocaGreenMD brands. Our portfolio of products focused on women’s health allows us to efficiently leverage our sales and marketing plan to grow our recently approved products. Beginning in 2018, the U.S. Food and Drug Administration (“FDA”) • In July 2018, we launched our FDA-approved product IMVEXXY (estradiol vaginal inserts) for the treatment of moderate-to-severe dyspareunia (vaginal pain associated with sexual activity), a symptom of vulvar and vaginal atrophy, or VVA, due to menopause, which was approved by the FDA in May 2018. • In April 2019, we launched our FDA-approved product BIJUVA (estradiol and progesterone) capsules, our hormone therapy combination of bioidentical 17ß-estradiol and bio-identical progesterone in a single, oral softgel capsule, for the treatment of moderate-to-severe vasomotor symptoms, or VMS, due to menopause in women with a uterus, which was approved by the FDA in October 2018. • In October 2019, we began a “test and learn” market introduction for our FDA-approved product ANNOVERA (segesterone acetate and ethinyl estradiol vaginal system), the first and only annual patient-controlled, procedure-free, reversible prescription contraceptive option for women, which was approved by the FDA in August 2018 and which we have licensed for commercialization in the U.S. pursuant to an exclusive license agreement with the Population Council, Inc. (the “Population Council”), or the Population Council License Agreement. We paused the full commercial launch of ANNOVERA in March 2020 due to the impact of the COVID-19 pandemic and resumed this initiative in July 2020. We have also entered into license agreements with strategic partners to commercialize IMVEXXY and BIJUVA outside of the U.S. • In July 2018, we entered into a license and supply agreement (the “Knight License Agreement”) with Knight Therapeutics Inc. (“Knight”) pursuant to which we granted Knight an exclusive license to commercialize IMVEXXY and BIJUVA in Canada and Israel. • In June 2019, we entered into an exclusive license and supply agreement (the “Theramex License Agreement”) with Theramex HQ UK Limited (“Theramex”) to commercialize IMVEXXY and BIJUVA outside of the U.S., excluding Canada and Israel. In 2021, Theramex secured regulatory approval for BIJUVA in certain European countries and began commercialization efforts in those countries.
COVID-19	COVID-19 With multiple variant strains of the SARS-Cov-2 virus and the COVID-19 disease that it causes (collectively, “COVID-19”) still circulating, we continue to be subject to risks and uncertainties in connection with the COVID-19 pandemic. The extent of the future impact of the COVID-19 pandemic on our business continues to be highly uncertain and difficult to predict. The ultimate global recovery from the pandemic will be dependent on, among other things, actions taken by governments and businesses to contain and combat the virus, including any variant strains, the speed and effectiveness of vaccine production and global distribution, as well as how quickly, and to what extent, normal economic and operating conditions can resume on a sustainable basis globally. Since the early phase of the COVID-19 pandemic, we have been using substantial virtual options to ensure business continuity. We have also partnered with independent community pharmacies and multiple third-party online pharmacies and telemedicine providers that focus on contraception or menopause which provide patients real-time access to both diagnosis and treatment. We continue to support prescribers’ needs with samples and product materials through our sales force. If access is restricted, we have mailing options in place for these materials. We also have business continuity plans and infrastructure in place that allows for live virtual e-detailing of our products. As part of our response to the COVID-19 pandemic, we implemented measures to reduce marketing expenses for 2020 and we also implemented cost saving measures in 2020 and 2021, which included negotiating lower fees or suspending services from third-party vendors; implementing a company-wide hiring restriction; delaying or cancelling non-critical information technology projects; and eliminating non-essential travel, entertainment, meeting, and event expenses. In addition, we implemented a significant cost savings initiative that is designed to reduce our annual costs in 2022 by at least $40.0 million. This figure does not include estimated annualized cost savings of approximately $20.0 million from, or the costs associated with the sale of vitaCare for which we signed a definitive agreement on March 6, 2022. See Note 17 – Subsequent events for a description of the vitaCare divestiture. The full impact of the COVID-19 pandemic continues to evolve. However, we remain committed to the execution of our corporate goals, despite the ongoing COVID-19 pandemic, as demonstrated in part by the increase in product revenue throughout 2021. As of the date of issuance of these consolidated financial statements, the future extent to which the COVID-19 pandemic may continue to materially impact our financial condition, liquidity, or results of operations remains uncertain. We are continuing to assess the effect of the COVID-19 pandemic on our operations by monitoring the spread of COVID-19 and the various actions implemented to combat the pandemic throughout the world. Even after the COVID-19 pandemic has subsided, we may continue to experience adverse impacts to our business as a result of any economic recession or depression that has occurred or may occur in the future. While we currently believe that our COVID-19 contingency plan has the ability to mitigate many of the negative effects of the COVID-19 pandemic on our business, the severity of the impact of the COVID-19 pandemic on our business will depend on a number of factors, including, but not limited to, the duration and severity of the pandemic, the duration of “social distancing” orders, the ability of our sales force to access healthcare providers to promote our products, increases in unemployment, which could reduce access to commercial health insurance for our patients, thus limiting payer coverage for our products, and the impact of the pandemic on our global supply chain, all of which remain uncertain. Our future results of operations and liquidity could be materially adversely affected by delays in payments of outstanding receivable amounts beyond normal payment terms, supply chain disruptions, uncertain demand, and the impact of any initiatives or programs that we may undertake to address financial and operations challenges that we may face.
Going Concern	Going Concern We incurred a net loss of $172.4 million during the year ended December 31, 2021, and as of that date, our current liabilities exceeded our current assets by $133.4 million and our total liabilities exceeded our total assets by $93.6 million. Along with considering additional financings, we have reviewed numerous potential scenarios in connection with steps that we may take to reduce our operating expenses. Based on our analysis, we believe that our existing cash reserves along with potential proceeds from the sale of certain non-core assets of the Company and proceeds from potential future financings, if available to us, would be sufficient to meet our cash needs arising in the ordinary course of business for the next twelve months from the date of this 2021 10-K Report. If we are unsuccessful with future financings and if the successful commercialization of IMVEXXY, BIJUVA, or ANNOVERA is delayed, or the continued impact of the COVID-19 pandemic or issues in our supply chains related to our third-party contract manufacturers on our business is worse than we anticipate, our existing cash reserves would be insufficient to maintain compliance with the Financing Agreement covenants or satisfy our liquidity. See “Inventory” in Note 3 for additional information regarding risks associated with our contract manufacturers, particularly for ANNOVERA. The presence of these projected factors in conjunction with the uncertainty of the capital markets raises substantial doubt about the Company's ability to continue as a going concern for the next twelve months from the issuance of these financial statements. The accompanying consolidated financial statements do not include any adjustments that might be necessary if the Company is unable to continue as a going concern.
Basis of presentation	A. Basis of presentation The consolidated financial statements and related notes include our parent company and all wholly-owned subsidiaries. The consolidated financial statements are prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). Our fiscal year-end is as of and for the year ended December 31st for each year presented. All intercompany transactions among our businesses have been eliminated. Certain amounts in the n otes to the consolidated financial statements
New accounting standards	B. New accounting standards Adoption of new accounting standards New accounting standards or accounting standards updates were assessed and determined to be either not applicable or did not have a material impact on the Company’s consolidated financial statements or processes. Accounting standards issued but not yet adopted Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting and Scope. In March 2020 and January 2021, Accounting Standards Update (“ASU”) 2020-04 and ASU 2021-01 were issued, respectively. These ASUs provide optional guidance for a limited period of time to ease potential accounting impacts associated with transitioning away from reference rates that are expected to be discontinued, such as London Interbank Offered Rate (LIBOR). These ASUs include practical expedients for contract modifications due to reference rate reform. Generally, contract modifications related to reference rate reform may be considered an event that does not require remeasurement or reassessment of a previous accounting determination at the modification date. These ASUs were effective upon issuance and may be applied prospectively to contract modifications made or evaluated on or before December 31, 2022. Our debt agreements currently include the use of alternate rates when LIBOR is not available. We do not expect the change from LIBOR to an alternate rate will have a material impact to our financial statements and, to the extent we enter into modifications of agreements that are impacted by the LIBOR phase-out, we will apply such guidance to those contract modifications.
Estimates and assumptions	C. Estimates and assumptions The preparation of consolidated financial statements in conformity to U.S. GAAP requires us to make certain estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. We evaluate our estimated assumptions based on historical experience and on various other assumptions that are believed to be reasonable, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ, at times in material amounts, from these estimates under different assumptions or conditions.
Cash	D . Cash We maintain cash at financial institutions that at times may exceed the Federal Deposit Insurance Corporation (“FDIC”) insured limits of $0.25 million per bank. We have never experienced any losses related to these funds.
Accounts receivable and allowance for doubtful accounts	E . Accounts receivable and allowance for doubtful accounts Accounts receivable are customer obligations due under normal trade terms and are measured at amortized cost. We extend credit on an unsecured basis to most of our customers based on an evaluation of a customer’s financial condition, and collateral is not required. Our accounts receivable concentration of credit risk is primarily limited customers who are drug wholesalers and retail pharmacy distributors. We review accounts receivable for uncollectible and delinquent accounts and credit card chargebacks, and we provide an allowance for doubtful accounts, which is based upon a review of outstanding receivables, historical collection information, reasonable supportable forecasts, and existing economic conditions , and we record an allowance that presents the net amount expected to be collected. We write off uncollectible and delinquent receivables against our allowance for doubtful accounts based on individual credit evaluations, the results of collection efforts, and specific circumstances of customers. We record recoveries of accounts previously written off when received as an increase in the allowance for doubtful accounts. To the extent data we use to calculate these estimates does not accurately reflect bad debts, adjustments to these reserves may be required. Our exposure to credit losses may increase if our customers are adversely affected by changes in healthcare laws, coverage, and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, disruption associated with the current COVID-19 pandemic, or other customer-specific factors. Although we have historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of trade receivables in the future.
Inventories	F . Inventories Inventories represent pharmaceutical products, packaged vitamins and raw materials which are valued at the lower of cost or net realizable value. Our pharmaceutical products are valued using first in first out method and our vitamins are valued using the average-cost method. We review inventories for excess and obsolescence, and we write-down obsolete or otherwise unmarketable inventory to its estimated net realizable value. Obsolescence may occur due to product expiring, product improvements rendering previous versions obsolete, or decreases in demand for our products.
Fair Value Measurements	G . Fair Value Measurements Fair value is the price to sell an asset or transfer a liability and therefore represents an exit price in the principal market (or in the absence of a principal market, the most advantageous market). It represents a market-based measurement that contemplates a hypothetical transaction between market participants at the measurement date. The unique characteristics of an asset or liability and the availability of observable prices affect the number of valuation approaches and/or techniques used in a fair value analysis. We measure fair value using observable and unobservable inputs. We give the highest priority to quoted prices (unadjusted) in active markets for identical assets or liabilities (Level 1 inputs) and the lowest priority to unobservable inputs (Level 3 inputs). We apply the following fair value hierarchy: • Level 1 - Quoted prices (unadjusted) in active markets for identical assets and liabilities. • Level 2 - Quoted prices in non-active markets or in active markets for similar assets or liabilities, observable inputs other than quoted prices; and inputs that are not directly observable but are corroborated by observable market data. • Level 3 - Inputs that are unobservable. The carrying amount of our cash, accounts receivable, accounts payable and accrued expenses approximate their fair value because of the short-term maturity of such instruments, which are considered Level 1 under the fair value hierarchy. The carrying amount of our debt approximates fair value since it bears interest either at variable rates or fixed rates which are not significantly different from market rates, which are considered Level 2 under the fair value hierarchy.
Fixed assets	H . Fixed assets Fixed assets are carried at cost less accumulated depreciation and amortization. We charge maintenance costs, which do not significantly extend the useful lives of the respective assets, and repair costs to operating expenses as incurred. We compute depreciation using the straight-line method over the estimated useful lives of the related assets, which range from three to seven years. Leasehold improvements are depreciated over the shorter of their useful life or the term of the lease. Long-lived assets held and used by us, including fixed assets, are assessed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. We capitalize software and software development costs incurred to create and acquire computer software for internal use, principally related to software coding and application development. We begin to capitalize software development costs when both the preliminary project stage is completed, and it is probable that the software will be used as intended. Capitalized software costs include only external direct costs and services utilized in developing or obtaining computer software. Capitalized software costs are amortized on a straight-line basis when placed into service over the estimated useful life, generally five to seven years.
License rights and other intangibles assets	I. License rights and other intangibles assets We record license rights and other intangible assets at cost, which includes external costs, consisting primary of legal costs, incurred in securing our patents and trademarks. We started amortizing license rights cost once ANNOVERA became commercially available for use. License rights cost is amortized over the useful life over which the license rights will contribute directly or indirectly to our cash flows, which is estimated to be the remaining patent life of ANNOVERA, expiring in June 2039. The cost is amortized using the straight-line method as the pattern of economic benefit cannot be reliably determined. Intangible assets subject to amortization, such as patents, are amortized over the useful life of the patent using the straight-line method. If the patent is not granted, we write-off any capitalized patent costs at that time. Intangible assets not subject to amortization, such as trademarks, are perpetual and have indefinite lives. We review license rights and other intangible assets subject to amortization on a periodic basis to determine whether events and circumstances would indicate impairment or warrant a revision to their remaining useful lives. We assess other intangible assets not subject to amortization for potential impairment at least annually during the fourth quarter of each year,
