Femtech startups are transforming women's healthcare

Hang onto your socks for this reality check: Until 1993, women in the US were excluded from participating in clinical research and trials due to the belief that their hormone cycles would distort test results. For decades, talking about women's sexual and reproductive health was considered taboo; even now, leading media like Meta and Instagram reject women's health ads because of allegedly “inappropriate” content.

It should come as no surprise then that the femtech industry was conceived as recently as 2016. The term “femtech” was coined by Ida Tin, the Danish-born founder of Clue, a period tracking app currently used by 8 million women in 180 countries.

Tin was one of the first to promote the idea that there are at least 4 billion reasons femtech is an autonomous business space. Not only do women make up half the planet, but they account for roughly $32 trillion in annual global consumer spending, which represents enormous opportunity.

Opportunity, however, isn’t just rooted in what’s in women’s wallets; it’s also rooted in their health concerns and conditions, which are often very distinct from those of men. The latter statement rests on a few surprising (for some) truths.

• Men and women suffer from many of the same diseases, but the symptoms can manifest differently. (For example, women can experience a heart attack without feeling chest pain or pressure.)
• Our biological sex determines susceptibility to some diseases and conditions. Autoimmune diseases, for example, strike women far more frequently than they do men, and women are more susceptible to stress cardiomyopathy.
• Ethnic and socioeconomic factors lead to the differential distribution of health risks and disparity in treatment among women. Black women, for example, face significant health disparities, like shorter life expectancies and a disproportionate burden of chronic conditions compared with other US women.

“Femtech” acknowledges these fundamental aspects of women’s health and appropriately delineates the tech-enabled solutions that address female-specific conditions and needs, including fertility, pregnancy, childcare, menstruation, menopause, pelvic and sexual health, contraception, family health, and other general conditions that affect women’s health and well-being.

That’s where femtech solutions like mobile health apps, telehealth products, wearables, and connected devices designed exclusively for women come into play.

Femtech companies may still account for only a tiny fraction of all digital health players, but investment into the global femtech market has increased markedly in just the past year. CB Insights data shows that in 2021, this reached a record $2.7B in funding — up 44 percent from $1.9B in 2020.

The sector also shows early signs of maturity: Even though the number of deals dropped from 272 in 2020 to 231 in 2021, the average deal size is increasing. Larger investment rounds and megarounds — deals worth $100 million or more — are no longer the rarity they once were, meaning we can expect more femtech startups to become unicorns and go public.

Some of the biggest deals of the year included Maven Clinic’s $110M Series D (backed by Oprah Winfrey), which propelled the parenthood benefits platform to unicorn status, and Tia’s $100M Series B, which marks the largest Series B investment in femtech history and supports “whole person” healthcare for women.

But despite these signals that femtech is gaining traction, the fact remains that venture capital remains male-dominated, and investors with XY chromosomes tend to overlook business opportunities that solely affect those with XX chromosomes. (It’s no accident that fertility startups have always garnered the largest funding — about 37 percent — in the femtech industry: Fertility challenges affect men, too.)

While fertility care is indeed one of the most important sub-sectors of femtech, the opportunity for women’s healthcare innovation extends far beyond the market of women in their reproductive years: There are roughly 1 billion women past childbearing age in the world and 600 million girls in puberty.

A growing crop of femtech startups are working hard to help consumers and femtech investors recognize that women are not born as adults like Aphrodite and that there are still 40+ years of a woman's life once the child-bearing years are over. Innovative, effective, and safe femtech apps that support women from menarche to menopause and beyond are the latest frontier.

Below is a non-exhaustive list of how businesses transform how women prevent, detect, and manage their health conditions throughout their lives.

According to a survey conducted by the global consulting firm Kearney, 37 percent of girls in the United States have no or very limited knowledge about menstruation before their first period. Recognizing the problem, a significant portion of femtech businesses work to improve menstrual health and hygiene management for teens and young women.

The field encompasses next-gen period products (e.g., absorbent underwear, menstrual cups, sustainable cloth pads), wearables like Livia that alleviate menstrual cramps, and smart period tracking apps like Glow.

For women from puberty through menopause, femtech products serve a host of sexual and reproductive health needs:

Contraception: Companies in this category offer contraceptive plans based on a woman's unique medical needs. For instance, telehealth startup Nurx (recently merged with Vention client Thirty Madison) provides online consultations for women to easily access their regular birth control as well as emergency contraception.

On-demand abortion care: The recent overturn of Roe v. Wade has increased the demand for medication abortions. Companies like Hey Jane are essentially digital clinics that provide patients with safe, FDA-approved abortion pills. Currently operating only in California, Colorado, Illinois, New Mexico, New York, and Washington, Hey Jane is planning to expand to more states to serve more women in affected areas.

STI testing: Another segment getting traction is at-home diagnostics of sexually transmitted infections (STIs). A great example is Ferne Health, a telehealth startup that offers easy-to-use STI screening kits and teleconsultations based on the results.

Fertility treatment: From fertility tracking devices and egg freezing services to employer-backed fertility plans, companies operating in this industry offer affordable and accessible options for dealing with infertility. For instance, German-based biotech Inne builds connected “minilabs” for at-home, saliva-based hormone testing to support fertility and cycle tracking.

Maternal and fetal health: These femtech startups are mainly focused on pregnancy. Consider Israel-based company Bloomlife, which provides pregnancy wearables that remotely monitor the health of mothers and babies and has aggregated a “monumental” dataset derived from biomarkers linked to birth outcomes, including preterm and stillbirths. Then there’s Oula Health, a “modern maternity center” offering remote and in-person obstetrics and midwifery care.

