Over the last year, we’ve published a series of blogs and white papers discussing the gender health gap – specifically, how we continue to make the same mistakes when it comes to women’s health – and how marketers, innovators and communicators can use these lessons to do better for women.

In this blog, we take a look at how the femtech industry is taking on this challenge.

So what is femtech?

The term ‘femtech’, short for female technology, was originally coined in 2016 by Ida Tin¹ (co-founder and CEO of menstrual cycle tracking app Clue) and refers to software, diagnostic equipment and products that use technology to improve the health and lives of women.

As we have spoken about in previous blogs, there are a lot of areas in women’s health that require improvement, such as people feeling dismissed by their GPs when explaining their symptoms,^2–4 or the fact that there are certain conditions which are extremely prevalent in the female population but remain underdiagnosed and poorly understood, like endometriosis.^5,6 It is hoped that by taking an innovative approach to women’s health, the femtech industry will provide solutions to some of these issues.

Why is the industry  proving to be so successful?

While the COVID-19 pandemic has accelerated the adoption of digital practices across many areas of healthcare (it is estimated that digital adoption for both consumers and businesses moved forward by 5-years in the space of eight weeks⁷), the femtech industry was already beginning to take off before this industry shake-up.⁸ Within the past 5 years, femtech has seen a boom in both revenue and popularity.⁹ While initially focussing on fertility and period tracking, it is now expanding to cover everything from pelvic floor health to improving diagnostic rates of certain cancers.

So why is femtech proving to be such a hit? Is it down to the ethos of addressing long-neglected areas of healthcare and providing the services that women have been requesting for years? Or could it be that by giving the industry a name, it’s made products addressing the more ‘taboo’ women’s health issues more appealing to investors and highlighted a new market niche?¹⁰

Whatever the answer, we believe that female technology is going to be a mainstay in women’s health going forward.

Who is femtech for?

The target audience of these technologies has also broadened over time. Although the majority of femtech falls under the direct-to-consumer category (with products such as smartphone apps and devices including everything from newly designed breast pumps to wearable fertility trackers), there are also companies that create products for HCPs (like updated diagnostic tools or apps to support HCPs on certain women’s health topics).

As we discussed in our previous blog, ‘Marketing healthcare and lifestyle to millennials’, people between the ages of 24–40 have a particularly strong demand for convenient, digital solutions. In fact 36% of all online purchases come from the millennial generation.¹¹ However, the older generations Gen X and Baby Boomers, along with the younger Gen Z are also embracing digital.¹²

As a result, this digital-focussed industry follows the trend by predominantly creating products for women in their reproductive years. There is a vast array of products focussed on cycle tracking, pregnancy planning and the early years of motherhood. As the industry expands, we are also seeing more products available for the older age groups who still have a strong digital capability: for example apps that provide advice on going through menopause.¹³

Ultimately, the major benefits of femtech include allowing these women to gain a greater level of understanding and control over their own health along with widening access and knowledge to the less well-understood women’s health topics, all in an innovative and digitally convenient way.

5 ways that femtech is improving the health experience for women:

1. It empowers women to better understand their own bodies

We already know that it is a common occurrence for women to feel dismissed or misunderstood by their healthcare providers.^1–3 While this is a serious issue that needs to be addressed, femtech companies are looking for ways to alleviate the issue in the meantime.

For example, apps such as menstrual cycle trackers can help people to understand the patterns of their own hormone cycles. Users are first asked to input dates of their menstrual periods along with information on their symptoms. Over time the apps will then use this data to be able to predict the dates of each phase of the menstrual cycle.

This personalised data can then be used for features such as:

Predicting and better understanding period symptoms

Apps such as Clue and Flo can be used to predict the start date of your next period; receive updates on likely symptoms and when they might start; and find clear explanations of how your current hormone levels could be influencing your mood.

Pregnancy planning and contraception

Some menstrual cycle trackers, along with dedicated fertility apps can be used to predict which days of the month are your ‘fertile window’, which can then be used to improve your chances of conception.