Segment reporting	J. Segment reporting We manage and operate as one business, which is focused on creating and commercializing products targeted exclusively for women. Our business operations are managed by a single executive leadership team, which is led by our chief executive officer. We do not operate separate lines of business with respect to any of our products, and we do not prepare discrete financial information with respect to separate products. All product sales are derived from sales within the United States. Accordingly, we view our business as one reportable operating segment. With one geographic location.
Revenue recognition	K. Revenue recognition We determine the amount of revenue to be recognized through application of the following steps: • Identification of the contract with a customer; • Identification of the performance obligations in the contract; • Determination of the transaction price; • Allocation of the transaction price to the performance obligations in the contract; and • Recognition of revenue when or as we satisfy the performance obligations. Essentially all of our revenue is generated through contracts with our customers, who are primarily wholesale distributors and retail pharmacies. A performance obligation is a promise in a contract to transfer a product or service to a customer. A good or service is considered to be transferred when the customer receives the goods or service or obtains control, and we treat shipping as a fulfillment activity rather than as a separate obligation. We generally recognize revenue at a point in time when all of our performance obligations under the terms of a contract are satisfied. Revenue is recognized upon transfer of control of promised products or services in an amount that reflects the consideration we expect to receive in exchange for those products or services. The collectability of consideration on the contract is reasonably assured before revenue is recognized. To the extent that customer payment has been received before all recognition criteria are met, these revenues are initially deferred in other accruals on the balance sheet and the revenue is recognized in the period that all recognition criteria have been met. Prescription products Prescription products are sold at fixed wholesale acquisition cost, or WAC, determined based on our list price. However, the total transaction price is variable as it is calculated net of estimated product returns, chargebacks, rebates, coupons, discounts and wholesaler fees. These estimates are based on the amounts earned or to be claimed on the related sales and are classified as reductions of accounts receivable (if the amount is payable to the customer) or a current liability (if the amount is payable to a party other than a customer). To determine the transaction price, we estimate the amount of variable consideration at the outset of the contract either utilizing the expected value or most likely amount method, depending on the facts and circumstances relative to the contract or each variable consideration. The estimated amount of variable consideration is included in the transaction price only to the extent that it is probable that a significant reversal in the amount of cumulative product revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved. In determining amounts of variable consideration to include in a contract’s transaction price, we rely on our historical experience and other evidence that supports our qualitative assessment of whether product revenue would be subject to a significant reversal. We consider all the facts and circumstances associated with both the risk of a product revenue reversal arising from an uncertain future event and the magnitude of the reversal if that uncertain event were to occur. Actual amounts of consideration ultimately received may differ from our estimates. If actual results in the future vary from our original estimates, we will adjust these estimates, which would affect net product revenue and earnings in the period such changes in estimates become known. We accept returns of unsalable prescription products sold through wholesale distributors within a return period of six months prior to and up to 12 months following product expiration. ANNOVERA cannot be returned before the expiration date and expired ANNOVERA can be returned up to 12 months past the expiration date. Our prescription vitamins, IMVEXXY and BIJUVA currently have a shelf life of 24 months from the date of manufacture and ANNOVERA currently has a shelf life of 18 months from the date of manufacture. We do not allow product returns for prescription products that have been dispensed to a patient. We estimate the amount of our product sales that may be returned by our customers and record this estimate as a reduction of product revenue in the period the related product revenue is recognized. Where historical rates of return exist, we use history as a basis to establish a returns reserve for products shipped to wholesalers. For our newly launched products, for which the right of return exists but for which we currently do not have history of product returns, we estimate returns based on available industry data, our own sales information and our visibility into the inventory remaining in the distribution channel. At the end of each reporting period, we may decide to constrain product revenue for product returns based on information from various sources, including channel inventory levels and dating and sell-through data, the expiration dates of products currently being shipped, price changes of competitive products and any introductions of generic products. We recognize the amount of expected returns as a refund liability, representing the obligation to return the customer’s consideration. Since our returns primarily consist of expired and short dated products that will not be resold, we do not record a return asset for the right to recover the goods returned by the customer at the time of the initial sale (when recognition of product revenue is deferred due to the anticipated return). We offer various rebate and discount programs in an effort to maintain a competitive position in the marketplace and to promote sales and customer loyalty. We estimate the allowance for consumer rebates and coupons that we have offered based on our experience and industry averages, which is reviewed and adjusted, if necessary, on a quarterly basis. We record distributor fees based on amounts stated in contracts. We estimate chargebacks based on number of units sold during the period taking into account prices stated in contracts and our historical experience. We provide discounts to our customers for prompt payment. Consumer rebates and coupons costs, distribution fees, chargebacks and discounts are deducted from gross product revenue at the time the product revenue is recognized. For our prescription products, we offer a co-pay assistance program for eligible enrolled patients whose out of pocket costs are reduced to a more affordable price. This allows patients to access the product at a reasonable cost and is in line with our responsible pricing approach. We reimburse pharmacies for this discount through third-party vendors. The variable consideration is estimated based on contract prices, the estimated percentage of patients that will utilize the copay assistance, the average assistance paid, the estimated levels of inventory in the distribution channel and the current level of prescriptions covered by patients’ insurance. Payers may change coverage levels for our prescription products positively or negatively, at any time up to the time that we have formally contracted coverage with the payer. As such, the net transaction price of our prescription products is susceptible to such changes in coverage levels, which are outside the influence of the Company. As a result, we constrain variable consideration for our prescription products to an amount that will not result in a significant product revenue reversal in future periods. Our ability to estimate the net transaction price for our prescription products is constrained by our estimates of the amount to be paid for the co-pay assistance program which is directly related to the level of prescriptions paid for by insurance. As such, we record an accrual to reduce gross sales for the estimated co-pay and other patient assistance based on currently available third-party data and our internal analyses. We re-evaluate variable consideration each reporting period. License revenue License arrangements may consist of non-refundable upfront license fees, exclusive licensed rights to patented or patent pending technology, and various performance or sales milestones and future product royalty payments. Some of these arrangements may include multiple performance obligations. Non-refundable up-front fees that are not contingent on any future performance by us, and do not require continuing involvement on our part, are recognized as revenue when the right to use functional intellectual property is transferred to the customer.
Cost of sales	L. Cost of sales Cost of sales includes the cost of inventory, manufacturing, manufacturing overhead and supply chain costs and product shipping and handling costs. The Population Council License Agreement requires royalty payments based on our net sales of ANNOVERA, which are recorded as a component of cost of sales. Additionally, the amortization costs of license rights are recorded as a component of cost of sales.
Research and development	M. Research and development Research and development expenses include internal R&D activities, costs of services of third-party contract research organizations (“CROs”) and usage of their clinical research sites, manufacturing, scale-up and validation costs, and other activities. Internal R&D activity expenses include laboratory supplies, salaries, benefits, and share-based payment award compensation costs. CRO activity expenses include preclinical laboratory experiments and clinical trial studies. Other activity expenses include regulatory consulting and other costs. The activities undertaken by our regulatory consultants that were classified as R&D expenses include assisting, consulting with, and advising our in-house staff with respect to various FDA submission processes, clinical trial processes, and scientific writing matters, including preparing protocols and FDA submissions. These consulting expenses were direct costs associated with preparing, reviewing, and undertaking work for our clinical trials and investigative drugs. We charge internal R&D activities and other activity expenses to operations as incurred. We make payments to CROs based on agreed-upon terms, which may include payments in advance of a study starting date. We expense nonrefundable advance payments for goods and services that will be used in future R&D activities when the activity has been performed or when the goods have been received rather than when the payment is made. We review and accrue CRO expenses and clinical trial study expenses based on services performed and rely on estimates of those costs applicable to the completion stage of a study as provided by CROs. Estimated accrued CRO costs are subject to revisions as such studies progress to completion. We charge revisions to expenses in the period in which the facts that give rise to the revision become known.
Share-based payment awards	N. Share-based payment awards We account for share-based payment awards on a fair value basis of the equity instrument issued. Under fair value accounting, the grant-date fair value of the share-based payment award is amortized as compensation expense, on a straight-line basis, over the service period (generally, the vesting period) for both graded and cliff vesting awards. We have elected to account for forfeitures as they occur.
Income taxes	O. Income taxes Income taxes are accounted for under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases, and operating loss and income tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted income tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in income tax rates is recorded as a component of the income tax provision in the period that includes the enactment date. Regular assessments are made on the likelihood that our deferred tax assets will be recovered from our future taxable income. Our evaluation is based on estimates, assumptions, and includes an analysis of available positive and negative evidence, giving weight based on the evidence’s relative objectivity. Sources of positive evidence include estimates of future taxable income, future reversal of existing taxable temporary differences, taxable income in carryback years, and available tax planning strategies. Sources of negative evidence include current and cumulative losses in recent years, losses expected in early future years, any history of operating losses or tax credit carryforwards expiring unused, and unsettled circumstances that, if unfavorably resolved, would adversely affect future profit levels. The remaining carrying value of our deferred tax assets, after recording the valuation allowance on our deferred tax assets, is based on our present belief that it is more likely than not that we will be able to generate sufficient future taxable income to utilize such deferred tax assets. The amount of the remaining deferred tax assets considered recoverable could be adjusted if our estimates of future taxable income during the carryforward period change favorably or unfavorably. To the extent we believe that it is more likely than not that some or all the remaining deferred tax assets will not be realized, we must establish a valuation allowance against those deferred tax assets, resulting in additional income tax expense in the period such determination is made. To the extent a valuation allowance currently exists, we will continue to monitor all positive and negative evidence until we believe it is more likely than not that it is no longer necessary, resulting in an income tax benefit in the period such determination is made. Our policy is to recognize both interest and penalties related to uncertain tax positions as part of the income tax provision. Significant judgment is required in evaluating our tax positions, and in determining our provisions for income taxes, our deferred tax assets and liabilities and any valuation allowance recorded against our net deferred tax assets. We establish reserves when, despite our belief that the income tax return positions are fully supportable, certain positions are likely to be challenged and we may ultimately not prevail in defending those positions.
Earnings per common share	P. Earnings per common share Basic earnings or loss per common share is computed by dividing net income or loss available to common stockholders by the sum of the weighted average number of shares of common stock. Diluted earnings per common share is computed by dividing net income available to common stockholders by the sum of the weighted average number of shares of common stock and the number of additional shares of common stock that would have been outstanding if our outstanding potentially dilutive securities had been issued. Potentially dilutive securities include awards of non-vested or vested and not settled restricted stock units, performance stock units where the performance requirements have been met and not settled, warrants and options. The dilutive effect of potentially dilutive securities is reflected in diluted earnings per common share by application of the treasury stock method, except if its impact is anti-dilutive. Under the treasury stock method, an increase in the fair market value of our common stock can result in a greater dilutive effect from potentially dilutive securities.
Leases	Q. Leases We adopted ASU 2016-02, Leases (Topic 842), including the related codification amendments, in 2019 utilizing the modified retrospective transition method and applying the transition provisions at the effective date. We determine if an arrangement is a lease at inception. Determining whether a contract contains a lease includes judgment regarding whether the contract conveys the right to control the use of identified property or equipment for a period of time in exchange for consideration. We account for our lease-related assets and liabilities based on their classification as operating leases or finance leases, following the relevant accounting guidance. For all the lessee arrangements, we have elected an accounting policy to combine non-lease components with the related-lease components and treat the combined items as a lease for accounting purposes. We measure lease related assets and liabilities based on the present value of lease payments, including in-substance fixed payments, variable payments that depend on an index or rate measured at the commencement date, and the amount we believe is probable we will pay the lessor under residual value guarantees when applicable. We discount lease payments based on our estimated incremental borrowing rate at lease commencement (or modification), which is primarily based on our estimated credit rating, the lease term at commencement, and the contract currency of the lease arrangement. We have elected to exclude short-term leases (leases with an original lease term less than one year) from the measurement of lease-related assets and liabilities. We test right-of-use asset in an operating or finance lease at the asset group level (because these assets are long-lived nonfinancial assets and should be accounted for the same way as other long-lived nonfinancial assets) whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable.
Loss Contingencies	R . Loss Contingencies In determining whether an accrual for a loss contingency is required, we first assess the likelihood of occurrence of the future event or events that will confirm the loss. When a loss is probable (the future event or events are likely to occur) and the amount of the loss can be reasonably estimated, the estimated loss is accrued. If the reasonable estimate of the loss is a range and an amount within the range appears to be a better estimate than any other amount within the range, that amount should be accrued. However, if no amount within the range is a better estimate, the minimum amount in the range should be accrued.

