The Rise of Femtech: Menstruation, Fertility, and Sex — Oh My!

Menstruation cramps, incontinence, breastfeeding, vaginal dryness, orgasms, menopausal symptoms, and other things that are awkward and not fun to discuss even with a friend. To say nothing of pitching any of them to a tech startup investor, a male investor.

After centuries of silence and shame, women are starting to see these topics leaving the realm of taboo, with the rise of technology for women — Femtech.

A catchy term, coined only a few years ago by Ida Tin, founder of the period-tracking app Clue, Femtech refers to technology for improving the health and wellbeing of women and people experiencing similar problems. Femtech products and tools include not only period trackers but also pelvic-floor exercisers, app-enabled sex toys, tampon alternatives, birth control apps, and other categories.

“That’s a big thing. … investors can say, 'I have four femtech companies in my portfolio' instead of 'I have a company for women peeing in their pants,” Ida Tin told the crowd at a Geekettes event, explaining the need to categorize the industry.

Currently, the Femtech market shows exponential growth, projected to reach an impressive $60.01 billion by 2027 from $18.75 billion in 2019, according to a recent report by Emergen Research.

There’s finally an increasing awareness of huge unmet demand. What was long considered niche needs actually affect roughly half of the global population — a market of 3.73 billion prospective customers.

Entering this largely unsaturated market may seem easy and complicated at the same time. To examine the controversy, let’s look at some stats, and then at challenges and opportunities that a femtech startup journey might involve.

Femtech sectors and numbers

As said above, the Femtech industry primarily refers to software, products, and tools that enhance women’s health and wellbeing. These are usually classified into the following categories:

Menstruation: Period apps for tracking cycles and recording symptoms, like Clue, Glow, Eve, Flo, Natural Cycles, My Calendar, and many others, with some also used to avoid or attempt pregnancy. Other top companies in this space provide subscription services to deliver feminine hygiene products to customers’ doorstep like Cora.

Birth Control: Apart from contraception apps like Natural Cycles, this category includes companies like Nurx that provide telemedicine prescription and home delivery of birth control products or Pexxi that uses genetic testing and AI to tell women which hormonal contraceptive will work for them.

Fertility: A growing list of companies offering digital solutions for those who try to conceive, addressing in vitro fertilization (IVF), egg freezing, or medical treatments. Among them is tech-enabled fertility clinic Kindbody, the Univfy AI platform, fertility benefits management company Progyny, and FertilityIQ that provides data about fertility clinics and doctors.

Menopause: Companies that address the needs of women in menopause like the telemedicine menopause clinic Gennev, CurieMD that offers remote consultation and mail-order prescriptions of hormonal replacement therapies, or EloCare that has produced a wearable multi-sensor Menopause Assistant for tracking menopausal symptoms.

Chronic Conditions: Innovative care and management of chronic conditions that disproportionally affect women, including certain cancers, cardiovascular disease, or depression.

Pelvic Health: Apps that offer pelvic floor muscle exercise programs to women who experience bladder control problems or want to improve their pelvic health for better intimacy or faster postnatal recovery. These include Elvie Trainer, an app-connected pebble-shaped pod placed inside like a tampon.

Sexual Wellness: Sexual health apps, audio guides, audio erotica, and smart vibrators connected to an app, like Lioness.

Gynecological Health: Solutions that span various healthcare services related to routine gynecologic care or sexual education, like the Supper Izzy AI chatbot that offers personalized data-based health advice to women.

Pregnancy and Motherhood: This list features pregnancy planning and tracking apps as well as connected and app-paired devices helping women through their journey from conception to birth and in the postnatal period. Companies specializing in this category also build baby monitor apps and apps empowering women to explore maternity care choices or make friends with other new moms in the neighborhood.

Breastfeeding: Innovators in the mother space include breastfeeding apps, mobile lactation apps for consultation, wearable breast pump makers like Elvie or Willow, breastfeeding communities like Pumpspotting, and breast milk shipping services like Milk Stork for working or traveling breastfeeding moms.

Lifestyle: Solutions for body and mind wellbeing like Kronaby watches that perform like smartwatches or the Bellabeat wellness tracker that monitors health, fitness, menstrual cycles, sleep patterns, meditation, and stress.

The Femtech industry currently comprises over 200 companies worldwide, of which 90% are led by women. As of June 30, 2020, almost half of US femtech companies (24 out of 51) with deals greater than $ 2 million specialized in the fertility sector, compared to 12 femtech companies targeting chronic diseases.

Source: Digital health seed fund Rock Health. Note: Only includes US deals > $2 million, data through June 30, 2020 .*Each femtech company can address multiple segments

Source: Digital health seed fund Rock Health

PitchBook analysts believe that despite the 2019 decline in investor funding, secular drivers can propel new growth opportunities in the industry, opening the door to new products and services.

This optimism is shared by Rock Health investors who say that femtech opportunities expand far beyond reproduction, with a number of femtech areas primed for innovation. US startups focusing on fertility, pregnancy, and motherhood solutions received 65% of all femtech funding at the beginning of 2020, while less than 45% of the female population in the US is of reproductive age, according to Rock Health.

Challenges faced by Femtech

While the femtech market presents a wealth of opportunities, with working-age women 75% more likely to use digital tools for health than men, femtech companies are facing big challenges as well. These essentially boil down to getting funded.

1. Investors do not always understand women’s health issues and hence, a value proposition. Vendor capital in the US is still a boys’ club. “It felt like — in my pitches — I was educating more than pitching, because it was a space people just didn’t know about,” Gennev Founder and CEO Jill Angelo told TechCrunch. Or, as Laurence Fontinoy, founder of fertility-tracking app Woom, recalled in her interview with The Guardian, a room full of investors can simply break into laughter at the mention of menopause.

