Digital Health: FemTech

In this article, we explore the evolving landscape of FemTech devices designed to monitor and enhance women’s health and wellness. Specifically, we address the following key questions:

• What are the unmet needs in women's health?

• What is the overall landscape of "Femtech" solutions?

• How are key players tackling these problems?

• What are emerging trends in capital deployment and startup focus?

I. Unmet needs in women's health

According to WEF estimates, despite living longer than men, women spend 25% more of their lives in debilitating health. The gender health gap currently stands at 75M DALY or 7 days per year of additional health burden per woman. If resolved, this can unlock an additional $1T in the global economy. As illustrated below, this is largely driven by effectiveness (58%) and the care delivery gap (34%). 60% of this burden is borne by women of working age (20-64) and 57% of this gap is due to conditions which affect women disproportionately. (WEF & McKinsey Health Institute, 2024)

A key factor driving the effectiveness and care delivery gap is the lack of R&D funding for women's health which accounts for only 5% of global R&D spend of which 4% was spent on cancer, 0.25% on fertility and 0.75% on other health conditions (Nature, 2024). This is completely disconnected from the top drivers of the $1T gap in women's health, which include endometriosis (~18%), anxiety / depressive disorders (~15%), menopause (~12%) and pre-menstrual syndrome (~12%). (WHO, IHME GBD, 2019) 

Additionally, despite an increase in healthcare offerings (providing symptomatic relief) there's an increasing sense of frustration about sub-par health experiences: (Source: Pulsar, 2021)

• ~45% of women feel ignored or gaslit 

• ~15% of women lack access to adequate healthcare or await long waiting times

• ~10% of women are misdiagnosed

(Report surveyed English-speaking posts in the US, UK, Australia and New Zealand)

II. What is the overall landscape of Femtech solutions?

The phrase ‘Femtech’ was coined by Ida Tin, the CEO and founder of the period-tracking app Clue, to describe the emergent sector better. The term came into mainstream use around 2021.

Global Femtech market size is expected to be in the $40-50B range and grow at 12-13% CAGR. (GVR, Yahoo Finance, GMI). The opportunity for fem tech interventions can be broken across 4 key stages of women's life: (BCG, 2023) 

• Puberty and menstruation

• Fertility and family planning

• Pregnancy and delivery

• Perimenopause and beyond

We observe that of these segments, currently maternal health (~30%), Menstrual Health (~20%), Gyn / Sexual health (~15%) and fertility (~15%) account for 3 quarters of femtech startups. These startups can be further classified based on their approach to women's health problems most startups focused on consumer products/devices/wearables (~45%), patient support and virtual care (~30%), and diagnostic tools (~10%). (McKinsey, 2022)

III. Deep dive on select Femtech players

Maven (Themes: Maternal Health x Patient Support and Virtual Care)

Founded in 2014 by Kate Ryder, Maven aims to address gaps in the pregnancy and postpartum continuum of care through a comprehensive telemedicine platform. The platform connects women across the United States with over 800 vetted health and wellness practitioners. The company offers two main products:

• Maven Marketplace (17M+ lives covered): A direct-to-consumer product allowing users to book virtual appointments with health practitioners across various specialities for a fee

• Maven Family Benefits Platform (2K employers covered): An enterprise product sold to large employers as an employee benefit, providing unlimited appointments and personalized educational content through program tracks like Maven Maternity and Maven Fertility

Differentiating features:

• Comprehensive maternity suite ranging from fertility and pregnancy to postpartum care and pediatrics

• 24/7 concierge service powered by dedicated care advocate and 800+ vetted health and wellness practitioners (OB/GYNs, doulas, nurses, nutritionists)

• Maven Wallet a reimbursement tool that helps employers pay for fertility, adoption and surrogacy needs seamlessly

• Emphasis on personalization and inclusivity as evidenced from major (curated educational content, guided tracks) and minor design elements (open text fields for gender identification, diverse imagery)

Outcomes:

• Fertility: 15-50K+ fertility patients covered - 30% conception rate,

• Maternity: 28% lower NICU rate, 30-50K+ NICU stay

• Business: 90% return to work, 20-80K+ talent attraction

• Mental health: 33% improved mental health

Funding: The company raised $150 million Series F @1.6B valuation led by StepStone (co-investors: Sequoia, General Catalyst, Dragoneer, Lux, Oak HC, Icon) on August 16, 2024. $437M raised to date.

Tia (Themes: Gyn, sexual and primary care (incl. mental health) x Innovative service)

Founded in 2017 by Carolyn Witte and Felicity Yost, Tia aims to revolutionize women's healthcare by providing a comprehensive, integrated care model. The company offers a "modern medical home for women" that combines primary care, gynecology, mental health, and wellness services in one seamless experience. Tia's approach focuses on treating women as whole individuals rather than fragmented body parts or reproductive life events.

Key features of Tia's model include:

• Integrated care teams comprising medical providers, clinical support staff, and care coordinators who provide a blend of primary care, gynecological care, mental health support, and wellness services

• Both virtual and in-person care through its clinics in New York City, Los Angeles, Phoenix, and San Francisco.

• Strategic partnerships with major health systems like CommonSpirit Health, Cedars-Sinai, and UCSF Health

• Focus on preventive care (significantly higher physical examination and screening rates)

Outcomes:

• NPS (Net Promotor Score) of 85 vs -1.2 (national avg primary care provider score)

• Higher preventive screening rates in members (65% annual physical exam vs 14% national benchmark and 94% cancer screening vs 35% national benchmark)

• Improved mental health screening (91% PHQ-2 and PHQ-9 vs national b/m of 49% with 74% patients experiencing quality of life improvement)

Funding: $21M raised in March 2023 from Pivotal Ventures (Melinda Gates backed). Peak valuation of $600M post $100M Series B in 2021. $157M raised to date.