Accounts receivable (Tables)

Accounts receivable (Tables)	12 Months Ended
	Dec. 31, 2021
Receivables [Abstract]
Summary of accounts receivable allowance for credit losses	The following sets forth activities in our allowance for credit losses (in thousands): 2021 2020 2019 Balance as of beginning of period $ 1,118 $ 904 $ 597 Charges to provision for credit losses 533 238 318 Write-off of uncollectible receivables (317 ) (24 ) (11 ) Balance as of end of period $ 1,334 $ 1,118 $ 904

Inventory (Tables)

Inventory (Tables)	12 Months Ended
	Dec. 31, 2021
Inventory Disclosure [Abstract]
Summary of Inventory	Our inventory consisted of the following (in thousands): As of December 31, 2021 2020 Raw materials $ 3,042 $ 3,748 Work in process 1,642 895 Finished products 2,938 3,350 Inventory $ 7,622 $ 7,993

Prepaid and other current ass_2

Prepaid and other current assets (Tables)	12 Months Ended
	Dec. 31, 2021
Prepaid Expense And Other Assets Current [Abstract]
Schedule of prepaid and other current assets	Our prepaid and other current assets consisted of the following (in thousands): As of December 31, 2021 2020 Insurance $ 2,731 $ 2,568 Paragraph IV legal proceeding costs 2,304 — Other 5,513 4,975 Prepaid and other current assets $ 10,548 $ 7,543

Fixed assets (Tables)

Fixed assets (Tables)	12 Months Ended
	Dec. 31, 2021
Property Plant And Equipment [Abstract]
Summary of Fixed Assets, Net	Our fixed assets, net consisted of the following (in thousands): As of December 31, 2021 2020 Furniture and fixtures $ 1,407 $ 1,407 Computer and office equipment 1,855 1,784 Computer software 375 412 Leasehold improvements 80 80 Fixed assets 3,717 3,683 Less: accumulated depreciation and amortization 2,518 1,741 Fixed assets, net $ 1,199 $ 1,942

Licensed rights and other int_2

Licensed rights and other intangible assets (Tables)	12 Months Ended
	Dec. 31, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Summary of Information about License Rights and Other Intangible Assets, Net	The following provides information about our license rights and other intangible assets, net (in thousands): As of December 31, 2021 As of December 31, 2020 Gross Gross Carrying Accumulated Carrying Accumulated Amount Amortization Net Amount Amortization Net License rights and other intangible assets subject to amortization: License rights $ 40,000 $ 6,826 $ 33,174 $ 40,000 $ 3,803 $ 36,197 Hormone therapy drug patents 5,834 1,042 4,792 4,045 749 3,296 Hormone therapy drug patents applied and pending approval 2,020 — 2,020 1,629 — 1,629 License rights and other intangible assets subject to amortization 47,854 7,868 39,986 45,674 4,552 41,122 Intangible assets not subject to amortization: Trademarks/trade name rights 332 — 332 323 — 323 License rights and other intangible assets, net $ 48,186 $ 7,868 $ 40,318 $ 45,997 $ 4,552 $ 41,445
Summary of License Rights And Other Intangible Assets Subject To Amortization Is Expected To Be Amortized	Our license rights and other intangible assets subject to amortization is expected to be amortized as follows (in thousands): Year ending December 31, 2022 $ 3,451 2023 3,445 2024 3,447 2025 3,445 2026 3,445 Thereafter 20,733 Total $ 37,966

Accrued expenses and other cu_2

Accrued expenses and other current liabilities (Tables)	12 Months Ended
	Dec. 31, 2021
Payables And Accruals [Abstract]
Schedule of Other Accrued Expenses and Other Current Liabilities	Other accrued expenses and other current liabilities consisted of the following (in thousands): As of December 31, 2021 2020 Payroll and related costs $ 13,764 $ 11,179 Rebates 11,010 11,011 Sales returns and coupons 2,422 7,057 Selling and marketing expenses 2,850 228 Research and development expenses 1,995 925 Wholesale distributor fees 3,614 2,632 Professional fees 2,571 925 Operating lease liabilities 1,361 2,254 Other 4,717 1,959 Accrued expenses and other current liabilities $ 44,304 $ 38,170

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Schedule of Debt	Our debt consisted of the following (in thousands): As of December 31, 2021 2020 Financing Agreement $ 200,000 $ 250,000 Less: deferred financing fees 11,731 12,302 Debt, net 188,269 237,698 Current maturities of long-term debt 188,269 — Long-term debt $ - $ 237,698
Summary of Interest Expense and Other Financing Costs	Interest expense and other financing costs consisted of the following (in thousands): 2021 2020 2019 Interest expense $ 22,568 $ 26,049 $ 16,526 Prepayment fees 4,660 — — Financing fees amortization 5,689 2,532 856 Interest expense and other financing costs $ 32,917 $ 28,581 $ 17,382

Commitments and contingencies (

Commitments and contingencies (Tables)	12 Months Ended
	Dec. 31, 2021
Commitments And Contingencies Disclosure [Abstract]
Schedule of Remaining Lease Payments	As of December 31, 2021, our remaining lease payments were as follows (in thousands): Year ending December 31, 2022 $ 1,413 2023 1,443 2024 1,477 2025 1,513 2026 1,551 Thereafter 5,883 Total undiscounted lease payments 13,280 Less: imputed interest 3,856 Present value of lease payments $ 9,424
Schedule of Supplemental Balance Sheet Information Related To Leases	The following table sets forth supplemental balance sheet information related to leases (in thousands): As of December 31, 2021 2020 Assets: Operating lease right-of-use assets $ 8,234 $ 9,566 Liabilities: Operating lease liabilities current (included in accrued expenses and other current liabilities) $ 1,361 $ 2,254 Operating lease liabilities, non-current 8,063 8,675 Total operating lease liabilities $ 9,424 $ 10,929
Schedule of Other Information Related to Leases	The following table presents other information related to leases: 2021 2020 Weighted average remaining term (years) - operating leases 8.7 9.0 Weighted average discount rate - operating leases 8.3 % 8.3 % Cash paid for amounts included in the measurement of lease liabilities from operating lease (in thousands) $ 2,335 $ 1,618 Right-of-use assets obtained in exchange for new operating lease obligations (non-cash in thousands) $ — $ 999

Stockholders_ Deficit (Tables)