The stigma around women’s issues makes it difficult for women founders of femtech companies to discuss their agenda freely. Over 90% of decision-makers at US venture capital are men, and many just can’t relate to a product offered by a femtech startup.

2. Women founders shy away from asking for money. While women-owned businesses in the US are growing 2x faster than all businesses nationwide, women are less likely to ask for outside funding than their male counterparts. According to a survey from SCORE spanning over 20,000 US small businesses, only 25% of women entrepreneurs seek financing over the lifespan of their business.

3. Those women who do get investor money, get less than guys. After studying years of data from TechCrunch Disrupt New York City, Dr. Dana Kanze of Columbia University and her fellow researchers have found that women are two times as likely to be treated negatively when asking for money from investors. Perhaps, this is a reason that men are more likely to borrow funds for a new product and borrow more than women, according to another SCORE report.

Opportunities for new Femtech players

Opportunities in the Femtech market are endless. This is simply because there’s been shockingly little innovation in the industry for many years — since the invention of the birth control pill in the 1950s, the applicator tampon in the 1930s, or the self-adhesive pantyliner in the 1970s.

Only in 1993, US Congress passed a law requiring the National Institutes of Health (NIH) to include women in government-funded medical research. Only in 2015, Apple has added a period-tracking feature to its Health app on iPhones after heavy criticism in 2014. And only in 2017, a red liquid was used for the first time ever instead of blue for depicting period blood in an ad campaign, run by the UK-based brand Bodyform.

Women don’t need apps with cute unicorns and pretty pink flowers. They need technology that can radically improve their health and wellbeing neglected for too long.

New product development

Period product innovations are changing the lives of women who on average have more than 500 menstrual cycles in their lifetime. We see the first startups developing smart tampons like my. Flow or smart menstrual cups like Looncup, but there’s still a long way to go in tackling women’s discomfort through technology and social norm change. The narrative around menstruation has been shifting after 2015, dubbed the year the period went public. However, over 40% of men still admit to joking or commenting on a menstruating partner’s mood and almost three-quarters of women hide a pad or tampon from view on their way to the bathroom, according to a study commissioned by THINX.

Prenatal care and maternity

From social media platforms like Peanut and Stork for women trying to conceive or looking to share experiences with other expecting moms to telemedicine and devices for pregnancy tracking, fetal monitoring, and contractions timing, innovations in this space have climbed in popularity. They educate women with doctor-authored articles, track symptoms, send reminders, and do other helpful stuff. They also reduce pregnancy management costs for both payers and providers and help moody and tired women feel less lonely and isolated. Prenatal depression and anxiety affect one in seven women, while postpartum depression occurs in 10 to 20% of women who have recently given birth.

Inclusivity

As evidenced by market trends, the femtech industry is focused on motherhood. This means there is so much room for catering to the unmet needs of LGBTQ+ communities, people who don’t menstruate, don’t want children, choose abortion when getting pregnant or have a reproductive disorder, such as polycystic ovary syndrome (PCOS). It’s time to make the space more inclusive, including for queer and gay communities. Millennials are twice as likely to identify as LGBT+ than previous generations, and only two-thirds of Gen Zs identify as exclusively heterosexual, according to a report from GLAAD.

Digital support for women with stigmatized health conditions

At least one in four women experiences distressing menstrual pain characterized by a need for medication. More than a third of women are affected by at least one pelvic floor disorder. To support women who might find it embarrassing to discuss these topics with a medical provider, femtech companies are emerging to provide remote care and digital therapeutics programs. These include Renovia that offers app-connected pelvic floor therapy, Visana Health with a digital program aimed at improving pain resolution for women who suffer from endometriosis, and Renalis working on a suite of prescribed digital therapeutics for patients with fibroids or endometriosis.

Menopause management

Among areas of innovation open in the femtech space is the menopause market. Treatments currently available to relieve symptoms of menopause, from hot flashes, night sweats, weight gain to insomnia include hormone replacement therapy and supplements, but there isn’t much anything else. As 85% of women experience a menopause-related symptom in their lifetime, innovation in this area can be very lucrative. So we see startups getting funding to build digital menopause management solutions, from wearables and symptom tracking apps to telemedicine services.

Support for women with Alzheimer’s disease and osteoporosis

Women account for nearly 75% of Americans living with Alzheimer’s and for 80% of Americans living with osteoporosis. However, there is still a lack of apps for improving the self-management of osteoporosis or supporting the complex needs of AD patients and their families with alert features, self-care tips, or social networking. Also, there is an unmet need for digital solutions that could enhance collaboration between medical providers to detect and manage such conditions.

Mental health apps

Femtech has big potential for offering mental wellness programs for women who are about twice as likely as men to be diagnosed with depression. App-based therapy can also help address gender-specific risk factors, such as miscarriages or gender discrimination. In addition, investors like Rock Health see a lack of digital solutions supporting victims of sexual violence. Approximately one in five women in the US has experienced completed or attempted rape during their lifetime.

Detection of early disease signs

Early detection and screening is another area ripe for disruption. By harnessing AI-powered healthcare solutions to train algorithms on medical data sets, emerging technology can help women detect early signals of disease, like ovarian cancer. Symptom-tracking apps can also help catch endometriosis symptoms early. So far, innovations in this area have predominantly addressed breast cancer through AI-powered research tools and services for pathology or AI systems for ultrasonography.

Summing up

“There’s an emerging understanding that there are many needs, and where there are many needs, there are also many opportunities,” Clue CEO Ida Tin said at a Geekettes panel. “The exciting part is, these needs are just beginning to be recognized, and there will be many more opportunities down the road to improve women’s lives through technology.”

Innovators just need to pick the right space they are passionate about.

If you’re one of them, drop us a line to build a disruptive product that will help improve the quality of women’s life.