Femtech - Tackling period, fertility, menopause and everything in between

The unique biological make up of the female population presents boundless opportunities for hungry innovators and entrepreneurs

A report by Emergen Research pegs the femtech market size to be valued at USD60.01 billion by 2027. In 2019, the femtech industry generated a staggering USD820.6 million in global revenue and is estimated to reach at least USD3 billion by the end of 2030. Femtech companies alone received USD592 million in VC investment in 2019.

Women are faced with degrading health and overall lack of solutions, which illustrates a clear demand and boundless opportunities for innovative solutions. Yet, despite the promising growth outlook, femtech remains - dare I say - significantly unseen and severely underdeveloped especially in the Southeast Asian region.

As of 2021, there are only 41 femtech companies in Southeast Asia - a mere fraction of the 318 femtech companies globally - and not nearly enough to provide solutions for over 300 million females living in this region. With Singapore in the lead with 24 femtech companies, followed by six femtech companies in Thailand, one wonders why there are only two femtech startups coming out of Malaysia despite having a population of over 16 million women.

The trends driving the femtech industry

In order to get to the root of the problem, it’s important to pay attention to the latest movements and trends driving femtech solutions.

1. Deeper understanding of women’s health

   As humans, we are inevitably curious about our bodies. These days, being curious is no longer considered taboo for women. From preserving one’s body purely for their partners to now being empowered in their bodies for the sake of one’s self has resulted in a major mindset and attitude shift. Also, due to modern-day stresses and nutrition, there are more prevalent women’s health issues today.

2. Adoption of online channels and tech tools

   As a means of managing one’s personal health and wellbeing, mobile apps and at-home diagnostic kits have made it significantly easier for women to track their bodies. With a growing presence of tele-health, this democratises access to relevant healthcare for all women across different stages of life. Evidence-based therapeutics are now able to offer previously unavailable insights.

3. Destigmatising and the power of community

   With centuries-old wisdom of past generations losing its credibility and appeal, women’s health is increasingly de-stigmatised. Women are open to sharing their womanhood troubles be it period, fertility, weight gains and losses, sex drive and menopause which forms powerful communities.

Challenges of femtech in Malaysia

In a country like Malaysia with a predominantly Muslim population, it has posed challenges when it comes to broaching the topics of period, sex and a woman’s wellbeing overall.

1. Cultural and social taboos around sexual health

   Sex is still perceived as a taboo topic. With very little being done to create safe dialogues for sex, this has been a deterrent in the advocacy towards topics like safe sex and sexual health and wellbeing. However, there are increasingly more millennial and Gen Z women talking about the subject at length including the likes of sex positive advocate Jasmine King.

2. Lack of education which leads to misunderstanding

   There is an overall lack of or otherwise zero existence of comprehensive sexual education programs in schools. Even if there is a sexual education curriculum, it is often painted negatively especially with regards to topics including unwanted pregnancies, abortions and birth control. This leads to grave and skewed misunderstandings of girls and women’s health.

3. Long-running stigma of vaginal health

   Parents of past generations couldn’t even say the word vagina to their own daughters (at least, that’s what happened to me). It’s no wonder that some girls grow up repelling their very own biological makeup which inhibits any sense to actually learn about their sexual organs and reproductive system.
   
   Take a look at what happened to Libresse recently who eventually withdrew its advertisements featuring illustrations of flowers inspired by vulvas after a small group of conservatives Yadim Muslim Women’s Council (MAYA) described it as a “dishonour to women”. This caused an uproar among celebrities, influencers and netizens who stood to defend the brand. MAYA’s chairperson Safinar Salleh mentioned that the Know Your V campaign to raise awareness about menstruation is placing “unnecessary attention on the private body parts”. Even in this instance, it has us questioning - if a brand that sells menstruation pads isn’t able to talk about vaginal health and wellbeing, then who can? After all, it wasn’t as if the brand was demeaning the topic but rather raising awareness of all things that have to do with a woman's sexual and reproductive organs.
   
   With the young female population developing a negative and close-minded perception of their bodies, the lack of education, conservative viewpoints and fear of the supposed unknown poses an incredible challenge to femtech companies. Companies struggle to educate female consumers on internal use products such as menstrual cups and intrauterine devices (IUDs) despite its purported health, environmental and societal benefits.

Limitless opportunities within the femtech space

According to The Global Cancer Observatory, breast cancer is the most common form of cancer in Malaysia representing 32.9% of new cases in 2020 among females with ovarian cancer at 7.2%, cervical cancer at 6.8% and endometrial at 5.5%. This cumulatively brings new cases of reproductive-system related cancer to 19.5%.