Stockholders’ Deficit (Tables)	12 Months Ended
	Dec. 31, 2021
Summary of our Outstanding and Exercisable Warrants and Related Transactions	The following table summarizes the status of our outstanding and exercisable warrants and related for each of the following years (in thousands, except weighed average exercise price and weighted average remaining contractual life data): Warrants outstanding and exercisable Warrants Weighted Average Exercise Price Aggregate Intrinsic Value Weighted Average Remaining Contractual Life (in Years) Balance, January 1, 2019 3,008 $ 2.78 $ 4,826 1.6 Issued/granted 75 5.63 Exercised (1,250 ) 3.20 2,263 Balance, December 31, 2019 1,833 2.62 2,448 2.0 Issued/granted 4,752 1.19 Cancelled/Forfeited (50 ) 6.35 Balance, December 31, 2020 6,535 1.55 1,041 7.3 Exercised (1,163 ) 0.31 1,146 Expired (245 ) 7.90 Balance, December 31, 2021 5,127 $ 1.52 $ — 8.3
Summary of Outstanding Awards Issued Pursuant to Share-based Payment Award Plans and Inducement Grants	The following table summarizes the outstanding awards issued pursuant to our share-based payment award plans and inducement grants as of December 31, 2021 and the remaining shares of common stock available for future issuance (in thousands): Plan Name Options RSUs PSUs (1) Remaining shares of common stock available for future issuance (2) 2019 Plan (3) 3,332 10,174 5,193 13,054 2012 Plan (4) 4,601 — — — 2009 Plan (5) 9,722 — — — 2021 Inducement Grants (6) — 3,410 3,010 — (1) The number of PSUs represents the base number of PSUs that may vest. The actual number of PSUs that will vest will be between zero and 11,687,530 depending on the Company’s achievement of certain performance goals. (2) The number of remaining shares of common stock available for future issuance is based on an assumption that the maximu m performance goals for PSUs were achieved, where applicable. (3) As of December 31, 2021, outstanding options have exercise prices ranging from $1.07 to $2.73 and will expire between January 2022 and June 2030. Unvested RSUs will vest between January 2022 and December 2024. If and when certain performance goals are achieved, then unvested PSUs will vest between June 2022 and March 2024. (4) As of December 31, 2021, outstanding options have exercise prices ranging from $2.55 to $8.92 and will expire between March 2022 and February 2029. (5) As of December 31, 2021, outstanding options have exercise prices ranging from $1.80 to $8.92 and will expire between January 2022 and February 2029. (6) As of December 31, 2021, unvested RSUs will vest between August 2022 and October 2024 and unvested PSUs upon achievement of certain performance goals will vest between October 15, 2022 and August 2024.
Summary of Stock Option Activity	The following table summarizes the status of our outstanding and exercisable options and related transactions, including the Exchange Offer, for each for the following years (in thousands, except weighed average exercise price and weighted average remaining contractual life data): Options awards outstanding Options awards exercisable Options Awards Weighted Average Exercise Price Aggregate Intrinsic Value Weighted Average Remaining Contractual Life (in Years) Options Awards Weighted Average Exercise Price Aggregate Intrinsic Value Weighted Average Remaining Contractual Life (in Years) Balance, January 1, 2019 20,873 $ 4.93 $ 12,240 5.9 16,069 $ 4.61 $ 12,240 5.1 Granted 4,620 3.10 Exercised (344 ) 0.32 1,427 Cancelled/Forfeited (93 ) 5.16 Expired (26 ) 5.57 Balance, December 31, 2019 25,030 4.65 3,668 5.8 18,026 4.88 3,320 4.6 Granted 737 1.58 Exercised (1,182 ) 0.23 1,739 Cancelled/Forfeited (416 ) 3.80 Expired (387 ) 3.76 Balance, December 31, 2020 23,782 4.80 152 5.2 19,863 5.06 117 4.6 Granted 60 1.21 Exercised (111 ) 0.03 61 Cancelled/Forfeited (5,048 ) 6.01 Expired (1,028 ) 4.02 Balance, December 31, 2021 17,655 $ 4.52 $ — 3.8 16,776 $ 4.62 $ — 3.6
Summary of Unrecognized Share Based Compensation Cost Expected to be Recognized	The unrecognized compensation cost as of December 31, 2021is expected to be recognized as share-based payment award compensation over a weighted average period of 2.1 years as follows (in thousands): Year ending December 31, 2022 $ 8,646 2023 5,199 2024 2,355 $ 16,200
Restricted Stock Units [Member]
Schedule of RSUs and PSUs	The following table summarizes the status of our RSUs and related transactions, including the Exchange Offer, for each for the following years (in thousands, except weighed average grant date fair value): RSUs awards outstanding RSUs awards vested and not settled RSUs Weighted Average Grant Date Fair Value Aggregate Intrinsic Value RSUs Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Balance, January 1, 2019 1,040 $ 4.06 $ 3,962 — $ — $ — Granted 200 2.18 Balance, December 31, 2019 1,240 3.56 3,001 150 4.06 363 Granted 6,153 1.39 Vested and settled (301 ) 1.78 479 Cancelled/Forfeited (31 ) 1.07 Balance, December 31, 2020 7,061 1.76 8,544 — — — Granted 12,977 1.05 Vested and settled (5,126 ) 1.57 4,021 Cancelled/Forfeited (1,328 ) 1.47 Balance, December 31, 2021 13,584 $ 1.16 $ 4,890 1,573 $ 2.11 $ 566
Performance Shares Unit [Member]
Schedule of RSUs and PSUs	The following table summarizes the status of our PSUs and related transactions for each for the following years (in thousands, except weighed average grant date fair value): PSUs awards outstanding PSUs awards vested and not settled PSUs Weighted Average Grant Date Fair Value Aggregate Intrinsic Value PSUs Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Balance, January 1, 2019 — $ — $ — — $ — $ — Granted 2,586 1.08 Vested and settled (152 ) 1.14 226 Cancelled/Forfeited (30 ) 1.07 Balance, December 31, 2020 2,404 1.08 2,909 — — — Granted 7,597 1.04 Vested and settled (1,680 ) 1.16 1,057 Cancelled/Forfeited (118 ) 1.07 Balance, December 31, 2021 8,203 (1) $ 1.03 $ 2,953 1,968 $ 1.18 $ 709 (1) The number of PSUs represents the base number of PSUs that may vest. The actual number of PSUs that will vest will be between zero and 11,687,530 depending on the Company’s achievement of certain performance goals.

Revenue (Tables)

Revenue (Tables)	12 Months Ended
	Dec. 31, 2021
Disaggregation Of Revenue [Abstract]
Summary of information about disaggregated revenue by product mix	The following table provides information about disaggregated revenue by product mix and service (in thousands): 2021 2020 2019 Product revenue: ANNOVERA $ 37,943 $ 19,611 $ 6,167 IMVEXXY 31,533 27,139 16,252 BIJUVA 10,579 6,354 1,836 Prescription vitamin 5,725 9,768 9,886 Product revenue, net 85,780 62,872 34,141 License revenue 1,171 2,000 15,506 Total revenue, net $ 86,951 $ 64,872 $ 49,647

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Schedule of Loss Before Income Taxes	Our loss before income taxes is as follows (in thousands): 2021 2020 2019 United States $ (172,415 ) $ (183,524 ) $ (176,145 )
Schedule of Components of Net Deferred Income Tax Asset	The components of the net deferred income tax asset as of December 31, 2021 and 2020 are as follows (in thousands): As of December 31, 2021 2020 Deferred income tax assets: Net operating loss $ 224,660 $ 195,008 Share-based payment compensation 17,698 17,252 Interest expense limitation 20,391 12,992 Accrual for sales returns and coupons 3,779 5,060 R&D credit 186 186 Other, net 1,674 (241 ) Deferred income tax asset 268,388 230,257 Valuation allowance (268,388 ) (230,257 ) Deferred income tax assets, net $ — $ —
Schedule of Effective Income Tax Rate Reconciliation	A reconciliation between taxes computed at the federal statutory rate and the consolidated effective tax rate is as follows: 2021 2020 2019 Federal statutory tax rate 21.0 % 21.0 % 21.0 % State tax rate, net of federal tax benefit 4.7 % 5.1 % 4.0 % Adjustment in valuation allowances (22.1 %) (27.0 %) (22.5 %) Excess stock benefits (1.5 %) 0.1 % 0.2 % Permanent and other differences (2.1 %) 0.8 % (2.7 %) Provision (benefit) for income taxes 0.0 % 0.0 % 0.0 %

Loss per common share (Tables)

Loss per common share (Tables)	12 Months Ended
	Dec. 31, 2021
Earnings Per Share [Abstract]
Summary of computation of basic and diluted loss per common share	The following table sets forth the computation of basic and diluted loss per common share for the periods presented (in thousands, except per share amounts): 2021 2020 2019 Numerator: Net loss $ (172,415 ) $ (183,524 ) $ (176,145 ) Denominator: Weighted average common shares for basic loss per common share 397,992 275,649 246,353 Effect of dilutive securities — — — Weighted average common shares for diluted loss per common share 397,992 275,649 246,353 Loss per common share, basic and diluted $ (0.43 ) $ (0.67 ) $ (0.72 )
Schedule of antidilutive securities excluded from computation of earnings per share	The following table sets forth the outstanding securities as of the periods presented which were not included in the calculation of diluted earnings per common share during 2021, 2020 and 2019 (in thousands): As of December 31, 2021 2020 2019 Stock options 17,655 23,782 25,030 RSUs 13,584 7,061 1,240 PSUs 8,203 2,404 — Warrants 5,127 6,535 1,833 44,569 39,782 28,103

Business concentrations (Tables

Business concentrations (Tables)	12 Months Ended
	Dec. 31, 2021
Summary of Customers with Product Revenue and Accounts Receivable	Customers with product revenue equal to or greater than 10% 2021 2020 2019 Customer A 11% 21% 37% Customer B 15% 16% 11% Customer C 17% 28% 13% Customer E 12% * * Customer F * * 12% * Less than 10% of total product revenue
Summary of Vendors with Product Purchases and Accounts Payable	Vendors with product purchases equal to or greater than 10% 2021 2020 2019 Catalent 33% 30% 24% Vendor A 36% 25% * Vendor B 27% 36% 27% Vendor I * * 35% * Less than 10% of total product purchases
Accounts Receivable [Member]
Summary of Customers with Product Revenue and Accounts Receivable	Customers that accounted for 10% As of December 31, 2021 2020 Customer A * 17% Customer B 21% 19% Customer C 35% 25% Customer D 11% 11% * Balance was less than 10% of accounts receivable, gross
Accounts Payable [Member]
Summary of Vendors with Product Purchases and Accounts Payable	Vendors that accounted for 10% As of December 31, 2021 2020 Vendor E 19% 17% Vendor F 20% 16% Vendor G * 10% * Balance was less than 10% of total accounts payable

Summary quarterly information_2

Summary quarterly information (unaudited) (Tables)	12 Months Ended
	Dec. 31, 2021
Quarterly Financial Information Disclosure [Abstract]
Summary quarterly information (unaudited)	The following table sets forth a summary of the unaudited quarterly results for 2021 and 2020 (in thousands, except per share amounts): March 31, June 30, September 30, December 31, 2021 2021 2021 (2) 2021 (3) Revenue, net $ 19,866 $ 23,001 $ 25,406 $ 18,678 Gross profit $ 15,179 $ 18,869 $ 20,124 $ 13,941 Loss from operations $ (29,278 ) $ (35,179 ) $ (39,921 ) $ (35,392 ) Net loss $ (39,383 ) $ (42,652 ) $ (47,420 ) $ (42,960 ) Loss per common share, basic and diluted (1) $ (0.11 ) $ (0.11 ) $ (0.11 ) $ (0.10 ) March 31, June 30, September 30, December 31, 2020 2020 2020 (4) 2020 (5) Revenue, net $ 12,251 $ 10,701 $ 19,342 $ 22,578 Gross profit $ 9,536 $ 6,301 $ 16,063 $ 16,997 Loss from operations $ (50,922 ) $ (45,038 ) $ (24,974 ) $ (34,607 ) Net loss $ (56,849 ) $ (51,976 ) $ (32,612 ) $ (42,087 ) Loss per common share, basic and diluted (1) $ (0.21 ) $ (0.19 ) $ (0.12 ) $ (0.15 ) (1) Basic and diluted loss per common share are computed independently for each quarter and the full year based upon respective weighted average shares outstanding. Therefore, the sum of the quarterly basic and diluted earnings per share amounts may not equal the annual basic and diluted earnings per share amounts reported. (2) Included $7.3 million in senior executive severances, which included our former EVP of Operations. (3) Included $5.1 million in senior executive severances, which included our former CEO. (4) Included (i) $2.0 million in license revenue related to the Knight License Agreement, (ii) $5.7 million in inventory charge, primarily related to BIJUVA, and (iii) $0.6 million in write off of certain costs related to trademarks and patents. (5) Included $0.5 million in write off of certain costs related to trademarks and patents.

Business, basis of presentati_3

Business, basis of presentation, new accounting standards and summary of significant accounting policies - Additional Information (Details)

3 Months Ended

12 Months Ended

Dec. 31, 2021USD ($)

Sep. 30, 2021USD ($)

[2]

Jun. 30, 2021USD ($)

Mar. 31, 2021USD ($)

Dec. 31, 2020USD ($)

[3]

Sep. 30, 2020USD ($)

[4]

Jun. 30, 2020USD ($)

Mar. 31, 2020USD ($)

Dec. 31, 2021USD ($)SegmentLocation

Dec. 31, 2020USD ($)

Dec. 31, 2019USD ($)

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Net loss

$ (42,960,000)

[1]

$ (47,420,000)

$ (42,652,000)

$ (39,383,000)

$ (42,087,000)

$ (32,612,000)

$ (51,976,000)

$ (56,849,000)

$ (172,415,000)

$ (183,524,000)

$ (176,145,000)

Current liabilities over current assets

133,400,000

Total liabilities over total assets

93,600,000

Cash FDIC insured amount

250,000

$ 250,000

License rights cost amortized expiration period

2039-06

Number of reportable segment | Segment

1

Number of operating segment | Segment

1

Number of geographic location | Location

1

Loss contingency accrual

0

$ 0

ANNOVERA [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Return period of unsalable prescription products

12 months

Vitamins, IMVEXXY and BIJUVA [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Shelf life of prescription products

24 months

BIJUVA and ANNOVERA [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Shelf life of prescription products

18 months

VitaCare [Member] | COVID-19 [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Cost savings initiative to reduce annual costs

20,000,000

$ 20,000,000

Minimum [Member] | Land and Building [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Useful life of assets

3 years

Minimum [Member] | Software and Software Development Costs [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Useful life of assets

5 years

Minimum [Member] | COVID-19 [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Cost savings initiative to reduce annual costs

$ 40,000,000

$ 40,000,000

Maximum [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Return period of unsalable prescription products

12 months

Maximum [Member] | Land and Building [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Useful life of assets

7 years

Maximum [Member] | Software and Software Development Costs [Member]

Business Basis Of Presentation New Accounting Standards And Summary Of Significant Accounting Policies [Line Items]

Useful life of assets

7 years

[1]

Included $5.1 million in senior executive severances, which included our former CEO.