Alongside recording the dates of your periods, the app Natural Cycles uses extra inputs such as daily basil body temperature, allowing their internal AI to predict your fertile window with more confidence. This has allowed the app to market itself as a form of digital contraception for those looking to avoid pregnancy.

Creating exercise regimes tailored to your current hormone levels

Jennis is an app, founded by Dame Jessica Ennis-Hill, that uses cycle-tracking to recommend a personalised daily exercise regime. The goal is to maximise psychological benefits and physical gains by suggesting the form of exercise that will be most beneficial (be it strength training, stretching, cardio etc.) at different stages during your cycle.

The app Natural Cycles is designed to be used as a digital form of contraception, using a simple colour coding system to indicate which days the user is at risk of pregnancy

(Image from Natural Cycles)

2. It's taking women's perspectives into account

In an industry that often leaves women feeling ignored, femtech puts women front and centre. A great example of this is the leading femtech brand Elvie, who pride themselves on improving long neglected areas of women’s health, designing alternative products with women’s lifestyles in mind.

Case study: redesigning the pelvic floor trainer

Elvie first entered the market with a pelvic floor trainer. Despite being an uncomfortable topic of conversation for many, pelvic floor disorders are surprisingly common: affecting 1 in 3 women at some point during their lives.¹⁴ Although studies have shown that pelvic floor exercises can lead to a substantial improvement in symptoms,¹⁴ the issue is that women don’t always adhere to these exercises in the long-term.¹⁵ Evidence also showed that the existing products created to improve adherence, did not appear to make a difference.^16,17

The Elvie Trainer was designed specifically to address this issue. The device incorporates biofeedback into an at-home device with an accompanying app which uses gamification and visualisation techniques to both encourage long-term adherence but also provide women with reassurance that they are doing the exercises correctly.¹⁸ The product was such a success that it is now offered to affected women via the NHS.¹⁹

For the design of their pelvic floor trainer, Elvie steered away from the more medical appearance of the existing technology, choosing a packaging style more similar to that of the technology or fitness tracking industries.

(Image from Elvie)

3. It's providing women with personalised advice and a sense of community outside of a healthcare setting

For those struggling to feel heard by their existing healthcare providers when it comes to women’s health, there are a wide range of Femtech apps providing advice and consultations with women’s health experts, accessible via smartphone. There are two key areas where we believe these apps can be extremely useful:

Pregnancy and breastfeeding

We discussed in our recent MAGNIFI: ‘Gender inequality: how COVID-19 impacted women’ how the pandemic has made pregnancy and postpartum a very isolating time for Mums across the globe. From attending doctors’ appointments alone throughout their pregnancy,²⁰ to the absence of in-person baby groups and classes, support networks for new mothers have been disbanded.²¹ This lack of community then makes tasks such as navigating breastfeeding for the first time a lot more difficult – this is an area where femtech might be able to help.

LactApp is a breastfeeding companion app which was designed in Spain and is now used by 19% of Spanish new mothers. The app uses AI to give personalised breast-feeding advice 24h-hours a day, 7 days a week.

Menopause

Menopause is another area of women’s health that is often considered taboo but where extra support is greatly needed. As discussed in our 2020 edition of MAGNIFI: ‘What’s missing in women’s health?’, menopause is poorly understood by the general public but also healthcare professionals. For example, the mental symptoms such as brain fog can be extremely debilitating but are rarely talked about.²²

Apps such as Stella and Alva are designed specifically to provide extra support for women going through menopause, providing resources such as personalised advice and even video consultations with experts on the subject – giving women access to someone who they know will take their symptoms seriously.

4. It's addressing the big risks for women

As the femtech landscape is expanding beyond its initial focus on menstruation and reproduction, it’s turning its attention to other unmet needs in women’s health, like improving the standard of care for some of the major conditions affecting women:

Breast cancer

Breast cancer is the most commonly occurring cancer in women. A diagnosis of breast cancer is a life changing moment. Even when treatment is successful, women are left to deal with the aftermath, including the psychological impact or even learning to feel comfortable with their body following mastectomy.

