By Karen Pallarito
If you haven’t noticed all the new wearables, mobile apps, self-care gadgets, or tech-enabled services designed for women’s health, well, you’re just not paying attention. Femtech is seeping into daily life. Hands-free breast pumps are a thing; period underwear is everywhere.
To many industry leaders, femtech is more than a market sector—it’s a movement. “It’s giving a voice to women that we never had,” Reenita Das, partner and senior vice president of transformational health at the global consulting firm Frost & Sullivan, tells Health. The firm forecasts global femtech revenues of at least $1.1 billion by 2024.
Ida Tin, CEO and co-founder of the period-tracking app Clue, takes credit for coining the term as a way to unify the women’s health technology sector. These femtech startups initially focused on reproductive health, paving the way for wider conversations around menstruation, ovulation, and lactation. While fertility and pregnancy companies have dominated the space, entrepreneurs and analysts see enormous opportunities for growth in relatively untapped areas, including menopause, pain management, and cancer care.
Maven Clinic founder and CEO Kate Ryder runs the nation’s largest virtual clinic for women’s and family health; it’s been named one of Fast Company’s “World’s Most Innovative Companies” for 2020. With custom offerings including fertility, pregnancy, and postpartum care, the clinic caters to female needs. Ryder, though, defines her mission in “people” terms. Users include same-sex couples and dads; 30% of Maven members are men, she points out. “Calling out femtech—it turns some people off and, quite frankly, it confuses some of the buyers of this category,” Ryder tells Health.
While not a fan of the term, MakeLoveNotPorn founder Cindy Gallop gives a shout-out to her fellow female founders who use it. “Women use ‘femtech’ to get funded. Because it’s just so fucking difficult for those of us trying to change the world… to raise the kind of funding young white men do for trivial shit,” she vents on Facebook.
You might say femtech has become something of a rallying cry. Frost & Sullivan’s Das says it’s empowering women to take charge of their health. And, she adds, femtech is forcing men to reckon with women’s health care needs: “We react to products differently; we think about health differently; we take care of ourselves differently.”
Meet the women disrupting the status quo
It’s hard to fathom, but more than half of maternal deaths in the US are preventable, and the maternal death rate highlights disparities in pregnancy and postpartum care, particularly for Black and American Indian/Alaska Native women. Up to one in five women experience postpartum depression, yet many fail to get help. Only 20% of ob-gyn, internal medicine, and family medicine doctors are trained in menopause management, even though up to 80% of women experience hot flashes and night sweats.
Think about the mom struggling to breastfeed her new baby. A lactation consultant might not be covered by her insurance, or it could take a month to get an appointment, says Maven Clinic’s Ryder. But what if she were able to book an affordable, virtual visit at 10 p.m. on a Sunday?
Femtech leaders are using technology to solve for situations like that. Sometimes their own sour experiences with the status quo are the source of inspiration.
A friend’s suicide attempt convinced Ariela Safira that no one should have to reach rock bottom before accessing mental health services. She envisioned an affordable, flexible, “user-focused” model of care that would make checking in with a therapist just as valuable as a gym membership. Her company, Real, is designing therapy that empowers women to deal with issues like body image, intimacy, self-pleasure, imposter syndrome, and doubts about having a child. When the COVID-19 pandemic hit, what began as a brick-and-mortar concept has expanded to a digital play serving all demographics.
As a college student, Emily Hochman says she feared the “freshman 15” and did what mass media seemed to be telling her to do: go on a diet. But after dieting “like crazy,” she became quite ill. Doctors diagnosed her with everything from polycystic ovarian syndrome and hyperthyroidism to pre-diabetes. Embarking on a journey to heal her body, Hochman earned certification as a health coach and “became obsessed with the power of food”—food as fuel, food as medicine. That inspired Wellory, an “anti-diet” app that matches users with a nutrition coach to help them learn how to eat.
Kiira Health was born out of Crystal Evuleocha’s lack of access to a personal physician. As a Nigerian immigrant who came to the US for college in 2010, she relied on the internet to diagnose her pain. Evuleocha self-medicated for what she thought were period cramps until learning, after emergency surgery, that it was actually her appendix flaring up. Kiira is designed to close the gap in access to care that she experienced by connecting young women of multicultural backgrounds to trusted clinicians. “Our whole goal is to revolutionize the women’s health space, and we feel like we can do it specifically by starting with the younger generation” Evuleocha tells Health.
When Ann Garnier was beset by hot flashes and headaches, she turned to Google and Facebook for help but found the information confusing, complex, and, in her words, “not very trustworthy,” she tells Health. That’s when the veteran health care executive took matters into her own hands. “There’s nothing like experiencing a problem firsthand to motivate you to want to solve it,” says Garner, founder and CEO of Lisa Health, which provides evidence-based support for managing menopause.
When women’s well-being is an afterthought
It’s 2020. Why has it taken so long for technology to make inroads in women’s health? In her bestseller, Invisible Women: Data Bias in a World Designed for Men, author and activist Caroline Criado Perez exposes the many ways in which half of the human population has been overlooked. Whether in the design of public restrooms, workplace policies, or consumer products, men are the default.
The same goes for medicine. “Historically, it’s been assumed that there wasn’t anything fundamentally different between male and female bodies other than size and reproductive function,” writes Criado Perez, “and so for years medical education has been focused on a male ‘norm,’ with everything that falls outside that designated ‘atypical’ or even ‘abnormal.’” This “gender data gap,” as she calls it, has fostered a pattern of systemic discrimination that has left women “chronically misunderstood, mistreated and misdiagnosed.”