[2]

Included $7.3 million in senior executive severances, which included our former EVP of Operations.

[3]

Included $0.5 million in write off of certain costs related to trademarks and patents.

[4]

Included (i) $2.0 million in license revenue related to the Knight License Agreement, (ii) $5.7 million in inventory charge, primarily related to BIJUVA, and (iii) $0.6 million in write off of certain costs related to trademarks and patents.

Accounts receivable - Summary O

Accounts receivable - Summary Of Accounts Receivable Allowance For Credit Losses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Credit Loss [Abstract]
Balance as of beginning of period	$ 1,118	$ 904	$ 597
Charges to provision for doubtful accounts	533	238	318
Write-off of uncollectible receivables	(317)	(24)	(11)
Balance as of end of period	$ 1,334	$ 1,118	$ 904

Inventory - Summary of Inventor

Inventory - Summary of Inventory (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw materials	$ 3,042	$ 3,748
Work in process	1,642	895
Finished products	2,938	3,350
Inventory	$ 7,622	$ 7,993

Inventory - Additional Informat

Inventory - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Inventory Disclosure [Abstract]
Inventory charge	$ 1,082,000	$ 7,205,000	$ 0

Prepaid and other current ass_3

Prepaid and other current assets - Schedule of prepaid and other current assets consisted of the following (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Prepaid Expense And Other Assets Current [Abstract]
Insurance	$ 2,731	$ 2,568
Paragraph IV legal proceeding costs	2,304
Other	5,513	4,975
Prepaid and other current assets	$ 10,548	$ 7,543

Fixed assets - Summary of Fixed

Fixed assets - Summary of Fixed Assets, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Property Plant And Equipment [Line Items]
Fixed assets	$ 3,717	$ 3,683
Less: accumulated depreciation and amortization	2,518	1,741
Fixed assets, net	1,199	1,942
Furniture and fixtures [Member]
Property Plant And Equipment [Line Items]
Fixed assets	1,407	1,407
Computer and office equipment [Member]
Property Plant And Equipment [Line Items]
Fixed assets	1,855	1,784
Computer software [Member]
Property Plant And Equipment [Line Items]
Fixed assets	375	412
Leasehold improvements [Member]
Property Plant And Equipment [Line Items]
Fixed assets	$ 80	$ 80

Fixed assets - Additional Infor

Fixed assets - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Property Plant And Equipment [Abstract]
Depreciation	$ 0.8	$ 0.8	$ 0.4

Licensed rights and other int_3

Licensed rights and other intangible assets - Summary of Information about License Rights and Other Intangible Assets, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Finite Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross Carrying Amount	$ 47,854	$ 45,674
Finite-Lived Intangible Assets, Accumulated Amortization	7,868	4,552
Finite-Lived Intangible Assets, Net	39,986	41,122
License Rights and Intangible Assets, Net, Gross Carrying Amount (Excluding Goodwill)	48,186	45,997
License rights and other intangible assets, net	40,318	41,445
License rights [Member]
Finite Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross Carrying Amount	40,000	40,000
Finite-Lived Intangible Assets, Accumulated Amortization	6,826	3,803
Finite-Lived Intangible Assets, Net	33,174	36,197
Hormone therapy drug patents [Member]
Finite Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross Carrying Amount	5,834	4,045
Finite-Lived Intangible Assets, Accumulated Amortization	1,042	749
Finite-Lived Intangible Assets, Net	4,792	3,296
Hormone therapy drug candidate patents - applied and pending [Member]
Finite Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross Carrying Amount	2,020	1,629
Finite-Lived Intangible Assets, Net	2,020	1,629
Trademarks/trade name rights [Member]
Finite Lived Intangible Assets [Line Items]
Indefinite-Lived Intangible Assets, Gross Carrying Amount and Net	$ 332	$ 323

Licensed rights and other int_4

Licensed rights and other intangible assets - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Dec. 31, 2020	Sep. 30, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Finite Lived Intangible Assets [Line Items]
Write-off of patent and trademark	$ 500	$ 600	$ 0	$ 1,132	$ 79
License rights [Member]
Finite Lived Intangible Assets [Line Items]
Amortization of intangible assets			3,000	3,000	800
Patents [Member]
Finite Lived Intangible Assets [Line Items]
Amortization of intangible assets			$ 300	$ 300	$ 200

Licensed rights and other int_5

Licensed rights and other intangible assets - Summary of License Rights And Other Intangible Assets Subject To Amortization Is Expected To Be Amortized (Details) $ in Thousands	Dec. 31, 2021USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
2022	$ 3,451
2023	3,445
2024	3,447
2025	3,445
2026	3,445
Thereafter	20,733
Total	$ 37,966

Accrued expenses and other cu_3

Accrued expenses and other current liabilities - Schedule of Other Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Payables And Accruals [Abstract]
Payroll and related costs	$ 13,764	$ 11,179
Rebates	11,010	11,011
Sales returns and coupons	2,422	7,057
Selling and marketing expenses	2,850	228
Research and development expenses	1,995	925
Wholesale distributor fees	3,614	2,632
Professional fees	2,571	925
Operating lease liabilities	$ 1,361	$ 2,254
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued expenses and other current liabilities	Accrued expenses and other current liabilities
Other	$ 4,717	$ 1,959
Accrued expenses and other current liabilities	$ 44,304	$ 38,170

Accrued expenses and other cu_4

Accrued expenses and other current liabilities - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Payables And Accruals [Abstract]
Advertising costs	$ 39.7	$ 35.8	$ 9

Debt - Schedule of Debt (Detail

Debt - Schedule of Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Less: deferred financing fees	$ 11,731	$ 12,302
Debt, net	188,269	237,698
Current maturities of long-term debt	188,269
Long-term debt	0	237,698
Financing Agreement [Member]
Debt Instrument [Line Items]
Financing Agreement	$ 200,000	$ 250,000

Debt - Additional Information (

Debt - Additional Information (Details) - USD ($)	1 Months Ended		3 Months Ended	12 Months Ended
	Nov. 30, 2020	Apr. 30, 2019	Mar. 31, 2021	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Sep. 30, 2020	Aug. 31, 2020
Debt Instrument [Line Items]
Debt financing fee paid				$ 5,118,000	$ 1,250,000	$ 6,652,000
Repayments of Debt				50,000,000		81,661,000
Future prepayment fee obligations				2,200,000
Deferred financing fees				11,731,000	$ 12,302,000
Loss of extinguishment of debt						$ 10,058,000
Repayment Period in March 2022 [Member]
Debt Instrument [Line Items]
Additional principal repayment			$ 5,000,000
Repayments through March 31, 2022 [Member]
Debt Instrument [Line Items]
Prepayment fee percentage			30.00%
Repayment Period in June 2022 [Member]
Debt Instrument [Line Items]
Additional principal repayment			$ 5,000,000
Repayment Period in September 2022 [Member]
Debt Instrument [Line Items]
Additional principal repayment			5,000,000
Repayment Period in December 2022 [Member]
Debt Instrument [Line Items]
Additional principal repayment			$ 10,000,000
Repayment on April 1, 2022 through March 31, 2023 [Member]
Debt Instrument [Line Items]
Prepayment fee percentage			5.00%
Repayments from April 1, 2023 through March 31, 2024 [Member]
Debt Instrument [Line Items]
Prepayment fee percentage			3.00%
Repayment Period in March 2023 [Member]
Debt Instrument [Line Items]
Additional principal repayment			$ 10,000,000
Repayment Period in June 2023 [Member]
Debt Instrument [Line Items]
Additional principal repayment			41,250,000
Repayment Period in September 2023 [Member]
Debt Instrument [Line Items]
Additional principal repayment			41,250,000
Repayment Period in December 2023 [Member]
Debt Instrument [Line Items]
Additional principal repayment			41,250,000
Repayment Period in March 2024 [Member]
Debt Instrument [Line Items]
Additional principal repayment			41,250,000
Imvexxy Bijuva and Annovera [Member]
Debt Instrument [Line Items]
Repayments of Debt			$ 50,000,000
Prepayment fee percentage			5.00%
Accrued Expenses and Other Current Liabilities [Member]
Debt Instrument [Line Items]
Future prepayment fee obligations				1,300,000
Other Non-Current Liabilities [Member]
Debt Instrument [Line Items]
Future prepayment fee obligations				$ 900,000
Financing Agreement Amendment 7 [Member] | Long-term Debt [Member]
Debt Instrument [Line Items]
Debt financing fee paid	$ 5,000,000
Lender Warrants [Member]
Debt Instrument [Line Items]
Number of warrants issued								4,752,116
Warrants exercise price								$ 1.58
Fair value of warrants								$ 7,400,000
Lender Warrants [Member] | Financing Agreement Amendment6
Debt Instrument [Line Items]
Warrants exercise price	$ 1.19							$ 1.58
Shares Issued, Price Per Share	$ 1.19
Estimated fair value of the adjustment to the exercise price	$ 200,000
Debt financing fee paid	$ 0
Financing Agreement [Member]
Debt Instrument [Line Items]
Initial facility fee paid at inception (percent)				2.50%
Debt Instrument, Description of Variable Rate Basis				3-month LIBOR
Debt Instrument, Basis Spread on Variable Rate				7.75%
LIBOR floor rate				2.70%
Debt Instrument, Interest Rate During Period				10.45%
Financing Agreement [Member] | Debt Covenants [Member]
Debt Instrument [Line Items]
Minimum quarterly revenue requirement under credit agreement		$ 26,500,000
Debt instrument, covenant compliance				As of December 31, 2021, our cash balance was in excess of the required minimum balance. However, beginning on February 7, 2022, we did not maintain the required minimum unrestricted cash balance of $ 60.0 million. In connection with Amendment No. 9, this event of default was waived by the Administrative Agent and  lenders, and the required minimum unrestricted cash balance was reduced.
Financing Agreement [Member] | January 7, 2022 to February 28, 2022 [Member] | Debt Covenants [Member]
Debt Instrument [Line Items]
Minimum cash balance requirement under credit agreements				$ 60,000,000
Financing Agreement [Member] | Tranche One [Member]
Debt Instrument [Line Items]
Term loan facility first tranche drawn		200,000,000
Financing Agreement [Member] | Tranche Two [Member]
Debt Instrument [Line Items]
Term loan facility second tranche drawn		50,000,000
Financing Agreement [Member] | Tranche Three [Member]
Debt Instrument [Line Items]
Term loan facility undrawn tranche no longer available		50,000,000					$ 50,000,000
Financing Agreement [Member] | Term Loan Credit Facility
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity		$ 300,000,000
Financing Agreement [Member] | Prime Rate [Member]
Debt Instrument [Line Items]
Debt Instrument, Description of Variable Rate Basis				prime rate
Debt Instrument, Basis Spread on Variable Rate				6.75%
Prime rate floor				5.20%
Financing Agreement Amendment No 8 [Member]
Debt Instrument [Line Items]
Deferred financing fees				$ 18,800,000
Financing Agreement Amendment No 8 [Member] | Repayments through March 31, 2022 [Member]
Debt Instrument [Line Items]
Prepayment fee percentage			5.00%
Additional principal repayment			$ 5,000,000
Financing Agreement Amendment No 9 [Member]
Debt Instrument [Line Items]
Debt instrument payment due payable in 2022				200,000,000
Financing Agreement Amendment No 9 [Member] | Paid In Kind
Debt Instrument [Line Items]
Deferred financing fees				30,000,000
Finance Agreement One Of Two Milestones Specified In Amendment Number Nine | Paid In Kind
Debt Instrument [Line Items]
Waivable in kind amendment fee				$ 16,000,000
Credit Agreement
Debt Instrument [Line Items]
Prepayment fee percentage		4.00%
Aggregate amount paid		$ 81,700,000
Repayment fee percentage		4.00%
Loss of extinguishment of debt		$ 10,100,000

