Switzerland is home to 33 startups working on tech-focused solutions to women’s health needs. One firm has developed a urine test that detects sexually transmitted infections (STIs). Another has designed a new type of cervical stabilizer that alleviates pain and bleeding. A third has devised a smart bracelet that tells wearers when they’re ovulating, in order to help them conceive. All of these companies share one thing in common: they’re part of the femtech movement, which seeks to address issues of fertility, contraception, reproduction, pregnancy and childbirth, periods, menopause, and sexual and mental health. Largely unknown just a few years ago, femtech has experienced a boom in North America and the United Kingdom, and it’s gaining traction in Switzerland too.
- Do obstetrics and gynecology need femtech?
- Combining nature and technology
- Opaque algorithms
- Tech4Eva, a unique startup accelerator in Europe
- “Too many CEOs still think femtech doesn’t concern them.”
Brimming with growth potential
According to a recent report, the femtech market was worth USD 40.2 billion in 2020 and is expected to swell to USD 79.4 billion by 2025. “Despite growing interest in recent years, the industry remains underestimated even though it’s brimming with growth potential,” says Maria Shmelova, Head of UK-based strategic analytical agency FemTech Analytics. It’s hard to gauge the value of this burgeoning market in Switzerland because most femtech firms are still in the early stages of development and some have yet to release their products or applications onto the market. But some Swiss startups have managed to attract substantial investment. ObsEva, which is working on new therapies for conditions such as endometriosis, recently secured investment worth 75 million Swiss francs. Anecova, which has developed a new infertility-focused device for transferring an embryo from the lab to the operating room so it can be implanted in-vitro, raised five million francs. Meanwhile, Aspivix, the firm behind the pain-free cervical stabilizer, has so far received 2.7 million francs in funding.
Fighting taboos
Despite clear and present demand, the Swiss femtech industry is struggling to flourish because of entrenched views and taboos around women’s health issues — which affect half of the population. “Health and well-being have a direct impact on women’s performance at work and, therefore, on the productivity of the companies that employ them,” says Lan Zuo Gillet, who heads Tech4Eva, EPFL’s femtech accelerator program. With the femtech sector still flying under the radar, founders are finding it hard to capture attention, especially from men. “Investors are all men in their fifties,” says Siew-Veena Sahi, CEO of Testmate Health, the firm behind the urine test for STIs. “Are they comfortable talking about sexually transmitted infections and their personal experiences of getting tested? No, of course not. But younger men are much more open about these things.” Klea Wenger, investment manager at Swisscom Ventures, shares a similar view:
“Finance and investment are a male-dominated landscape. That’s one reason why the femtech industry isn’t growing as quickly as it should.” Startups also face barriers when it comes to advertising their products, especially on social media. “These platforms automatically block messages, posts and other content about women’s sexual health because the moderators consider them inappropriate,” explains Oriana Kraft, founder of the FemTechnology Summit in Zurich.
Men struggle to understand issues that don’t affect them directly, so they take less of an interest in these matters.”
Oriana Kraft, Founder and producer of the FemTechnology Summit.
Around 40 investors
Despite these challenges, some Swiss investors are starting to recognize the potential of femtech startups. According to FemTech Analytics, around 40 have invested in the sector to date, with a further 15 nonprofits also offering funding. One of them is Swisscom Ventures, which seven years ago put money into Avawomen, the Swiss startup behind the fertility-tracking bracelet. “We’re determined to step up our investment in this highly promising industry,” says Wenger. “Femtech firms have long been undercapitalized and underdeveloped relative to their peers in other sectors. The demand for women-focused tech is enormous.” Loïc Mühlemann, speaking on behalf of Groupe Mutuel, Tech4Eva’s main partner, makes a similar point: “The femtech industry is experiencing rapid growth. We expect it to attract over USD 60 billion in investment in 2025.”
Switzerland leading the way on fertility
Fertility and pregnancy are one area of women’s health that isn’t shrouded in taboo. Here, securing investment is far less of a challenge. What’s more, it appears to be more accessible than areas like periods and menopause, with more than half of all Swiss startups focusing on this niche. One such firm is YONI Solutions, which has developed technology for analyzing the vaginal microbiome as a way to increase success rates for in-vitro fertilization (IVF). Another is Annaida Technologies, an EPFL spin-off offering an embryo analysis device to support IVF treatments. Its founder, Gora Conley, acknowledges that fertility is a much more accessible subject for investors: “It’s a problem that men face too, personally or with their partner.” Kraft makes a similar argument: “Men struggle to understand issues that don’t affect them directly, so they take less of an interest in these matters.”