Lattice Medical is a biomedical start-up that specialises in soft-tissue reconstruction. They’re currently working to make the process of recovering from a mastectomy as simple as possible, through designing a 3D printed breast implant that can help rebuild a woman’s breast tissue. The implant will then fully degrade within a year, so no invasive removal surgery is needed.²³

Cervical cancer

This is the fourth most common cancer in women globally but also one of the most successfully treated if caught early and managed properly.²⁴

Mobile ODT is a femtech company using smartphones and AI to help improve the process of cervical screening; making it easier to carry out screenings quickly and at scale, by a broader range of healthcare providers. They are even working with the WHO, helping them towards their goal of eliminating cervical cancer – their first ever plan to eliminate a cancer!²⁵

5. It's bridging the gender data gap

As we mentioned in our recent blog ‘Why the COVID-19 vaccines are a women’s health issue’, there is a concerning lack of healthcare data on women, particularly pregnant women. This is an issue that is cultivated throughout the whole process of medical research from the use of male animals or male-derived cells in preclinical studies,²⁶ all the way to the clinical trial process.

In clinical trials, gender analysis is often omitted,²⁷ pregnant women are for the most-part excluded,²⁸ and it was only in 1993 that the inclusion of women in clinical trials actually became mandated by the national institutes of health (NIH) following a ban by the US FDA.²⁹

Now that we are seeing an increase in the popularity of femtech apps and wearables, we are generating huge amounts of data on women’s health and lifestyles, across countries and cultures.

The implications of this, particularly in the future treatment of poorly understood conditions such as endometriosis, are extremely promising. The SORA app from Syrona Heath allows women to track their gynaecological and general health symptoms, with a particular emphasis on those struggling with either endometriosis or polycystic ovary syndrome (PCOS). The app even incorporates gamification in order to promote retention amongst its users – could we use apps such as this to improve knowledge around these conditions?

The Main challenges

As the femtech industry is rapidly gaining momentum, there are some obvious challenges and concerns that need to be addressed:

Funding

While predictions for investment in femtech are good,³⁰ and there have been a series of high-profile funding wins for femtech companies over the last year,³¹ there are still hurdles to overcome. The most obvious being that while the vast majority of femtech companies are pioneered by women, female-led start-ups only make up a small fraction of investments – accounting for less than 3% of venture capital funding in 2020.³²

Could the involvement of more high-profile influencers and celebrities be a way to garner more attention from both investors and the general public? The Jennis app, founded and fronted by Dame Jessica Ennis Hill is a perfect example, having recently received €1.17 million in pre-seed funding.³³

Within the UK at least, we are increasingly seeing more and more women in the public eye open up about their experiences with women’s health: including television presenter Naga Munchetty discussing her negative experience with getting a contraceptive coil fitted³⁴; and more recently radio presenter Jo Whiley confessing how her experience of menopause negatively impacted her work life.³⁵

Quality control and regulation

With femtech products increasingly bridging the gap between wellbeing and medical devices, regulation is proving to be a complex topic along with creating confusion for the consumer.³⁶ For example, period trackers use a variety of metrics and inputs to influence their predictions – how does the consumer know which product is more accurate?

Birth control apps in particular have been facing backlash when it comes to their claims. Natural Cycles have already experienced complaints from several regulatory bodies for the efficacy claims made in their adverts.³⁷ While the app is approved for sale in the UK and can be advertised to the public, NICE still argues that there is not yet sufficient evidence for the app to be recommended as an approved form of contraception by the NHS.³⁸ So it’s important that as the industry grows, the regulations catch up.

Privacy

While the vast amount of data collected through these apps and products has the potential to narrow the gender health gap, it is critical that the uses of this data are securely managed. Cycle tracking app Flo has already come under scrutiny for allegedly disclosing sensitive health information – including pregnancies within its users – to third party companies.³⁹

In order to maintain the confidence of the women who use them, this is another area in which femtech companies will need to be careful, especially if the data is ever to be used for future research purposes.