Clue (Themes: Menstrual Health x Tracker)

Founded in 2013 by Ida Tin, Hans Raffauf, Mike LaVigne, and Moritz von Buttlar, Clue is a mobile application designed to track the fertility cycle. The platform has 11M+ users across 190 countries and provides accurate, personalized insights about menstrual and reproductive health. Clue offers two main products:

• Clue App (100M+ downloads, 11M+ active users): A free period-tracking app that allows users to log and analyze their menstrual cycles, symptoms, and related health data

• Clue Plus (premium subscription @$40): An enhanced version of the app providing advanced cycle insights, predictions, and pattern analysis, along with additional features like Clue Connect for sharing cycle information with partners or loved ones

Differentiating features:

• Advanced cycle tracking (up to 12 cycles into the future), predictive analytics (including mood patterns) and custom reminders

• Comprehensive tracking options for over 150+ health categories, with personalized Clue Conceive, Pregnancy and Perimenopause modes and integration with select wearables and trackers (Oura, Apple Health (not Watch)

• Medical grade tracker (CE-marked Class 1 medical-grade device), developed in collaboration with top health researchers (Stanford, Columbia, Oxford) to ensure scientific accuracy, reliability and data-backed insights

• Curated Educational content (200+ articles, blog, Clue Ambassadors)

Funding: The company raised EUR 8M @EUR 60M valuation in equity crowdfunding via Crowdcube as of October 19, 2023. The round also saw participation from Union Square, Balderton, NGP, TeamPact and Tomcat ventures.

Carrot Fertility (Themes: Fertility x Patient Support)

Founded in 2016 by Tammy Sun, Dr. Asima Ahmad, and Juli Insinger, Carrot Fertility is a global fertility benefits provider for employers. The platform serves millions of members across 170+ countries, offering comprehensive services including egg freezing, in vitro fertilization (IVF), family-building, and more, enabling organizations to get their employees diagnosed with their fertility health in a hassle-free manner. Carrot provides two main products:

• Carrot Plans: Personalized fertility and family-building guides with over 200K+ combinations, tailored to each member's specific needs, goals, and health concerns. Members receive unlimited access to experts for one-on-one support throughout their journey

• Carrot Card: A financial solution that provides members with preloaded funds to pay for fertility treatments and services directly, making benefits more accessible and inclusive.

Differentiating features:

• Global reach with 10K+ eligible providers and 24/7 expert support in a 100% Carrot-managed network

• Comprehensive care options including egg and sperm freezing, IVF, gestational surrogacy, adoption, and menopause support

• Culturally competent care with language, currency, and payment options to match every member's needs

• Inclusive approach catering to diverse needs across all genders and family structures

Outcomes:

• 89% members intend to transfer single embryo instead of multiple embryos after engaging with Carrot, reducing risks of labor complications and NICU admission

• 93% single embryo transfer rate vs 74% national average

• 31% reduction in C-section rates and the highest single embryo transfer rate among fertility benefits providers

Funding: Carrot raised $75 million through the combination of debt and Series C funding @275M post money valuation from Tiger Global Management & Drive Capital on August 17, 2021. The company has raised $116M to date.

Evernow (Menopause x Virtual Care)

Founded in 2019 by Alicia Jackson, PhD, Evernow is an online teleconsultation platform designed to guide women during and after menopause. The company connects women with tailored prescription treatments and expert clinicians for ongoing virtual support. Evernow offers two main products:

• Personalized Care Plans ($35-50 pm): A comprehensive approach that includes prescription medications, validated supplements, and self-guided programs tailored to address each woman's specific needs.

• 24/7 Expert Support: Access to menopause society-certified clinicians through messaging and video visits, allowing users to track symptoms, connect with providers, and adjust medications entirely online or via a mobile app.

Differentiating features:

• Multidisciplinary team of medical experts specially certified in menopause care

• Personalized matching of women with appropriate treatments and clinicians

• Focus on both immediate symptom relief and long-term health management based on evidence-based treatment developed by studying over 100K+ women

• Ongoing research efforts to advance scientific understanding of women's health journey after 40

Outcomes: 75% improvement across all reported symptoms at 4 months of treatment

Funding: Evernow raised $29 million Series A @84M valuation led by New Enterprise Associates on September 30, 2022. Deal saw interest from several VC funds (Alumni, Regactor, Mana, Gaingels etc.) and celebrities (Gwyneth Paltrow, Drew Barrymore, Cameron Diaz, Demi Moore and others)

IV. Performance of Femtech Sector and emerging trends

In line with the rest of digital health / health tech deal flow, capital invested in femtech fell from $5B+ in 2021 to <$2B in 2023, before jumping to $3B+ in 2024. The deal count also fell from ~600 in 2021 to ~400 in 2024. (Pitchbook, 2024)

The proportion of capital invested in early stages (1-3) fell from ~50% in 2021 to 25% in 2024, largely driven by market maturation, shift from B2C to B2B or B2B2C models and advent of femtech VC funds eg. Astarte or Amboy Street (Femtech Insider)

Emerging trends in recent years:

• Shift in domain focus with newer investments in tech, wellness or wearables space, followed by life sciences and digital health (Visible VC, Deloitte, 2024)

• Evolution in healthcare delivery models with newer startups focused on integrated care, at-home diagnostics and enabling self-care. This is further bolstered by improvements in wearables and AI (McKinsey, 2022)

• Shift from B2C to B2B models largely driven by employer focus on benefits in order to retain 43% qualified women who step away from the workforce due to maternity (Capshift)