Debt - Summary of Interest Expe

Debt - Summary of Interest Expense and Other Financing Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Debt Disclosure [Abstract]
Interest expense	$ 22,568	$ 26,049	$ 16,526
Prepayment fees	4,660
Financing fees amortization	5,689	2,532	856
Interest expense and other financing costs	$ 32,917	$ 28,581	$ 17,382

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Thousands	1 Months Ended	12 Months Ended
	Sep. 30, 2021Executive	Dec. 31, 2021USD ($)Option	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Aug. 01, 2019ft²	Jun. 01, 2019ft²	Oct. 02, 2018ft²
Recorded Unconditional Purchase Obligation [Line Items]
Net rentable area | ft²								56,212
Rented area lease | ft²								7,561
Additional rented area occupied under the lease | ft²						48,651	6,536
Operating lease term						11 years
Number of options to extend lease | Option		2
Lease renewal term		5 years
Operating lease expense		$ 2,100	$ 2,300	$ 1,600
Variable lease payment		700	400
Number of senior executives agreed for separation excluding former EVP and former CEO | Executive	3
Share-based payment compensation costs		$ 18,125	10,679	10,682
Matching contribution percentage		4.00%
Maximum matching contribution per year		$ 2
Defined contribution plan vesting service period		5 years
Contributions under plan		$ 600	$ 500	500
Executive Officer [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Severance expenses		12,400
Share-based payment compensation costs		8,000
Prepaid Expenses and Other Current Assets [Member] | Paragraph Four Certification Notice Letter [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Legal proceeding costs		$ 2,300
BIJUVA [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Minimum supply commitment fee percentage payable		50.00%
IMVEXXY [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Minimum supply commitment fee percentage payable		60.00%
ANNOVERA [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Minimum purchase commitment, 2022		$ 2,100
Catalent [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Minimum purchase commitment, 2022		5,200
Minimum purchase commitment, 2023		3,900
Minimum purchase commitment, 2024		4,300
Minimum purchase commitment, 2025		4,700
Minimum purchase commitment, 2026		4,800
Minimum purchase commitment, thereafter		11,500
Population Council License Agreement [Member] | ANNOVERA [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Milestone payment				$ 20,000	$ 20,000
Milestone payments recorded as license rights		40,000
Milestone payment upon cumulative net sales		40,000
Cumulative net sales for 1st milestone payment		200,000
Cumulative net sales for 2nd milestone payment		400,000
Cumulative net sales for 3rd and final milestone payment		1,000,000
Costs and expenses associated with post approval study		20,000
Annual net sales for tier one royalty payment		50,000
Annual net sales greater than amount for tier two royalty payment		50,000
Annual net sales less than or equal to amount for tier two royalty payment		150,000
Annual net sales greater than or equal to amount for tier three royalty payment		$ 150,000
Percentage of royalty rate reduced to initial rate		50.00%
Reduction in percentage of initial rate		20.00%
Population Council License Agreement [Member] | ANNOVERA [Member] | Tier One [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Percentage of royalty on net sales		5.00%
Population Council License Agreement [Member] | ANNOVERA [Member] | Tier Two [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Percentage of royalty on net sales		10.00%
Population Council License Agreement [Member] | ANNOVERA [Member] | Tier Three [Member]
Recorded Unconditional Purchase Obligation [Line Items]
Percentage of royalty on net sales		15.00%

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Remaining Lease Payments (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Commitments And Contingencies Disclosure [Abstract]
2022	$ 1,413
2023	1,443
2024	1,477
2025	1,513
2026	1,551
Thereafter	5,883
Total undiscounted lease payments	13,280
Less: imputed interest	3,856
Present value of lease payments	$ 9,424	$ 10,929

Commitments and Contingencies_3

Commitments and Contingencies - Schedule of Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Assets:
Operating lease right-of-use assets	$ 8,234	$ 9,566
Liabilities:
Operating lease liabilities current (included in accrued expenses and other current liabilities)	1,361	2,254
Operating lease liabilities, non-current	8,063	8,675
Total operating lease liabilities	$ 9,424	$ 10,929

Commitments and Contingencies_4

Commitments and Contingencies - Schedule of Other Information Related to Leases (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Commitments And Contingencies Disclosure [Abstract]
Weighted average remaining term (years) - operating leases	8 years 8 months 12 days	9 years
Weighted average discount rate - operating leases	8.30%	8.30%
Cash paid for amounts included in the measurement of lease liabilities from operating lease (in thousands)	$ 2,335	$ 1,618
Right-of-use assets obtained in exchange for new operating lease obligations (non-cash in thousands)		$ 999

Stockholders' Deficit - Common

Stockholders' Deficit - Common Stock and Warrants - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Feb. 08, 2021	Mar. 31, 2021	Feb. 28, 2021	Nov. 30, 2020	Oct. 31, 2019	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Class Of Stock [Line Items]
Shares issued for exercise of options (in shares)						111,000	1,182,000	344,000
Number of shares under warrants granted							4,752,116
Outside Consultant [Member]
Class Of Stock [Line Items]
Number of shares under warrants granted								75,000
Warrant [Member]
Class Of Stock [Line Items]
Weighted average grant date fair value							$ 1.56	$ 3
Expected term							10 years	5 years
Volatility rate							68.80%	60.80%
Dividend yields							0.00%	0.00%
Risk-free interest rate							0.30%	2.50%
Common Stock [Member]
Class Of Stock [Line Items]
Proceeds from stock plans			$ 96.6	$ 31.7	$ 77
Shares issued for sale of common stock, net of cost (in shares)			59,459,460	26,953,125	29,900,000	121,765,000	26,953,000	29,900,000
Shares Issued, Price Per Share			$ 1.85	$ 1.28	$ 2.75
Shares issued for exercise of options (in shares)				3,515,625	3,900,000	111,000	1,182,000	344,000
2021 ATM Program [Member] | Common Stock [Member]
Class Of Stock [Line Items]
Public offering of common stock authorized for sale		$ 100
Percentage of commission rate gross sales price		3.00%
Sale of stock, number of shares issued in transaction						33,705,315
Sale of stock, price Per share						$ 1.21
Proceeds from stock plans						$ 39.4
2020 ATM Program [Member] | Common Stock [Member]
Class Of Stock [Line Items]
Public offering of common stock authorized for sale				$ 50
Percentage of commission rate gross sales price				3.00%
Sale of stock, number of shares issued in transaction	28,600,689
Sale of stock, price Per share	$ 1.75
Proceeds from stock plans	$ 48.1

Stockholders' Deficit - Summary

Stockholders' Deficit - Summary of our Outstanding and Exercisable Warrants and Related Transactions (Details) - Warrant [Member] - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Class Of Warrant Or Right [Line Items]
Beginning balance, Warrants	6,535	1,833	3,008
Issued/granted, Warrants		4,752	75
Exercised, Warrants	(1,163)		(1,250)
Cancelled/Forfeited, Warrants		(50)
Ending balance, Warrants	5,127	6,535	1,833	3,008
Expired, Warrants	(245)
Beginning balance, Weighted Average Exercise Price	$ 1.55	$ 2.62	$ 2.78
Issued/granted, Weighted Average Exercise Price		1.19	5.63
Exercised, Weighted Average Exercise Price	0.31		3.20
Cancelled/Forfeited, Weighted Average Exercise Price		6.35
Ending balance, Weighted Average Exercise Price	1.52	$ 1.55	$ 2.62	$ 2.78
Expired, Weighted Average Exercise Price	$ 7.90
Warrants, Aggregate Intrinsic Value		$ 1,041	$ 2,448	$ 4,826
Exercised, Weighted Average Exercise Price	$ 1,146		$ 2,263
Warrants, Weighted Average Remaining Contractual Life (in Years)	8 years 3 months 18 days	7 years 3 months 18 days	2 years	1 year 7 months 6 days

Stockholders' Deficit - Share-b

Stockholders' Deficit - Share-based Payment Award Plans - Additional Information (Details) $ / shares in Units, $ in Millions	1 Months Ended				12 Months Ended
	Oct. 31, 2021shares	Sep. 30, 2021EmployeeInstallment$ / sharesshares	Aug. 31, 2021shares	Jun. 30, 2020shares	Dec. 31, 2021USD ($)$ / sharesshares	Dec. 31, 2020USD ($)$ / sharesshares	Dec. 31, 2019USD ($)$ / shares	May 31, 2021shares	Jun. 30, 2019shares
Class Of Stock [Line Items]
Number of shares outstanding					42,925,277
Exercise price per share | $ / shares		$ 5.01
Eligible Employees who elected to exchange Eligible Options | Employee		69
Options granted to purchase an aggregate shares of common stock		4,493,000
Percentage of shares of common stock underlying eligible options		91.50%
Number of annual installments vest | Installment		3
Common Stock, Shares, Issued					429,886,000	299,765,000
Share-based payment arrangement, expense | $					$ 18.1	$ 10.7	$ 10.7
Total unrecognized share based compensation | $					$ 16.2
Share-based compensation over a weighted average period					2 years 1 month 6 days
Restricted Stock Units [Member]
Class Of Stock [Line Items]
Share based compensation arrangement by share based payment award, grants in period in exchange for cancellation of tendered eligible options		700,264
Performance Shares Unit [Member]
Class Of Stock [Line Items]
Number of shares outstanding					39,440,678
Options [Member]
Class Of Stock [Line Items]
Weighted average grant date fair value | $ / shares					$ 0.77	$ 1.58	$ 3.10
Expected term					6 years 10 months 24 days
Volatility rate					67.60%
Volatility rate, minimum						63.50%	61.30%
Volatility rate, maximum						67.90%	64.58%
Dividend yields					0.00%	0.00%	0.00%
Risk-free interest rate					1.10%
Risk-free interest rate, minimum						0.30%	1.60%
Risk-free interest rate, maximum						1.70%	2.50%
Options [Member] | Minimum [Member]
Class Of Stock [Line Items]
Expected term						6 years	5 years 6 months
Options [Member] | Maximum [Member]
Class Of Stock [Line Items]
Expected term						6 years 9 months 18 days	6 years 6 months
2019 Stock Incentive Plan [Member]
Class Of Stock [Line Items]
Share-based compensation arrangement by share-based payment award, number of shares authorized					37,475,000
Additional authorized shares added in 2021								22,475,000
Number of shares common stock available									0
Award expiration period					10 years
2021 Inducement Grants [Member] | Restricted Stock Units [Member] | Time-Based Units [Member]
Class Of Stock [Line Items]
Share-based compensation arrangement by share-based payment award, grants in period	660,000		2,750,000
2021 Inducement Grants [Member] | Performance Shares Unit [Member] | Performance Units [Member]
Class Of Stock [Line Items]
Share-based compensation arrangement by share-based payment award, grants in period	260,000		2,750,000
Employee Stock Purchase Plan [Member]
Class Of Stock [Line Items]
Number of shares common stock available				5,400,000
Common Stock, Shares, Issued					336,056
Eligible employees to purchase common stock price per share equal to percentage				85.00%
Sale of stock, price Per share | $ / shares					$ 0.69
Proceeds from stock plans | $					$ 0.2

