FemTech and personalized nutrition a natural match or evolution
The Digital health industry has developed in growth spurts over the last decade. Despite women being historically left out in research and technological advances, the tide is finally changing. Learn about the rapidly growing FemTech industry, the drivers and application and why now is the time for women in tech and health
FemTech as the north star of Digital Health
The development and adoption of digital health solutions has increased significantly over the last decade. This development has meant that personalized health care can be delivered in a more personalized, cost-effective and remote way than ever before. One area in particular, has enjoyed the spotlight under Digital Health more so than others. This is the rapidly emerging FemTech industry which currently has over 1500 FemTech companies which cater to the unique health and wellbeing needs of the global women. who make up about 49% of the global population. These wonderful population of women also happen to make 80% of the healthcare decisions in the home.
These FemTech companies are creating solutions that place women’s long-overlooked and disregarded health needs front and center, crushing taboos associated with women’s bodies and health information, and creating spaces where women can openly discuss their diverse experiences and get accurate information at their fingertips.
But how did an entire industry start within an existing and established health industry?
Healthcare for women across the lifespan
Healthcare for women has been established over many decades focusing mainly on fertility and maternal care.
It is well known that the nutritional and health requirements of a woman changes significantly over her lifespan from childhood to the good years. For instance women have a higher nutrition requirement during adolescence for iron, during pregnancy their need for folate, omega 3 and iodine needs to be met and during the post-partum phase their calorie, protein and calcium needs increase. To complicate things further beyond the lifespan, women have hormonal fluctuations over an entire month, every month that can impact her response to treatment, medications and other interventions.
Whilst women had to content with existing services which relied on a Dr’s or healthcare practitioner visit, women became increasingly educated and frustrated with the dismissal or misunderstanding of their symptoms they were seeking help for. For example, research showed that around women said that their Dr dismissed their symptoms of Irritable bowel symptoms (Halbert 2018) and many told to just deal with their unbearable symptoms of Menopause (Aninye et al 2021). Women also suffer from Cardiovascular disease at higher rates yet they are treated the same as men (tests, medications) and present with symptoms of heart attacks such as nausea and sweating differently in comparison to men who experience chest pain (Brigham and women’s hospital).
In order to make sense of the historical mismanagement and misunderstanding of women’s health, we need to dive into the past to appreciate how health got it so wrong for women for so long.
The assumed insignificance of women in health and technology
Women’s health concerns have always taken the back seat in scientific research, education, accessibility, and innovation in healthcare, so it’s no surprise that technologies dedicated to catering to women’s health needs have been given little to no attention too. One of the reasons for this is the increased variability in biochemical markers and disease symptoms caused by variations in hormones. Men were historically considered easier to study, as they created less “noise” in the data. It is also easier to study one sex or gender for means of comparison of results also known as a homogenous group.
In 1977, the US Food and Drugs Administration (FDA) brought out a guideline excluding women of "childbearing potential" from participating in clinical trials to protect “the most vulnerable populations''. In simple terms, women were not to be included as research participants because of their gender, a major decision made by a majority of men. This had significant implications for understanding how specific molecules, ingredients and interventions worked in the contact of women’s bodies. The research that was conducted in all areas from cancer, to Diabetes and Heart disease meant that any findings that translated into drug dosages, duration of treatment and potentially a combination of drugs were the result of the studies conducted on male bodies. These same results were then simply applied to women, meaning women ‘s bodies were considered small versions of men with no hormonal, structural or physiological differences..
Thankfully, this exclusion of women ended only in 1993, but cultural, organizational and funding bodies don’t change that fast. The male body continued to be considered the “only standard in life science”, meaning that women made up a tiny percentage of clinical studies or they continued to be entirely excluded to ensure “homogeneity” of the group.
Scientific findings often lead to innovations which are translated into technology in the industry. As most of the science was conducted in men, these led to the development of products based on male science for men.
In fact, a 2019 study suggests that many healthcare technology tools are created with the “white, male, and middle class” user in mind. This gender bias in healthcare technology explains how much innovation in healthcare is targeted at the male audience, once again denying women the ability to fully use much-needed digital health tools to improve their health and wellbeing.
