Recently, it was National Women's Health Week, an annual event led by the United States Department of Health and Human Services to promote awareness of women’s health concerns. While the broad social message had focused on exhorting women to make better health decisions, there are challenges women face beyond the remit of eating more fruit and taking longer walks. To balance the headlines of tech ignoring — or evening actively worsening — the needs of women, I wanted to focus this article on the ways that new science and product initiatives have been actively working to improve underserved areas of women’s health.
One of the biggest challenges to women’s health is the lack of unbiased, accurate data about women. Caroline Perezs’ 2019 book Invisible Women, lays out dozens of sobering examples of how data collected primarily on men led to decisions about infrastructure, work, and health that had negative consequences when applied to women. In a medical context, the most dangerous knowledge is that which we don’t know is missing. Perez’s book is a wake-up call about the socio-cultural and medical aspects of women’s health that we never knew were missing from the scientific data.
Programs and initiatives
There are multiple initiatives, both private and public, working to change that. The “All of Us” initiative by the National Institute of Health (NIH) is working to collect long term health data from a million diverse US participants, collecting from every sex, age, racial background, geographic location, and socio-economic status. The SWAN (Study of Women’s Health across the Nation) study, started in 1994, is a cooperative effort across seven major research institutions to study midlife women from diverse ethnicities and socio-economic backgrounds. Data heavy start-ups are also joining in the effort, with companies like NextGen Jane currently running the only longitudinal molecular study of women’s menstruation on the planet.
Some of the most dangerous data missing in women’s health has nothing to do with the handful of organs unique to our sex, but the ones that we share with men. Even though it’s been twenty years since the American Heart Association published the first gender-specific clinical recommendations for heart disease, women still struggle to receive the same treatments and outcomes in cardiac disease as men. Women are more likely to put off seeking care, more likely to be misdiagnosed, and more likely to ultimately die from a heart attack. Working to change this, Verily’s project Baseline has partnered with the American Heart Association’s Go Red program to launch Research Goes Red, a massive tech enabled study on heart health exclusively in women.
While osteoporosis has been recognized as a far greater risk in women for generations, we are only just beginning to understand how our systemic hormone cycling affects injury risk across the musculoskeletal system. Bone Health Technologies is developing a device treatment (one free of drug or hormones) for the disproportionately traumatic hip fractures found in aging women. Professional sports team are now working to track elite athlete menstrual cycles to optimize their training and reduce injury risk. For those of us not on a sports team, Oura ring now has period tracking functions and advice on managing its whole body impact.
In her book Lean in, Sheryl Sandberg described shocking her superior with demanding up front parking spaces for pregnant workers. The shock was not that she had asked, but that their company had never thought to offer such a simple and easy to implement benefit. Women’s health is full of these little pockets of “silent suffering”. The clinical data are there, but the cultural awareness to act on it is lacking. Some areas of women’s health (such as menstruation, pregnancy, and breast cancer) are far more visible than others, and so they carry the majority of the popular attention. This spills over into the health technology that is developed and invested in. McKinsey highlighted this imbalance in an analysis of the FemTech industry last year.
This is surprising, since the silent problems are frequently big, unmet ones, which represent a massive opportunity. Urinary incontinence is currently the number one driver of early care home admission for elderly women, affecting up to half of all women over 60. Companies like Jogo Health and Leva Therapy are working to scale pelvic floor therapies via digital/wearable platforms, rather than offer the next greatest adult diaper (an industry currently worth north of 26 billion annually). Fibroids and endometriosis are probably the most common uterine conditions you’ve never heard of, which may explain why women can suffer unaware for decades. Fighting to shorten that diagnostic journey are companies like Dotlab, NextGen Jane, and HERABiotech. Meanwhile, women can experience menopause with minimal interruption of their lives, or be thrown through years of migraines, insomnia, brain fog, and other symptoms that can force them into retirement a decade early. For a condition that nearly all women are destined to experience, the training we receive is nonexistent. Thankfully, companies like Evernow and Elektra Health, like an advanced version of high school health class, are providing access to the medications, education, and coaching that can make all the difference to women going through it.
Tech alone cannot answer the many challenges of women’s health. There are too many social, economic, and cultural factors twisted into the basic clinical need to be overcome with “the perfect app” and miraculous mechanism. However, each of these companies mentioned above are not just providing a new product, they are reinventing and working out just how women’s health products should be made.
Like learning how women’s hearts are unique, we can’t assume that women’s health tech companies will grow and develop the same way as any other tech or device startup. The founders look different (70% women compared to the 20% in non-femtech companies). With only 4% of the available venture capital, they fight harder to fund their companies. Even these hurdles are minor compared to the major cultural taboos they will need to navigate on a tightrope. Ultimately, it will be how well our industry works to address these problems, not just the clinical ones in the pitch decks, that will define the impact tech will have on women’s health.
Addressing the challenges of women’s health will be a key topic discussed at MedtechWOMEN’s annual conference this September as part of a broader discussion about health equity.