Femtech: Women Overcoming Challenges of Accessibility & Design to Control Their Health-The HSB Blog
While digital tools geared at addressing the needs of female patients, often referred to as “femtech” have gained in popularity significant challenges remain as women seek to regain at least partial autonomy over the care of their bodies These challenges include limited accessibility, biased design, lack of privacy, lack of regulation, and a narrow evidence base. This is particularly true as women increasingly seek more and better information, control, and gender-specific care over their health and bodies, something that has become of utmost concern in the wake of the Dobbs decision. While investment in women’s health has increased dramatically over the last 10 years “it accounted for just 3% of health technology funding for women-led companies in 2020 – and only 0.64% was allocated to businesses led by women of color”, according to the World Intellectual Property Organization (WIPO). Moreover, Femtech sales accounted for approximately $821M in global revenues in 2019 which pales in comparison to the almost $500B currently spent worldwide on women’s healthcare and the $1T projected by 2026 by an article in The Lancet Digital Health.
The cost of menopause due to lost days of work is nearly $2B and almost $25B in annual medical costs (Mayo Clinic)
Femtech sales hit $821M globally in 2019 which pales in comparison to the almost $500B currently spent worldwide on women’s healthcare and the $1T projected by 2026 (World International Property Organization & The Lancet Digital Health)
Femtech represents a promising opportunity to address existing gaps in women’s health care, the intended recipients of femtech innovations largely appear to be healthy, affluent, white, cis women (JMIR)
42% of women say they have never discussed menopause with their healthcare provider, yet hormonal changes due to menopause can raise the risk of heart disease, lead to losses in bone mass, and result in concentration problems, among other things (AARP)
Despite the growing femtech sector, there are still gaps in representation and inclusivity. Additionally, not all femtech solutions undergo rigorous scientific validation or regulatory scrutiny. This can result in varying levels of accuracy and reliability in the products and services offered. As a result, some apps and devices may lack clinical evidence to support their claims, potentially leading to misinformation or ineffective outcomes.
Integrating femtech solutions within the existing healthcare system and collaborating with healthcare providers can be challenging. Limited interoperability and a lack of standardized protocols can hinder the seamless incorporation of femtech into routine healthcare practices. There is also a risk that overdiagnosis and unnecessary medicalization with certain femtech solutions can have unintended results. For example, fertility tracking apps that provide inaccurate or misleading information about a woman's fertility status can lead to undue stress or unnecessary medical procedures including additional ultrasounds or hormonal testing.
The rapid advancement of technology, particularly in the fields of digital health, wearable devices, and mobile applications, has created new opportunities for addressing women's health needs. In addition, the global women's empowerment movement has played a significant role in bringing attention to women's health issues and demanding better solutions. Advocacy efforts have highlighted the need for improved healthcare access, research, and awareness of women's unique health concerns. However, even though innovative solutions in the realm of women's health have grown in number and breadth, these technologies are not often targeted to meeting the needs of the underrepresented. For example, as noted in “A Framework for Femtech: Guiding Principles for Developing Digital Reproductive Health Tools in the United States.”, “while femtech represents a promising opportunity to address existing gaps in women’s health care, the intended recipients of femtech innovations largely appear to be healthy, affluent, white, cis women. In the current model, an opportunity is missed to engage populations who have been historically underserved and bear the largest burden of poor pregnancy and perinatal outcomes.”
Research and medical advancements have predominantly focused on male-centric models, leaving women's health needs understudied or misunderstood. In the words of one observer, “Doctors and clinicians were trained to look at women as if they were just small men”. Femtech aims to bridge this gap and provide tailored solutions specifically designed for women. However, the regulatory environment is uncertain and clinical evidence is often lacking, leading to some treatments being less robust than they should be. For example, in “Fertile Ground: Rethinking Regulatory Standards for Femtech”, the authors state ``the FDA classifies apps that dispense fertility and pregnancy information as low-risk, meaning that they do not require agency approval, even if some women use them for contraceptive purposes.” Not only could this leave users vulnerable to serious health issues such as unwanted pregnancies or needless infertility treatments, but it could also potentially lead to false readings causing additional emotional distress and unnecessary testing and procedures.
Femtech has the potential to empower women by providing them with easy access to convenient and accurate information related to conditions impacting only women. These tools can help promote education and awareness about various aspects of women's health, such as menstrual health, fertility, pregnancy, menopause, sexual health, and overall well-being, many of which doctors may be unaware or under-educated about. For example, according to AARP 42% of women say they have never discussed menopause with their healthcare provider, yet hormonal changes due to menopause can raise the risk of heart disease, lead to losses in bone mass, and result in concentration problems, among other things. Moreover, conditions like menopause have a significant productivity impact on society since women between the ages of 45-65 are often in the heat of their careers. One study from the Mayo Clinic Women’s Health indicated that the cost to society of menopause due to lost days of work is nearly $2B and almost $25B in annual medical costs and that does not take into account the additional costs of reduced hours at work, loss of employment, early retirement or the impact of changing jobs.
Sadly, it appears that the U.S. is well behind the rest of the world in terms of recognition and coverage of the diagnosis and treatment of conditions specific to women. As noted by Chris Keynon, “the conversation in the United Kingdom is about 2 years more aware in terms of sophistication and awareness [of women’s health issues] than in the U.S.”. Improving this and broadening the widespread use of femtech solutions would generate valuable data insights that can be aggregated and anonymized to help destigmatize women’s health, improve practices, and advance scientific understanding of women's health.
While femtech has the potential to positively impact women's health, it's important to address challenges such as affordability, inclusivity, data privacy, and regulatory considerations to ensure that these technologies are ethical, equitable, and effectively meet the diverse needs of women, particularly the underserved. As noted in “A Framework for Femtech: Guiding Principles for Developing Digital Reproductive Health Tools in the United States”, “in the current model, an opportunity is missed to engage populations who have been historically underserved and bear the largest burden of poor pregnancy and parietal outcomes.” To combat this the authors recommend 3 principles: 1) creating interdisciplinary stakeholder inclusive teams-review content and functionality iteratively with members of key stakeholder groups (patients, medical experts, community leaders).; 2) taking a person-centered approach-designing features and content that incorporate clinical best practices while focusing on user's informational needs and personal values; and, 3) advancing reproductive equity-using advisory panels that include content and lived-experience experts with diverse backgrounds and perspectives.
By incorporating principles such as these, Femtech solutions can enable personalized and patient-centric healthcare, allowing women to actively manage their health, monitor their health indicators, receive personalized insights, and make informed decisions about their healthcare.