Audience

Despite the femtech industry broadening its products and targets, it is still predominantly focussed on women in their reproductive years or going through menopause, leaving unmet health needs for women outside of this age range.⁴⁰ Will we see femtech branch out even further to fill this gap?

If this is to be the case, a key consideration will be that while the primary audience for femtech right now is of an age more likely to engage with technology such as smartphones, older audiences have lower levels of digital confidence and are less likely to have access to the relevant devices,⁴¹ potentially excluding these adults further from an increasingly digital society and creating further challenges for the industry to address.

The future of femtech

While femtech is taking a refreshing approach to healthcare by putting women front and centre, it is still an industry in it’s infancy that requires a lot of work. We personally are interested to see where the future of femtech lies, and what other neglected areas of healthcare could benefit from the increasing prevalence of digital solutions.

For more content on women’s health, digital healthcare, marketing best practice and much more, keep an eye on our blog.

References

1. An Interview with Clue CEO, Ida Tin. FemTech Live. Resource. Published February 11, 2021. Accessed November 3, 2021.
2. Gaslighting in women’s health: when doctors dismiss symptoms. Northwell Health. Resource. Accessed October 27, 2021.
3. Zhang L, Losin EAR, Ashar YK, Koban L, Wager TD. Gender biases in estimation of others’ pain. J Pain. 2021;22(9):1048-1059. Resource. Accessed November 9, 2021.
4. Marsh S. ‘I was told to live with it’: women tell of doctors dismissing their pain. The Guardian. Resource. Published April 16, 2021. Accessed October 27, 2021.
5. World Health Organisation. Endometriosis. Resource. Published March 31, 2021. Accessed November 3, 2021.
6. All Party Parliamentary Group on Endometriosis. Endometriosis in the UK: time for change. October 2020. Resource. Accessed November 9, 2021.
7. Baig A, Hall B, Jenkins P, Lamarre E, McCarthy B. Digital adoption through COVID-19 and beyond . McKinsey Digital. Resource. Published May 14, 2020. Accessed November 5, 2021.
8. Clark K. Femtech’s billion-dollar year. TechCrunch. Resource. Published April 3, 2019. Accessed November 5, 2021.
9. Femtech market share 2021: growth opportunities, top key players, upcoming trends, competitive landscape, business strategy and forecast to 2026. MarketWatch. Resource. Published October 19, 2021. Accessed November 3, 2021.
10. Dodgson L. Why founder of Clue Ida Tin coined the term “FemTech.” Insider. Resource. Published June 5, 2020. Accessed November 3, 2021.
11. Ross L. Millennial online shopping habits – statistics and trends. invesp. Resource. Published February 12, 2021. Accessed November 5, 2021.
12. Vogels EA. Millennials stand out for their technology use. Pew Research Center. Resource. Published September 9, 2019. Accessed November 5, 2021.
13. Das R. Menopause unveils itself as the next big opportunity in Femtech. Forbes. Resource. Published July 24, 2019. Accessed November 5, 2021.
14. Price N, Dawood R, Jackson SR. Pelvic floor exercise for urinary incontinence: a systematic literature review. Maturitas. 2010;67(4):309-315. Resource. Accessed October 27, 2021.
15. Gillard S, Shamley D. Factors motivating women to commence and adhere to pelvic floor muscle exercises following a perineal tear at delivery: the influence of experience. J Assoc Chart Physiother Women’s Heal. 2010;106:5-18. Resource. Accessed October 27, 2021.
16. Porta Roda O, Díaz López MA, Vara Paniagua J, Simó González M, Díaz Bellido P, Espinós Gómez JJ. Adherence to pelvic floor muscle training with or without vaginal spheres in women with urinary incontinence: a secondary analysis from a randomized trial. Int Urogynecol J. 2016;27(8):1185-1191. Resource. Accessed October 27, 2021.