But women, whilst frustrated, were not just sitting idly by and started taking matters into their own hands.
Digital health and the Birth of the FemTech industry
The term FemTech, of course alluding to technology for females, was coined in 2016 by Ida Tin, co-founder of Clue, to describe innovations prioritizing and increasing the inclusion, autonomy, affordability, and accessibility in women’s healthcare. Since the industry was given its name, it has witnessed unprecedented growth and is predicted to become a $50 billion industry by 2025.
FemTech includes a range of solutions such as: medical devices, software, wearables diagnostic, products, services, apps, and other technology supporting women’s health across the lifespan starting at adolescence.
"In fact, 49% of the population represents something more than a niche market”
What are the FemTech Marker drivers?
Beyond the obvious market push from women themselves, HIT Consultant, reported that one of the factors promoting this industry’s popularity is that women are entering the core of tech innovations and taking up male-dominated leadership roles in the space. This means that the growth of the industry is lead by women themselves, by driving change in terms of product development, marketing and research.
According to Frost and Sullivan a favorable regulatory environment has been a key driver for the introduction of FemTech innovations to the market. Femtech’s market opportunity, the rise in healthcare innovations, and the conducive regulatory environment increase the industry's success potential.
Increased adoption and engagement of digital health technologies has contributed to market growth.
According to a report from Frost and Sullivan, women are 75% more likely to adopt digital health tools than men. Based on a 2019 study that explored how women use technology for health, found that women play huge roles as “digitally engaged patients and carers” in accessing and providing health information for themselves and their homes. This means that women are not only influencing market growth in FemTech, they are key drivers of the Heath and Digital healthcare overall.
"Women are not only influencing market growth in FemTech, they are key drivers of the Heath and Digital healthcare industry overall"
A 2021 femtech report noted that the growing trend in Prevention, personalization in healthcare, and direct-to-consumer healthcare also significantly impacts Femtech’s rise a sentiment echoed by TechCrunch.
Current applications in FemTech
FemTech innovations have exploded over the last few years and these cover a range of applications across health namely:
- General healthcare
- Gynecological care
- Mental health
- Reproductive health
- Pregnancy
- Nursing care
- Sexual health
- Chronic diseases
- Hormonal disorders
- Nutrition
- Health diagnostics and self-monitoring devices
As the market evolves, we are certainly due to see more and better products with research supporting the use.
The FemTech market overview
According to a FemTech market report, the industry was valued at $18.7B in 2019 and is projected to rise to $50 billion in 2025 and to $60 billion by 2027, at a CAGR of 15.6%.
FemTech innovations are most prominent in the US market, with the African continent taking up the smallest size according to Statista, see diagram below
Figure 1. Geographical distribution of the FemTech innovations
This geographic distribution of FemTech companies highlights the need to expand and make FemTech more accessible to developing regions of the world, especially since women in these regions experience a more significant disparity in healthcare.
“FemTech started as a niche market, it’s experienced massive expansion because more healthcare companies recognize the importance of creating solutions targeted at women’s unique health needs” Frost & Sullivan
What are current trends in investments?
Historically, investments in women’s health have been only 4% of healthcare dollars. Rock Health report suggests that FemTech took up only 3.3% of digital health funding in 2019 and 1.5% in the first half of 2020.
Data from Pitchbook shows that financing that went to the global FemTech industry added up to just $23 million just about a decade ago.
Compared to previous years, the FemTech industry experienced a massive rise in investment funding, in 2015, with total financing totaling $334 million. This funding amount is almost double 2014’s total funding in the sector. However, despite 2016 being FemTech’s landmark year, it still experienced a dip in financing as total funding that went to this sector was only $226 million.
In 2017, FemTech companies secured a total of $354 million in funding which increased to $650 million in 2018, and then the obvious happened, COVID-19 which impacted every industry and every corner of the globe.
Statista report shows that capital funding dropped to $592 million in 2019 and $520 million in 2020.
One reason for the poor historic investment is because the venture capitalist community is largely male-dominated. This has impacted how much investment goes to technologies solving women’s health issues specifically. Not only is women’s health seen as niche in the eyes of the male investor, it does not have the vast body of supporting research which is required for validation and approval due to the historical exclusion of women in research as mentioned before.