Stockholders' Deficit - Schedul

Stockholders' Deficit - Schedule of Outstanding Awards Issued to Share-based Payment Award Plan and Inducement Grants (Details) - shares	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options	17,655,000	23,782,000	25,030,000	20,873,000
2019 Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares common stock available	13,054
2019 Plan [Member] | Options [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options	3,332
2019 Plan [Member] | Restricted Stock Units [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
RSUs/PSUs	10,174
2019 Plan [Member] | Performance Shares Unit [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
RSUs/PSUs	5,193
2012 Plan [Member] | Options [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options	4,601
2009 Plan [Member] | Options [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Options	9,722
2021 Inducement Grants [Member] | Restricted Stock Units [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
RSUs/PSUs	3,410
2021 Inducement Grants [Member] | Performance Shares Unit [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
RSUs/PSUs	3,010

Stockholders' Deficit - Sched_2

Stockholders' Deficit - Schedule of Outstanding Awards Issued to Share-based Payment Award Plan and Inducement Grants (Parenthetical) (Details)	12 Months Ended
	Dec. 31, 2021$ / sharesshares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share-based Payment Award, Award Vesting Rights	(1) The number of PSUs represents the base number of PSUs that may vest. The actual number of PSUs that will vest will be between zero and 11,687,530 depending on the Company’s achievement of certain performance goals.   (2) The number of remaining shares of common stock available for future issuance is based on an assumption that the maximum performance goals for PSUs were achieved, where applicable.   (3) As of December 31, 2021, outstanding options have exercise prices ranging from $1.07 to $2.73 and will expire between January 2022 and June 2030. Unvested RSUs will vest between January 2022 and December 2024. If and when certain performance goals are achieved, then unvested PSUs will vest between June 2022 and March 2024.   (4) As of December 31, 2021, outstanding options have exercise prices ranging from $2.55 to $8.92 and will expire between March 2022 and February 2029.   (5) As of December 31, 2021, outstanding options have exercise prices ranging from $1.80 to $8.92 and will expire between January 2022 and February 2029.   (6) As of December 31, 2021, unvested RSUs will vest between August 2022 and October 2024 and unvested PSUs upon achievement of certain performance goals will vest between October 15, 2022 and August 2024.
Performance Shares Unit [Member] | Minimum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares expected to vest | shares	0
Performance Shares Unit [Member] | Maximum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares expected to vest | shares	11,687,530
Options [Member] | 2019 Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Exercise price range, lower limit	$ 1.07
Exercise price range, upper limit	2.73
Options [Member] | 2012 Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Exercise price range, lower limit	2.55
Exercise price range, upper limit	8.92
Options [Member] | 2009 Plan [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Exercise price range, lower limit	1.80
Exercise price range, upper limit	$ 8.92

Stockholders' Deficit - Summa_2

Stockholders' Deficit - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Equity [Abstract]
Options awards outstanding, Beginning balance	23,782	25,030	20,873
Options awards outstanding, Granted	60	737	4,620
Options awards outstanding, Exercised	(111)	(1,182)	(344)
Options awards outstanding, Cancelled/Forfeited	(5,048)	(416)	(93)
Options awards outstanding, Expired	(1,028)	(387)	(26)
Options awards outstanding, Ending balance	17,655	23,782	25,030	20,873
Options award outstanding, weighted average exercise price, Beginning balance	$ 4.80	$ 4.65	$ 4.93
Options award outstanding, weighted average exercise price, Granted	1.21	1.58	3.10
Options award outstanding, weighted average exercise price, Exercised	0.03	0.23	0.32
Options award outstanding, weighted average exercise price, Cancelled/Forfeited	6.01	3.80	5.16
Options award outstanding, weighted average exercise price, Expired	4.02	3.76	5.57
Options award outstanding, weighted average exercise price, Ending balance	$ 4.52	$ 4.80	$ 4.65	$ 4.93
Options award outstanding, aggregate intrinsic value		$ 152	$ 3,668	$ 12,240
Options award exercised, aggregate intrinsic value	$ 61	$ 1,739	$ 1,427
Options awards outstanding, Weighted Average Remaining Contractual Life (in Years)	3 years 9 months 18 days	5 years 2 months 12 days	5 years 9 months 18 days	5 years 10 months 24 days
Options awards exercisable, Option Awards	16,776	19,863	18,026	16,069
Options awards exercisable, Weighted Average Exercise Price	$ 4.62	$ 5.06	$ 4.88	$ 4.61
Options awards exercisable, Aggregate Intrinsic Value		$ 117	$ 3,320	$ 12,240
Options awards exercisable, Weighted Average Remaining Contractual Life (in Years)	3 years 7 months 6 days	4 years 7 months 6 days	4 years 7 months 6 days	5 years 1 month 6 days

Stockholders' Deficit - Sched_3

Stockholders' Deficit - Schedule of Restricted Stock Units (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
RSU Awards Outstanding [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Beginning balance, number of shares	7,061	1,240	1,040
Share-based compensation arrangement by share-based payment award, grants in period	12,977	6,153	200
Vested/Released, number of shares	(5,126)	(301)
Forfeited, number of shares	(1,328)	(31)
Ending balance, number of shares	13,584	7,061	1,240
Beginning balance, weighted average grant date fair value	$ 1.76	$ 3.56	$ 4.06
Granted, weighted average grant date fair value	1.05	1.39	2.18
Vested/Released, weighted average grant date fair value	1.57	1.78
Forfeited, weighted average grant date fair value	1.47	1.07
Ending balance, weighted average grant date fair value	$ 1.16	$ 1.76	$ 3.56
Beginning balance, aggregate intrinsic value	$ 8,544	$ 3,001	$ 3,962
Aggregate intrinsic value, vested/released	4,021	479
Ending balance, aggregate intrinsic value	$ 4,890	$ 8,544	$ 3,001
RSU Awards Vested and Not Settled [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Beginning balance, number of shares		150
Ending balance, number of shares	1,573		150
Beginning balance, weighted average grant date fair value		$ 4.06
Ending balance, weighted average grant date fair value	$ 2.11		$ 4.06
Beginning balance, aggregate intrinsic value		$ 363
Ending balance, aggregate intrinsic value	$ 566		$ 363

Stockholders' Deficit - Sched_4

Stockholders' Deficit - Schedule of Performance Stock Units (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021		Dec. 31, 2020
PSUs Awards Outstanding [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Beginning balance, number of shares	2,404
Share-based compensation arrangement by share-based payment award, grants in period	7,597		2,586
Vested and settled, number of shares	(1,680)		(152)
Forfeited, number of shares	(118)		(30)
Ending balance, number of shares	8,203	[1]	2,404
Beginning balance, weighted average grant date fair value	$ 1.08
Granted, weighted average grant date fair value	1.04		$ 1.08
Vested and settled, weighted average grant date fair value	1.16		1.14
Forfeited, weighted average grant date fair value	1.07		1.07
Ending balance, weighted average grant date fair value	$ 1.03		$ 1.08
Aggregate intrinsic value	$ 2,953		$ 2,909
Aggregate intrinsic value, vested/released	$ 1,057		$ 226
PSUs Awards Vested and Not Settled [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Ending balance, number of shares	1,968
Ending balance, weighted average grant date fair value	$ 1.18
Aggregate intrinsic value	$ 709
[1]	The number of PSUs represents the base number of PSUs that may vest. The actual number of PSUs that will vest will be between zero and 11,687,530 depending on the Company’s achievement of certain performance goals.

Stockholders' Equity (Deficit)

Stockholders' Equity (Deficit) - Schedule of Performance Stock Units (Parenthetical) (Details) - Performance Shares Unit [Member]	Dec. 31, 2021shares
Minimum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares expected to vest	0
Maximum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares expected to vest	11,687,530

Stockholders' Equity (Deficit_2

Stockholders' Equity (Deficit) - Summary of Unrecognized Share Based Compensation Cost Expected to be Recognized (Details) $ in Thousands	Dec. 31, 2021USD ($)
Equity [Abstract]
2022	$ 8,646
2023	5,199
2024	2,355
Total	$ 16,200

Revenue - Summary of informatio

Revenue - Summary of information about disaggregated revenue by product mix (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Product revenue:
Revenue from Contract with Customer, Including Assessed Tax	$ 86,951	$ 64,872	$ 49,647
ANNOVERA [Member]
Product revenue:
Revenue from Contract with Customer, Including Assessed Tax	37,943	19,611	6,167
IMVEXXY [Member]
Product revenue:
Revenue from Contract with Customer, Including Assessed Tax	31,533	27,139	16,252
BIJUVA [Member]
Product revenue:
Revenue from Contract with Customer, Including Assessed Tax	10,579	6,354	1,836
Prescription Vitamins [Member]
Product revenue:
Revenue from Contract with Customer, Including Assessed Tax	5,725	9,768	9,886
Product [Member]
Product revenue:
Revenue from Contract with Customer, Including Assessed Tax	85,780	62,872	34,141
License [Member]
Product revenue:
Revenue from Contract with Customer, Including Assessed Tax	$ 1,171	$ 2,000	$ 15,506

Revenue - Additional Informatio

Revenue - Additional Information (Details)	1 Months Ended		12 Months Ended
	Dec. 31, 2021USD ($)	Dec. 31, 2021EUR (€)	Dec. 31, 2021USD ($)	Dec. 31, 2021EUR (€)	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2019EUR (€)
Disaggregation Of Revenue [Line Items]
Sales			$ 86,951,000		$ 64,872,000	$ 49,647,000
BIJUVA [Member]
Disaggregation Of Revenue [Line Items]
Sales			10,579,000		6,354,000	1,836,000
IMVEXXY [Member]
Disaggregation Of Revenue [Line Items]
Sales			31,533,000		27,139,000	16,252,000
Knight License Agreement [Member]
Disaggregation Of Revenue [Line Items]
Milestone fees paid upon first regulatory approval					$ 2,000,000
Knight License Agreement [Member] | BIJUVA [Member]
Disaggregation Of Revenue [Line Items]
Sales			0
Knight License Agreement [Member] | IMVEXXY [Member]
Disaggregation Of Revenue [Line Items]
Sales			$ 0
Theramex License Agreement [Member]
Disaggregation Of Revenue [Line Items]
Upfront fee paid						$ 15,500,000	€ 14,000,000
Percentage of quarterly royalty payments received			5.00%	5.00%
Theramex License Agreement [Member] | Maximum [Member]
Disaggregation Of Revenue [Line Items]
Additional milestone payments received in sales milestone payments | €				€ 27,500,000
Milestone payments to be paid in escalating tranches | €				100,000,000
Theramex License Agreement [Member] | Minimum [Member]
Disaggregation Of Revenue [Line Items]
Milestone payments to be paid in escalating tranches | €				25,000,000
Theramex License Agreement [Member] | IMVEXXY [Member]
Disaggregation Of Revenue [Line Items]
Additional milestone payments received	$ 600,000	€ 500,000
Theramex License Agreement [Member] | BIJUVA [Member]
Disaggregation Of Revenue [Line Items]
Sales			$ 1,400,000
Additional milestone payments received			1,200,000	€ 1,000,000
Theramex License Agreement [Member] | IMVEXXY [Member]
Disaggregation Of Revenue [Line Items]
Sales			$ 0

