Let’s start by defining briefly what we mean by women’s health. Women’s health is much more than just reproductive health; it incorporates both female-specific conditions and general health conditions that affect women differently or disproportionately. The diagnosis, prevention, and treatment of these conditions—and technologies and treatments for them—are the key elements of women’s health.
Many elements of reproduction—menstruation and menopause, contraception, fertility, and maternal health—are, of course, largely female-specific, as are gynecology (endometriosis, pelvic floor issues, sexual health, and gynecological infections such as bacterial vaginosis and cervicitis) and women’s oncology (including breast, ovarian, and cervical cancers).
General health conditions in which gender plays a part include those that affect women differently, such as cardiovascular disease; affect women disproportionately, such as autoimmune diseases, migraines, and osteoporosis; or are characterized by gender bias in care delivery, as often occurs with pain and mental health.
Modern medicine was developed with male physiology as the default. Aside from their reproductive organs, women were largely assumed to be like men, only smaller. That began to change in the 1990s, in part because of the NIH Revitalization Act of 1993, which required that women be included in studies funded by the National Institutes of Health, but parity has still not been reached. Funding is not proportionate; only about 12 percent of the nearly $2.4 billion the National Institutes of Health spent funding Alzheimer’s disease research in 2019 went to female-focused projects, for example, though nearly two-thirds of Alzheimer’s patients are women. Women remain underrepresented in clinical trials, and animal studies and cell lines are still heavily biased toward males. We see these inequities not only in research but also in drug development and care delivery. For instance, women are twice as likely as men to experience adverse events from medications, in part because of incorrect dosage recommendations, and a 2018 literature review found that in six high-income countries, doctors—still!—tended to describe men with chronic pain as “stoic” and “in control,” and women as “hysterical,” “emotional,” “complaining,” and “malingerers.”
A mismatch between investment and need
Women represent about 50 percent of the world’s population and, in the United States, 76 percent of healthcare industry workers. They also use healthcare more than men, make more healthcare decisions for their families, and spend more than men on healthcare throughout their adult lives. All this opens up vast opportunities for savvy entrepreneurs, business owners, and investors and can have serious implications not only for women’s health but also for society as a whole; healthier women make for stronger economies, and women’s health likely has cascading benefits for children and others they may be caring for. Furthermore, research that takes gender into account benefits everyone; it has found, for example, that depression is more often fatal in men, that men are more likely to develop early-onset Alzheimer’s, and that they tend to get colon cancer earlier than women.
An analysis of the current global innovation pipeline in women's health reveals a stark mismatch between investment and need. A study published in the Journal of Women’s Health in 2021 found that “In nearly three-quarters of the cases where a disease afflicts primarily one gender, the funding pattern favours males, in that either the disease affects more women and is underfunded (with respect to [disease] burden), or the disease affects more men and is overfunded.” The true disparity is even more pronounced, given that entire categories of female conditions, such as menopause, are completely omitted from global disease burden databases. A February 2022 analysis by McKinsey found that only about 1 percent of healthcare research and innovation is invested in female-specific conditions beyond oncology.
Femtech: A clear opportunity for investors
Against this backdrop of unmet need and low historical investment comes femtech. The term, coined in 2016 by entrepreneur Ida Tin, who created the period-tracking app Clue, describes consumer-centric, tech-enabled software, devices, diagnostics, products, and services that address women’s most pressing healthcare needs.
The segment is powered, to a large extent, by female entrepreneurs; more than 70 percent of the 763 femtech companies McKinsey analyzed this year have at least one female founder, compared with a norm of 20 percent for new companies overall. But this is not helping the femtech industry when it comes to venture funding, as venture capital is still dominated by men, who tend to overlook this segment. Venture firms with at least one female founder are twice as likely to invest in female founding teams; unfortunately, only about 12 percent of venture capital firms are led by women. So, though investment has nearly tripled in the past five years, to $1.9 billion, femtech startups still receive only 5 percent of all digital health funding.
This is short-sighted, because despite its funding challenges, femtech is growing exponentially in terms of public awareness and company formation, and it has already demonstrated impressive early wins. Femtech companies are filling gaps not yet addressed by established biopharma and device companies. In maternal health, for example, virtual clinics such as Tia, and direct-to-consumer prescription delivery services like The Pill Club give women access to care in a more convenient, consumer-centric manner. The segment is improving diagnoses, addressing stigmatized areas, such as menstrual health and menopause, and delivering culturally sensitive and tailored care for marginalized groups—all areas today’s more informed consumers are clamouring for.
Many big pharma players are beginning to dip their toes into the femtech space with new women’s health divisions, and an even greater disruption could be ahead. Femtech’s market size is estimated at 22.5 billion worldwide, and forecasts suggest opportunities for double-digit revenue growth—as much as 16 percent by 2027. There are still plenty of opportunities to get in on the ground floor.
Life science technologies such as proteomics and tissue engineering, for example, could address what have long been poorly understood female-specific diseases such as polycystic ovarian syndrome and endometriosis. Women’s access to care and quality of care is also being taken to the next level, with virtual clinics, innovative brick-and-mortar practices, and direct-to-consumer prescription delivery services providing more convenient, consumer-friendly solutions. Technology, too, is booming, with trackers, wearables, and home diagnostics among the solutions that empower women to take charge of their own health and health data.
All this presents remarkable opportunities for investing in women’s health. We are at a watershed moment, with richer data, more advanced technologies, and a better understanding of biological differences. Medicines, therapies, and devices of the future will only be more attuned to women’s needs as the informed market continues to grow. Now is the time to invest in women's health.
Written by Gila Tolub, Partner at McKinsey Israel