However, the tide is turning albeit slowly. Investors are now realizing the benefit of investing in the FemTech space due to its large base of proactive health consumers. The emergence of FemTech funds dedicated to supporting health solutions for women have led to the rise in investment funds for FemTech.
Venture capital firms focusing on raising financing solely for FemTech are also springing up. These firms include Astarte Ventures, The Portfolia FemTech Fund, Avestria Ventures, SteelSky Ventures, Female Founders Fund, The Case for Her, and Rhia Ventures.
The relevance of FemTech in Personalized Nutrition
FemTech innovations focus on a range of women’s health issues. These issues can be a result of hormones, genetics, lifestyle, differences or changes in the microbiome, social and health determinants and many more. FemTech innovations collect a variety of data coming from personal data as well as biological data which may or may not be influenced or determined by the nutritional status of the woman across their lifespan. FemTech therefore offers a bi-directional opportunity to personalize healthcare by considering nutrition as a core component. This means that for specific innovations, data obtained from FemTech solutions can inform a personalized nutrition plan which covers diet and lifestyle. Whereas in turn, A Personalized nutrition approach can inform the development of a FemTech solution as specific nutritional recommendations can impact health outcomes.
Current research has already recognized that a number of women’s health issues benefit from personalized nutritional interventions which include: menstrual health, fertility care, perimenopause and menopause, prenatal and new mother care, and polycystic ovary syndrome (PCOS) which we will detail next.
PCOS: Polycystic ovary symptoms
This condition affects 3.4% of women globally. It is characterized by endocrine and metabolic disorders, such as insulin resistance, unwanted hair growth, usually higher waist lines (apple shaped) as well as fertility and digestive issues. Current management includes following a moderate to low carbohydrate diet, taking nutritional supplements such as inositol and horsetail. Recent research demonstrates an association between adherence to a mediterranean diet and the severity of the PCOS in women. PCOS women consume less extra-virgin olive oil, legumes, fish/seafood, and nuts; and a higher quantity of simple, refined carbohydrates, total and saturated and omega 6 fats.
How could a personalized nutrition approach help?
Continuous glucose monitoring - To understand individual response to diet, supplements and ingredients; and variability in menstrual cycle in accordance with hormone changes.
Sensors : In the form of sweat patches or tattoos, could provide insight into hormonal fluctuations and stress response, as well as, provide actionable insights into timing of meals, physical activity and meal composition and portion size
Body composition assessment: Digital scales that can provide insight into body composition and caloric needs and how interventions influence this
Coaching : Could help consumers make specific dietary and lifestyle changes based on data which naturally could change over months and years.
DIY kits: At home testing kits for Vitamin D or even saliva can provide better insight into fluctuations throughout the entire month
Menstruation
Affects 50% of the world population. Symptoms affect women differently however, pain, excessive bleeding, increased appetite, mood swings as well as bloating and weight gain are commonly reported concerns and can be grouped into syndromes called premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Recent research indicates that up to 90% of adolescents have menstrual irregularities including period pain (90%) and PMS (47%) In a nationwide survey of women ages 15-45 years, 85% complained of period pain, 77% complained of psychological symptoms, and 71% of tiredness. . Yet women generally have to find their own ways of coping with symptoms naturallyVisiting a Dr usually results in a recommendation for birth control pills and ibuprofen unless there are specific requirements for other types of medical intervention.
How could a personalized nutrition approach benefit these consumers?
Dietary intake: increased intake of Magnesium and B6 have been shown to reduce the impact of monthly symptoms however the ideal dose is not known per individual
Functional foods: These foods can contain specific ingredients targeted at the individual to help with symptoms which could be consumed at the onset of the due period days
Sensors: could provide insights into hormonal changes
At home biomarkers: Could identify how blood loss impacts real-time iron levels to provide real-time dietary advice for correction and repletion
Personalized activity: It is well known that physical activity can ameliorate the debilitating effects of menstruation. Having a personalized plan could help consumers adhere to their goals and prevent absence from work.
Perimenopause
Affects 100 % of women who reach the age of 50. Over 1 billion women will be perimenopausal by 2025. Up to 70% will suffer life disrupting symptoms, Symptoms can include appetite changes, depression, anxiety, hot flushes, sleep disturbances, urinary tract infections, weight gain, fatty liver and osteoporosis.