Income Taxes - Schedule of Loss

Income Taxes - Schedule of Loss Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
United States	$ (172,415)	$ (183,524)	$ (176,145)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) $ in Millions	12 Months Ended
	Dec. 31, 2021USD ($)
Operating Loss Carryforwards [Line Items]
Net operating loss carry forwards	$ 885.1
Net operating loss carryforwards term	20 years
Net operating loss carryforwards expiration year	2031
Percentage of future taxable income	80.00%
Expiration Period 20 Years [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carry forwards	$ 338.8
Expiration Period Indefinite [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carry forwards	$ 546.3

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Income Tax Rate Reconciliation (Details)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Federal statutory tax rate	21.00%	21.00%	21.00%
State tax rate, net of federal tax benefit	4.70%	5.10%	4.00%
Adjustment in valuation allowances	(22.10%)	(27.00%)	(22.50%)
Excess stock benefits	(1.50%)	0.10%	0.20%
Permanent and other differences	(2.10%)	0.80%	(2.70%)
Provision (benefit) for income taxes	0.00%	0.00%	0.00%

Income Taxes - Schedule of Comp

Income Taxes - Schedule of Components of Net Deferred Income Tax Asset (Details) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Deferred income tax assets:
Net operating loss	$ 224,660	$ 195,008
Share-based payment compensation	17,698	17,252
Interest expense limitation	20,391	12,992
Accrual for sales returns and coupons	3,779	5,060
R&D credit	186	186
Other, net	1,674	(241)
Deferred income tax asset	268,388	230,257
Valuation allowance	$ (268,388)	$ (230,257)

Loss per common share - Summary

Loss per common share - Summary of computation of basic and diluted loss per common share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended																12 Months Ended
	Dec. 31, 2021	[1]	Sep. 30, 2021	[2]	Jun. 30, 2021		Mar. 31, 2021		Dec. 31, 2020	[3]	Sep. 30, 2020	[4]	Jun. 30, 2020		Mar. 31, 2020		Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Numerator:
Net loss	$ (42,960)		$ (47,420)		$ (42,652)		$ (39,383)		$ (42,087)		$ (32,612)		$ (51,976)		$ (56,849)		$ (172,415)	$ (183,524)	$ (176,145)
Denominator:
Weighted average common shares for basic loss per common share																	397,992	275,649	246,353
Effect of dilutive securities																	0	0	0
Weighted average common shares for diluted loss per common share																	397,992	275,649	246,353
Loss per common share, basic and diluted	$ (0.10)	[5]	$ (0.11)	[5]	$ (0.11)	[5]	$ (0.11)	[5]	$ (0.15)	[5]	$ (0.12)	[5]	$ (0.19)	[5]	$ (0.21)	[5]	$ (0.43)	$ (0.67)	$ (0.72)
[1]	Included $5.1 million in senior executive severances, which included our former CEO.
[2]	Included $7.3 million in senior executive severances, which included our former EVP of Operations.
[3]	Included $0.5 million in write off of certain costs related to trademarks and patents.
[4]	Included (i) $2.0 million in license revenue related to the Knight License Agreement, (ii) $5.7 million in inventory charge, primarily related to BIJUVA, and (iii) $0.6 million in write off of certain costs related to trademarks and patents.
[5]	Basic and diluted loss per common share are computed independently for each quarter and the full year based upon respective weighted average shares outstanding. Therefore, the sum of the quarterly basic and diluted earnings per share amounts may not equal the annual basic and diluted earnings per share amounts reported.

Loss per common share - Schedul

Loss per common share - Schedule of calculation of diluted net loss per share allocable to common stockholders (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	44,569	39,782	28,103
Stock options [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	17,655	23,782	25,030
RSUs [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	13,584	7,061	1,240
PSUs [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	8,203	2,404
Warrant [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	5,127	6,535	1,833

Related parties - Additional In

Related parties - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Catalent [Member]
Related Party Transaction [Line Items]
Amount billed	$ 4,100,000	$ 3,000,000	$ 6,100,000
Estimated amounts payable to related party	900,000	300,000
American International Group [Member]
Related Party Transaction [Line Items]
Amount billed	100,000	200,000
Estimated amounts payable to related party	$ 0	$ 0

Business concentrations - Addit

Business concentrations - Additional Information (Details)	12 Months Ended
	Dec. 31, 2021
Customer Concentration Risk [Member] | Maximum [Member] | Revenue [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Customer Concentration Risk [Member] | Maximum [Member] | Accounts Receivable [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Customer Concentration Risk [Member] | Minimum [Member] | Revenue [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Customer Concentration Risk [Member] | Minimum [Member] | Accounts Receivable [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Vendor Concentration Risk [Member] | Maximum [Member] | Product purchases [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Vendor Concentration Risk [Member] | Maximum [Member] | Accounts Payable [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Vendor Concentration Risk [Member] | Minimum [Member] | Product purchases [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%
Vendor Concentration Risk [Member] | Minimum [Member] | Accounts Payable [Member]
Concentration Risk [Line Items]
Concentration Risk, Percentage	10.00%

Business concentrations - Summa

Business concentrations - Summary of Customers with Product Revenue (Details) - Customer Concentration Risk [Member] - Revenue [Member]	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Customer A [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	11.00%	21.00%	37.00%
Customer B [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	15.00%	16.00%	11.00%
Customer C [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	17.00%	28.00%	13.00%
Customer E [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	12.00%
Customer F [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage			12.00%

Business concentrations - Sum_2

Business concentrations - Summary of Customers that Accounted for 10% or Greater of Accounts Receivable (Details) - Customer Concentration Risk [Member] - Accounts Receivable [Member]	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Customer A [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage		17.00%
Customer B [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	21.00%	19.00%
Customer C [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	35.00%	25.00%
Customer D [Member]
Disclosure Of Customers With Product Revenue And Account Receivable For The Period [Line Items]
Concentration Risk, Percentage	11.00%	11.00%

Business concentrations - Sum_3

Business concentrations - Summary of Vendors with Product Purchases (Details) - Product purchases [Member] - Vendor Concentration Risk [Member]	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Catalent [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	33.00%	30.00%	24.00%
Vendor A [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	36.00%	25.00%
Vendor B [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	27.00%	36.00%	27.00%
Vendor I [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage			35.00%

Business concentrations - Sum_4

Business concentrations - Summary of Vendors Accounted for 10% or Greater of Accounts Payable (Details) - Vendor Concentration Risk [Member] - Accounts Payable [Member]	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Vendor E [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	19.00%	17.00%
Vendor F [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage	20.00%	16.00%
Vendor G [Member]
Disclosure Of Vendors With Product Purchases And Accounts Payable For The Periods [Line Items]
Concentration Risk, Percentage		10.00%

Summary quarterly information_3

Summary quarterly information (unaudited) - Summary of Quarterly Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended																12 Months Ended
	Dec. 31, 2021	[1]	Sep. 30, 2021	[2]	Jun. 30, 2021		Mar. 31, 2021		Dec. 31, 2020	[3]	Sep. 30, 2020	[4]	Jun. 30, 2020		Mar. 31, 2020		Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Quarterly Financial Information Disclosure [Abstract]
Total revenue, net	$ 18,678		$ 25,406		$ 23,001		$ 19,866		$ 22,578		$ 19,342		$ 10,701		$ 12,251		$ 86,951	$ 64,872	$ 49,647
Gross profit	13,941		20,124		18,869		15,179		16,997		16,063		6,301		9,536		68,113	48,897	43,312
Loss from operations	(35,392)		(39,921)		(35,179)		(29,278)		(34,607)		(24,974)		(45,038)		(50,922)		(139,770)	(155,541)	(151,205)
Net loss	$ (42,960)		$ (47,420)		$ (42,652)		$ (39,383)		$ (42,087)		$ (32,612)		$ (51,976)		$ (56,849)		$ (172,415)	$ (183,524)	$ (176,145)
Loss per common share, basic and diluted	$ (0.10)	[5]	$ (0.11)	[5]	$ (0.11)	[5]	$ (0.11)	[5]	$ (0.15)	[5]	$ (0.12)	[5]	$ (0.19)	[5]	$ (0.21)	[5]	$ (0.43)	$ (0.67)	$ (0.72)
[1]	Included $5.1 million in senior executive severances, which included our former CEO.
[2]	Included $7.3 million in senior executive severances, which included our former EVP of Operations.
[3]	Included $0.5 million in write off of certain costs related to trademarks and patents.
[4]	Included (i) $2.0 million in license revenue related to the Knight License Agreement, (ii) $5.7 million in inventory charge, primarily related to BIJUVA, and (iii) $0.6 million in write off of certain costs related to trademarks and patents.
[5]	Basic and diluted loss per common share are computed independently for each quarter and the full year based upon respective weighted average shares outstanding. Therefore, the sum of the quarterly basic and diluted earnings per share amounts may not equal the annual basic and diluted earnings per share amounts reported.

Summary quarterly information_4

Summary quarterly information (unaudited) - Summary of Quarterly Information (Parenthetical) (Details) - USD ($) $ in Thousands

3 Months Ended

12 Months Ended

Dec. 31, 2021

Sep. 30, 2021

Jun. 30, 2021

Mar. 31, 2021

Dec. 31, 2020

Sep. 30, 2020

Jun. 30, 2020

Mar. 31, 2020

Dec. 31, 2021

Dec. 31, 2020

Dec. 31, 2019

Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]

Total revenue, net

$ 18,678

[1]

$ 25,406

[2]

$ 23,001

$ 19,866

$ 22,578

[3]

$ 19,342

[4]

$ 10,701

$ 12,251

$ 86,951

$ 64,872

$ 49,647

Inventory charge

5,700

Write-off of patent and trademark

$ 500

600

$ 0

$ 1,132

$ 79

Knight License Agreement [Member]

Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]

Total revenue, net

$ 2,000

Senior Executive [Member]

Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]

Amount in severances

$ 5,100

$ 7,300

[1]

Included $5.1 million in senior executive severances, which included our former CEO.

[2]

Included $7.3 million in senior executive severances, which included our former EVP of Operations.

[3]

Included $0.5 million in write off of certain costs related to trademarks and patents.

[4]

Included (i) $2.0 million in license revenue related to the Knight License Agreement, (ii) $5.7 million in inventory charge, primarily related to BIJUVA, and (iii) $0.6 million in write off of certain costs related to trademarks and patents.

Subsequent events - Additional

Subsequent events - Additional Information (Details)	Mar. 06, 2022USD ($)Tranche	Mar. 31, 2022USD ($)	Dec. 31, 2023USD ($)	Dec. 31, 2022USD ($)
Subsequent Event [Member] | Financing Agreement Amendment No 9 [Member]
Subsequent Event [Line Items]
Minimum cash balance requirement under credit agreements		$ 60,000,000
Prepayment penalty		60,000,000
Payment of in kind amendment fee		30,000,000
Subsequent Event [Member] | Financing Agreement Amendment No 9 [Member] | Debt Covenants [Member]
Subsequent Event [Line Items]
Waivable in kind amendment fee		$ 16,000,000
VitaCare Divestiture [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Proceeds from divestiture of business	$ 150,000,000
Contingent cash consideration from sale of business	$ 7,000,000
Number of earned cash consideration tranches | Tranche	2
Maximum transition services provided period	12 months
VitaCare Divestiture [Member] | Revenue Target for 2022 [Member] | Forecast [Member]
Subsequent Event [Line Items]
Contingent cash consideration from sale of business				$ 3,500,000
VitaCare Divestiture [Member] | Revenue Target for 2023 [Member] | Forecast [Member]
Subsequent Event [Line Items]
Contingent cash consideration from sale of business			$ 3,500,000