17. Hagen S, Elders A, Stratton S, et al. Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial. BMJ. 2020;371. Resource. Accessed October 27, 2021.
18. Elvie. Elvie Trainer. Resource. Accessed November 3, 2021.
19. Elvie. Elvie and the NHS. Resource. Accessed November 3, 2021.
20. Covid: Being alone in pregnancy due to hospital rules. BBC News. Resource. Published January 26, 2021. Accessed November 3, 2021.
21. House of Commons Petition Committee. The impact of Covid-19 on maternity and parental leave. Resource. Published July 6, 2020. Accessed November 3, 2021.
22. Girvin J. Everything I needed to know about the menopause… No One Told Me. Evidently Cochrane. Resource. Published March 11, 2015. Accessed November 3, 2021.
23. Knowles K. This start-up is 3D printing breast implants for cancer survivors. Sifted. Resource. Published May 16, 2019. Accessed November 3, 2021.
24. World Health Organisation. Cervical cancer. Resource. Accessed November 3, 2021.
25. World Health Organisation. A cervical cancer-free future: First-ever global commitment to eliminate a cancer. Resource. Published November 17, 2020. Accessed November 3, 2021.
26. Ravindran TS, Teerawattananon Y, Tannenbaum C, Vijayasingham L. Making pharmaceutical research and regulation work for women. BMJ. 2020;371. Resource. Accessed November 3, 2021.
27. Brady E, Nielsen MW, Andersen JP, Oertelt-Prigione S. Lack of consideration of sex and gender in COVID-19 clinical studies. Nat Commun. 2021;12(1):1-6. Resource. Accessed November 3, 2021.
28. Blehar MC, Spong C, Grady C, Goldkind SF, Sahin L, Clayton JA. Enrolling Pregnant Women: Issues in Clinical Research. Womens Health Issues. 2013;23(1):e39. Resource. Accessed November 3, 2021.
29. NIH Grants and Funding. NIH Policy and Guidelines on The Inclusion of Women and Minorities as Subjects in Clinical Research.  Resource. Published October 9, 2001. Accessed October 27, 2021.
30. Ugalmugle S, et al. Femtech market size 2021-2027.; 2021. Global Market Insights. Resource. Accessed November 4, 2021.
31. Mathur P. Flo raises millions as femtech frenzy continues. PitchBook. Resource. Published September 9, 2021. Accessed November 4, 2021.
32. Teare G. Global VC funding to female founders dropped dramatically this year. CrunchBase News. Resource. Published December 21, 2020. Accessed November 4, 2021.
33. Jennis raises a £1m pre-seed round for its wellness app, that helps women map their workouts to their cycle. FemTech Insider. Resource. Published October 4, 2021. Accessed November 4, 2021.
34. Munchetty N. Coil fitting agony: “My screams were so loud” . BBC News. Resource. Published June 21, 2021. Accessed November 4, 2021.
35. Jo Whiley was struggling with menopause during Radio 2 show backlash. BBC News. Resource. Published November 2, 2021. Accessed November 4, 2021.
36. McDevitt A. ‘Femtech’ wanders into uncharted regulatory territory. Compliance Week. Resource. Published November 20, 2019. Accessed November 4, 2021.
37. Crouch H. Natural Cycles Facebook ad banned by Advertising Standards Agency. Digital Health. Resource. Published September 10, 2018. Accessed November 4, 2021.
38. Wilkinson E. NICE: More evidence needed before NHS can adopt use of contraception app. Pulse Today. Resource. Published February 3, 2021. Accessed November 4, 2021.
39. Lomas N. Flo gets FTC slap for sharing user data when it promised privacy. TechCrunch. Resource. Published January 12, 2021. Accessed November 4, 2021.
40. Olsen E. Why femtech needs to move past reproductive healthcare. MobiHealthNews. Resource. Published August 12, 2021. Accessed November 4, 2021.
41. Nearly two million over-75s in England are still digitally excluded in a COVID-19 world. Age UK. Resource. Published March 5, 202