There are approximately 30 different symptoms that affect women in perimenopause to menopause and that vary over the 10 year perimenopausal trajectory towards menopause. Whilst women have been generally left to their own devices to cope with their symptoms, recent research indicates that specific dietary interventions such as soy, vitamin D, calcium, and magnesium; as well as various herbal remedies and associated combinations can support the perimenopausal transition.
Once recent development is Oura has teamed up with Clue and the University of California Berkeley to conduct menopause research as part of the company’s ongoing commitment to women’s health research. Oura will donate rings to the UC Berkeley study participants and collect biometric data, including heart rate, skin temperature, heart rate variability, and sleep changes. The proposed study will use historical cycle data (cycle length and variability), a survey, Clue symptom tracking, and Oura data (sleep, stress, HRV, etc.) to help quantify when someone is entering perimenopause, and, if relevant, how far they are into their journey. The study aims to improve understanding of and predict the changes women go through in later life, and to help provide them with resources, tools, and guidance to feel supported through this transition.
How could a personalized nutrition approach benefit these consumers?
Dietary advice: By this stage, women have pretty much their established routines and dietary preferences. By providing personalized dietary advice, consumers can get insight into which specific dietary composition or ingredients could help alleviate the menopause symptoms. Additionally, women may want to look at the elimination of certain ingredients or foods from the diet, such as cows milk products.
Physical activity: Only weight-bearing exercise can help reduce the impact and risk of Osteoporosis in aging women. A personalized plan can help consumers stick to their daily exercise routine.
Symptom diaries: These self-administered questionnaire can provide insight into how menopause is affecting the health, quality of life as well as happiness of the consumer. These can help both the consumer and health care practitioners target specific interventions or approaches (such as CBT) to cope with the changes they are experiencing. These can be as simple as emoji’s or Likert scale type questions linked to a final score to track changes over time.
Biomarkers: A combined approach looking at both physical and mental health can be used to provide targeted supplementation and lifestyle interventions to improve biomarkers.
Microbiome: Aging affects the microbiome composition and biodiversity on the skin, gut, vaginal and oral mucosas, Understanding how the microbiome can be modulated to reduce the impact of menopausal symptoms will become more important in the years to come.
Digital therapeutics: The future of treatment will be increasingly using plant extracts. We see the use of digital therapeutics which combine a specific ingredient with a biomarker approach driven by AI.
Fertility
Problems conceiving can affect 15% of couples globally. Investing in fertility treatments currently costs around £5,000 or more for one treatment cycle, which is out of the reach of many consumers and generally the success rate is low. Research indicates that problems with fertility rates have increased over the last decade . Whilst nutrition has always been perceived as a side-show, it has over the last few years enjoyed centre-stage attention because it is such a crucial component to general health. However research indicates that nutrition can play an important role in the management of fertility through provision of B vitamins, minerals and vitamin D, as well as, key antioxidant nutrients and a well balanced diet.
How could a personalized nutrition approach benefit these consumers?
Dietary advice: With obesity a common denominator for fertility issues, a personalised dietary approach to weight could increase fertility in women.
Supplementation: This can range from Zinc, Folate, Vitamin D or functional ingredients
Nutrigenetics: Understanding where there may be issues that may hinder conception
Physical activity: Can improve physical health
CBT (Cognitive Behavioural Therapy): Can help to address emotional issues as well as find actionable ways to overcome potential barriers.
Biomarkers: whether via sensors or metabolites, these can provide objective insights into individual responses. These can include glucose, Vitamin D, Omega 3.
A look at some innovative companies
Various FemTech startups are adopting personalized nutrition strategies to create solutions that meet women’s health and wellbeing needs.
Some exciting innovations in this space include:
- Wellory: New-York based healthtech startup, Wellory provides a science-based nutrition platform helping people improve their relationship with food and their body, build healthier eating habits, and follow real-time personalized nutrition advice by connecting them with a nutrition coach. The company boasts a network of dietitians and nutrition experts from diverse background thereby serving a wider community with different needs and goals. The company also recently partnered with Thrive market, offering its services to Thrive customers who are looking for personalised dietary advice.