Femtech apps and solutions in this category assist new moms with the knowledge, skills, and confidence for a better transition to a new role.

Startups like Elvie (which has raised $151M to date) and Willow are developing technologies such as wearable, connected breast pumps to make lactation more efficient and comfortable.

Other businesses build hardware and wearable baby monitoring solutions. NY-based Nanit, for example, builds computer vision-enabled smart cameras to track everything happening in and around the crib in real-time. A plan to build a line of breath-monitoring wearables for infants helped earn Nanit a $21M investment in 2020.

These startups address challenges around menopause and other mid-life health conditions. As ovaries age more than twice as fast as all other tissues, there are quite a few solutions that prolong ovarian function to ultimately extend women’s lifespans, including Oviva Therapeutics and Gameto, a biotech that aims to delay ovarian decline — and eventually push it off forever — through cellular reprogramming. Then there are others that provide menopause support and easily accessible hormone replacement therapy like Evernow, which recently landed $28.5M in Series A funding, and Elektra Health, a platform that helps women navigate the menopausal transition.

Go-getters in this space are definitely onto something: Some estimates put the menopausal market at $600B.

Globally, the population aged 65 and over is growing faster than any other age group; that’s why we’re beginning to see a greater range of women’s health companies catering to an older demographic. These pioneers primarily deal with feminine incontinence products (Renovia, which just got FDA clearance for home-based treatment for fecal incontinence that pairs an app with a vaginal sensor) and solutions that evaluate risks of age-related conditions like osteoporosis (Vira Health).

These products address general health conditions that may show up with different symptoms, severity, and prevalence in women. One of the top femtech startups working in this space is our client Aavia, which we partnered with for project management and iOS app development services. Aavia offers a patented birth control pill case and a mobile app that helps users gain better insight into their hormonal cycles and, ultimately, optimize their physical and mental health.

“Historically, medical research has been predominantly conducted on and by people with testes, which means that hormone fluctuations and potential pregnancies weren’t considered in the development of health services, many times intentionally,” says Aya Suzuki, co-founder of Aavia.

That gap in health data, Suzuki adds, puts women at risk because they’re still prescribed the same medications and therapies as men without taking into account biological differences like hormone cycles.

“Hormonal fluctuations are normal and part of being a female,” she says. “It’s imperative that these differences are acknowledged and understood, and thankfully now more work is being done to care for female bodies.”

Gynecological disorders: Startups in this space tackle the most common chronic gynecological diseases like endometriosis. Prominent examples include California-based healthtech NextGen Jane, which is developing smart tampons that detect early signs of endometriosis, and Hera Biotech, which produces the world’s first non-surgical tests for definitive diagnosis of endometriosis.

Culturally and ethnically sensitive products: These are femtech apps tailored to the health needs of women in underrepresented populations: LGBTQIA+ folks (FOLX Health, specializing in queer healthcare, and Plume, which recently raised a $24M Series B to scale its gender-affirming care services); low-income communities (Kasha, which provides health and self-care products for low-income women in rural areas); BIWOC (Exhale, which features meditations, guided visualizations, and coaching designed by and for the multiracial population).

Cancer screening: As oncologic conditions are a leading cause of death worldwide, the femtech market map wouldn’t be complete without startups building accessible screening products for ovarian, breast, and cervical cancers. For example, Olea Medical develops apps that provide automatic data visualization for women’s health MRIs.

Another major player in the sector, Michigan-based healthtech Delphinus, builds solutions that make mammography more accurate for patients with dense breast tissue. The company recently raised a $30M Series D (a rare late-stage investment in femtech) to support its game-changing 3D breast tomography system.

As more and more women run businesses and investment funds, women’s healthcare will logically become an increasing priority. Similarly, as 70 percent of femtech startups have at least one woman founder, the scales will continue to tip toward funding companies that support women. Add in the fact that current early-stage femtech startups are maturing past small-fry status to garner late-stage capital investments (like Delphinus), and more and more funding will be directed toward femtech as time goes on.

Moreover, in just a few years, a new generation of women that has grown up amid a newer wave of women’s and trans rights and equality movements will gain more influence, which should result in more solutions that move beyond stereotypes and stigmas attached to female health and sexuality. We can expect to see more products and services for menopause symptom management, specialized care for queer and transgender communities, sex education for young women, and interventions to address high maternal mortality — especially among women of color.

We could also see a rise in the demand for solutions supporting women’s health in the workplace, as more employers see this as a necessity to retain women. As they strive to do their part in protecting women’s reproductive rights in a post-Roe world, many companies will also provide more health plans that cover abortions and travel expenses if needed.

Consider as well that blockchain — a startup darling and investment magnet — is wending its way into reproductive health, just as it has with just about every other industry. Companies like Elevance Health and Eggschain allow people to store records of frozen eggs, embryos, and other biospecimens in a decentralized and immutable infrastructure. These products could also produce more use cases that demonstrate how women can securely manage their identity and maternal and reproductive health data — a major concern since the overturn of Roe v. Wade — using crypto technologies.

The femtech market is moving towards having a more defined value in the consumer market and generating active interest from investors, payers, and healthcare providers. And while it might seem just a small step for the digital health space in general, that’s a giant leap toward finally making “fem” and “tech” equals.