There are many femtech opportunities that can support a woman’s entire life cycle from the time they get their first period (average age of 12 years old) to menopause (average age of 50 years old) to post menopause. Now that’s a whole lot of opportunity! In this regard, we could be looking at a really extensive range of startups across various areas including:

• Sex-ed

  • Reproductive system

  • Period health

• Sextech

  • Sex toys

  • Sexual health and wellness

  • Personalised female-oriented approach to general health, wellbeing and disease management

• Reproduction

  • Fertility care

  • Pregnancy

  • Postpartum care such as diastisis recti, tackling postpartum depression (PPD) and incontinence

  • Lesser known ailments that impede reproduction including polycystic ovary syndrome (PCOS) and endometriosis

  • Sterilisation

• Menopause

  • Wearables to manage menopause

  • Digital therapeutics to navigate menopause

What can we do to support femtech?

As is the case with the lack of support for female founders and funders, the same can be said for female founders in femtech. It’s pertinent that all players in the ecosystem make the space as friendly and supportive as possible to allow femtech to no longer be viewed as a niche but rather a mainstream - especially given that half of the world’s population are female.

One way would be to build a pipeline of femtech entrepreneurs. This can include running accelerators dedicated to femtech, having investment funds dedicated to femtech - be it wholly focused or purposefully apportioned - and most importantly, bringing in more women to the cap table. Who better to understand the unique challenges and opportunities than a female investor?

There also needs to be a realisation of how femtech is in fact a viable investment opportunity. Historically speaking, there have only been 32 successful femtech exits to date - four of which are valued over USD1 billion dollars. Yet, time and time again, femtech founders either get shot down when asking for investment or worse yet, throw in the towel as the realisation dawns on them that the playing field isn’t as equal for women as it should be.

“We just closed our angel round in June and to be frank, it was incredibly challenging to find investors. Majority of investors are men, so they either couldn’t really understand nor wanted to understand the femtech market. I even had an investor tell me that he wasn’t married nor was he thinking about having a child. The other challenge I’ve been facing is the understanding of femtech which isn’t so prevalent here in Malaysia. Japan has 51 femtech companies whilst Singapore has 24. However, Malaysia only has two. After speaking with investors in Malaysia, I realised the challenges and have decided to raise from Japanese and Singaporean investors as their appetite for the femtech market is bigger,”said Anna Yamauchi, Founder and CEO of fertility space platform Lumirous.

“In my opinion, when a femtech company is raising their Series A round, it’s not particularly difficult to raise money from investors. However, the chances of a seed or early-stage female founder securing an investment in comparison to a male founder are far less despite playing in the same space. Investors tend to perceive male founders as less risky as they don’t stop to question things like them leaving the company or taking paternity leave or looking after their child - just because they aren’t able to biologically carry a child. However, I beg to differ. As Bumble’s founder Whitney Wolfe Herd has clearly proven, she was able to take her company public even after giving birth to her son in 2019,” Anna continued.

More interestingly, there’s also the need to widen the scope of what actually falls under femtech. One polarising topic is how femtech companies can and should also serve different subsegments including the LGBTQ+ community. Take for example the male-turned female community who typically need to undergo hormone therapy as they transition. Or what about egg donors for LGBTQ+ couples which allows them to have biological children. Understandably, some countries and religions do not allow for this due to ethical and religious reasons. With the increasing demand for such options, there’s been a slow and steady shift towards the general population being accepting of the change.

Some solutions go hand in hand with other health solutions. An often overlooked area of women struggling with infertility is the mental condition and health of the expectant mother. This can severely impact their infertility further. “Being cognisant of this, we offer online fertility counselling and coaching services via Zoom sessions. This gives women a safe space to unload their thoughts and feelings, and more importantly increases their chances of conceiving. Sadly, fertility and infertility are still considered taboo which leads to many women not being able to express their thoughts. We need to change people’s mindset and get people to understand that infertility is nothing to be ashamed of. In view of this, we organise fertility related boot camp webinars once a week where we provide feedback on one’s fertility nutrition from a certified nutritionist. We hope that by doing this, we’re able to build a safe space for our community to share their innermost issues and problems,” said Anna.

Propelling the femtech market forward

Identifying trends, closely following technological developments in the femtech space and matching needs to solutions that can be built to scale will likely be the winning combo for both founders and investors. A potentially strategic first move could be incorporating genetics to help women understand more about their bodies. “Although normal genetic testing may not be able to tell very much when it comes to puberty and one’s biological clock, it can most definitely look at a woman’s biological inheritance. This can then help women be aware of their propensity as a disease carrier which in turn will help them properly plan their pregnancies,” said Yong Wei Shian, founder of Advanx Health. Although we may be limited by what our current solutions provide us, the potential is limitless.