- Evvy: Evvy is another company innovating at the intersection of femtech and personalized nutrition and empowering women to have a better understanding of their vaginal microbiome, how it impacts their health and wellness, and how they can improve their microbiome health through dietary and lifestyle recommendations.
- Lycovary Daily: Lycovary Daily, an oxygenation product from Cambridge Diagnostic Imaging, CaDi, is a daily food supplement that enhances women’s ovarian and hormonal health.
- MPowder: MPowder is a London-based femtech startup helping women manage perimenopausal and menopausal symptoms through its plant-based supplement powder range.
- PhenomX Health: PhenomX Health is a new startup that provides precision nutrition solutions for hormonal health and aging in women.
- Culina Health: Is a Digital health platform that focuses on providing personalized nutrition services for frequently overlooked or minority groups
Current gaps and future outlook?
Despite facing unprecedented growth and success over the years, the FemTech industry still faces several challenges that need to be addressed to fulfill its mission of making healthcare more equitable, affordable, accessible, and women-centered.
Around 50% of FemTech innovations cater primarily to pregnancy, nursing or reproductive care. While this is plausible, there's a need for more technologies driving towards fulfilling other unmet women’s health needs, especially those that affect more women than men, such as hormonal health imbalances and aging, mental health, osteoarthritis, stroke, and heart diseases. These require long-term follow up, a multidisciplinary approach as well as digital tools.
FemTech innovations are more prominent in developed countries such as North America and Europe. The femtech market needs to expand into developing regions so that healthcare can be genuinely more accessible to meet the needs of underrepresented women in developing and low-resource countries who frequently have higher infant mortality rates, higher rates of both malnutrition as a result of both over and undernutrition.
There’s also the issue of affordability, with news showing that some of these FemTech products may be cost-intensive, especially for economically disadvantaged groups.
There is also a great connection between health literacy and nutrition literacy. This means that there is a great opportunity to better connect the dots between providers of health and nutrition care in order to improve women’s health.
Although financing for FemTech companies has increased over the past five years, it still takes up a tiny percentage of the total funding in the healthtech sector.
In terms of Research and Development, women’s health may still be downplayed. Research suggests that just 4% of Research and Development funding is directed at women’s health. This means there is still a lot of work to do.
However, thanks to rapid advances in remote monitoring through wearables and apps, advances computing power (AI & machine learning) through chat interfaces and increased consumer appetite for personalized advice and healthcare, we only expect the market to grow allowing more women to participate in investments, product development and research in greater numbers to drive the change that is so desperately needed.
In conclusion
FemTech is a rapidly growing industry that serves and caters to the unique biological needs of women. Nutrition is a key pillar of health for many issues women face across their lifespan, making personalized nutrition a natural fit and evolution of FemTech solutions that can impact health and behavioral outcomes.
There is plenty of room for growth in the industry and companies (and investors) who are not focusing on women’s health as a strategic direction will be missing out on a huge opportunity. As consumer demand for effective products and services increases crossing the lines between food-pharma and consumer health, we expect technologies to play an increasingly important role where data is at the center of providing targeted personalization.
References
- Halpert A. Irritable Bowel Syndrome: Patient-Provider Interaction and Patient Education. J Clin Med. 2018 Jan 2;7(1):3. PMID: 29301273; PMCID: PMC5791011. |
- Aninye IO, Laitner MH, Chinnappan S; Society for Women's Health Research Menopause Working Group. Menopause preparedness: perspectives for patient, provider, and policymaker consideration. Menopause. 2021 Jun 28;28(10):1186-1191. doi: 10.1097/GME.0000000000001819. PMID: 34183564; PMCID: PMC8462440 |
- FemTech market Frost and Sullivan |
- Femtech poised for growth beyond Fertility - Techcrunch
- Femtech is expansive, time to treat it as such Rock Health
- Top 13 VC investors in FemTech Pitchbook
- VC investments in FemTech worldwide Pitchbook
- https://ouraring.com/blog/clue-berkeley-perimenopause-study/?utm_source=linkedin&utm_medium=organic&utm_campaign=alwayson_pulseblog&utm_content=static