Women’s lack of inclusion began decades ago. A 1977 guideline issued by the US Food and Drug Administration (FDA) barred women of childbearing age from participating in clinical trials. Only after the US Department of Health and Human Services convened the first task force on women’s health did the matter come under scrutiny. It led to new guidance encouraging broader inclusion of women. Yet gaps persisted: a 1992 government audit found, for example, that women were underrepresented in half of trials of cardiovascular drugs.
Congress finally enacted legislation the following year to ensure that women and minorities are included in clinical research. Decades later, women’s health is still playing catch-up.
Fighting gender bias one algorithm at a time
Consider heart disease, the No. 1 killer of women. Shouldn’t there be better tools for detecting women’s heart problems and improving health outcomes?
Alicia Chong Rodriguez
Alicia Chong Rodriguez is on a mission to give women a tool that can help. Her company, Bloomer Tech, is integrating washable fabric sensors with machine-learning capabilities into a bra that provides continuous heart monitoring. Bloomer Tech’s “smart bra” is designed to provide medical-grade data, yet it looks just like any other bra, nothing like an old-school Holter monitor (a portable electrocardiogram device that a woman might strap on for a 24- to 48-hour period). A woman with risk factors might one day access the bra through her health care provider. Currently, it’s available only to beta testers. Meantime, the company is looking to expand its pilot programs with key partners (such as hospitals and pharmaceutical manufacturers) to collect more data and further develop the product.
What’s cool about the bra is what makes it smart. Chong Rodriguez, the company’s founder and CEO, is determined to avoid the sort of “algorithmic bias” that has tripped up other tech developers. Studies show, for example, that facial recognition software works well if you’re a white guy, but not so much if you’re trans or a woman of color. The algorithms—or instructions—for discerning differences in appearance fail to adequately account for such variations.
The same biases creep into health technology when developers rely on historical data based on men’s physiology. Chong Rodriguez hopes to accelerate progress in women’s heart health by collecting that missing data. “It’s really important for us to design around the uniqueness of the female body in order to capture high-fidelity data,” she tells Health. “We’re going to be building better algorithms for the individuals that are using these devices by understanding her physiology better.”
Better algorithms could benefit women with other health conditions, too. Diagnostic testing startup NexGen Jane is beta testing a “smart tampon” that collects menstrual effluence. By analyzing cells and tissue shed during a woman’s period, the company hopes to create algorithms to identify important early warning signs of endometriosis and other health conditions.
Where is my urethra?—and other important conversations that need to happen
The expanding pipeline of science-based femtech products means women are bound to have lots of questions. Rather than simply push product, some femtech CEOs are helping women make informed decisions.
Launched in 2018, Natalist curates products for women who are planning a pregnancy: think ovulation and pregnancy tests, prenatal vitamins, and lube. What buyers won’t find on the website are “products that failed science class,” including gender prediction tests, birth control cleanses, and even at-home ovarian reserve test kits. Founder and CEO Halle Tecco devotes a webpage to products banned from the site and reasons why they don’t make the cut. “We don’t want people to waste their money on things that don’t have evidence,” Tecco tells Health.
When a women’s health product is first in class—a novel solution to a common problem—well, you can just imagine how crucial it would be to reach out to users and potential customers.
This month, more than 800 Target stores nationwide began stocking their shelves with Finess, the first FDA-cleared bladder-leak product designed to stop urine from escaping, say, when a woman exercises, coughs, or sneezes. It’s not a bulky pad. It’s a soft, disposable, landfill-friendly foam patch a woman places over her urethral opening, through which urine passes. Each package contains an insert with an anatomical diagram of a vagina to assist women with positioning the patch correctly. While there’s data to prove its efficacy, “we are creating an entirely new category,” Evi Heilbrunn, CEO of feminine-care company Privy, which brought Finess to market, tells Health. [Editor’s note: Heilbrunn is a former employee of Meredith, Health’s parent company.] And with it comes a massive opportunity to educate and shed light on what have been historically taboo, below-the-waist issues that women experience.
How investments in women’s health technology are stacking up
There are signs that investors are warming up to femtech’s market potential. In 2018, US femtech startups attracted $388 million in venture capital—a record year, according to Rock Health, a funder of digital health startups. At the same time, it was a drop in the bucket, representing just 4.7% of total VC funding that year. Femtech’s slice of the pie shank to 3.3% in 2019, says Rock Health; it accounted for just 1.5% of total funding in the first half of 2020.
Compared with how much money is going toward men’s health, or even femtech companies founded by men, “it’s still a very trivial amount,” Elizabeth Galbut, a founding partner of SoGal Ventures, the first female-led venture capital firm that invests in how the next generation lives, works, and stays healthy, tells Health.
Case in point: In 2017, telehealth startup Ro launched Roman to make it easier for men experiencing erectile dysfunction to connect with a clinician and get ED medication. Ro, which has since launched two more brands—Rory for women’s health and Zero for smoking cessation—has raised $376 million since inception. Now compare that with Maven Clinic, one of the most successful fundraisers in the femtech space, which has attracted $88 million.
Male investors, in general, don’t grasp the immensity of the femtech market, observes Natalist’s Tecco, an investor in women’s health and the founder and former CEO of Rock Health. They haven’t experienced periods or pregnancy; there’s stigma around female symptoms, like pregnancy-related constipation and hemorrhoids. “Women have been left out because men are running the show,” she says, “but also because we don’t have an open dialogue about really important topics.”
Ultimately, Frost & Sullivan’s Das predicts that, by 2030 or 2040, the conversation will have shifted from women’s health to “human health.” But we’re not there yet.