In addition to fertility being less of a taboo subject, there’s another reason why firms in this niche tend to fare better: their technologies address a pressing social challenge. “By putting their careers first, women are tending to have children later and later in life,” says Shmelova. “Between 2000 and 2020, the average age of first-time mothers in Switzerland increased from 28.9 to 30.9 years. The increased rate of infertility that comes with age is encouraging women to seek medically assisted reproduction.” Mathieu Horras, CEO of Aspivix, also cites financial reasons for this trend: “There’s this impression that fertility is a high value-added market, which makes it appealing to investors.”
It’s a problem that men face too, personally or with their partner.”
Conceiving with the help of an app
Some women use mobile apps to track their menstrual cycle and increase their chances of getting pregnant. Swiss company Daysy has developed a smart thermometer that sends data to an app to indicate when women are fertile. Avawomen’s technology follows a similar principle, but uses a wearable bracelet instead. There are also simpler apps that let users take their own temperature and input the readings themselves, leaving AI and algorithms to do the heavy lifting. Hélène Legardeur, a gynecologist at Lausanne University Hospital (CHUV), believes these apps have important practical benefits: “In the past, patients struggled to remember when they last had their period. But for our examinations, we need to know when a woman last menstruated. Now, they can tell us the exact date, which is extremely helpful.” But Legardeur cautions against using these apps as a contraceptive method: “Women sometimes come to us with unwanted pregnancies because they thought that, by tracking their cycle with these apps, they could avoid conceiving.”
Digital health
With around 30 active startups, there’s still significant room for growth in the Swiss femtech landscape — especially in mental and sexual health, and in periods and menopause, where investment has so far been lacking. The priority in the years ahead will be to develop tech-powered solutions while allaying privacy fears about personal data collection and automated processing. Whatever the future holds, one thing is certain: with the femtech movement, digital technology will play an ever-bigger role in the way women manage their health — and their lives.
In the past, patients struggled to remember when they last had their period”
One in three Swiss women experiences what they consider a traumatic childbirth. Although the blame is often pinned on information and communication failures, some of the tools that obstetricians and gynecologists use provoke fear and are seen as instruments of torture. The speculum, which holds open the vaginal walls to allow access to the cervix, is perhaps the most terror-inducing instrument of all — and its design has barely changed since its invention in the 1800s. Other examples include the tenaculum, which uses sharp-pointed hooks to grasp the cervical tissue, and forceps, a metal instrument shaped like a large pair of scissors that’s sometimes applied to the baby’s head to ease delivery.
“Giving birth lying on your back is unnatural”
As the femtech movement gathers pace, many women are looking to technology to update gynecology instruments. One person who shares this hope is Aline Forgerit, a nurse and member of Lausanne-based nonprofit (Re)Naissances. “There are so many ways we could improve patient care in obstetrics and gynecology,” she explains, citing examples such as redesigning the delivery table so women can adopt different positions during childbirth. “The traditional delivery table is designed to make life easier for gynecologists. But giving birth lying on your back is unnatural.”
Redesigning Instruments
Mathieu Horras, CEO of Aspivix, has decided to tackle this problem head on. Working with an EPFL-trained engineer and a clinical gynecologist, this entrepreneur has come up with a device to replace the conventional tenaculum. The instrument, called Carevix, uses suction technology to stabilize the cervix, significantly reducing the trauma associated with pain and bleeding. Aspivix is the first Swiss femtech startup to focus on redesigning gynecology instruments. “Pelvic exams provoke fear and anxiety because of the outdated instruments that gynecologists use,” says Horras. “They weren’t designed with women in mind.” Despite promising progress in the femtech community, convincing clinicians to adopt these technologies is proving challenging. “Medical professionals have to be willing to learn how to use these new instruments,” explains Horras. “Reaching that point will require a shift in mindset.” However, the fact that these alternatives cause women less pain is a strong argument for their adoption in clinical practice.
“A huge step forward”
Hélène Legardeur, a gynecologist at Lausanne University Hospital (CHUV), has used Carevix with her patients. While she acknowledges its benefits, she has no plans to abandon the tenaculum for good. “Carevix is a huge step forward in terms of improving patient comfort during IUD insertion procedures,” she says. “But that technology has its limitations, and there are some situations where we still have to use a tenaculum.” Legardeur argues that conventional instruments have changed little over time precisely because they work: “There’s definitely scope to improve some of the methods we use. But we’re not in the business of torturing our patients. Their health remains our priority.”
Symbols of male domination
Although these tools serve a functional purpose, they remain symbols of male domination over women, and over all aspects of childbirth in particular. Women perceive procedures involving instruments like the tenaculum, speculum or forceps as intrusive — tantamount to an invasion of their bodies. While femtech innovations could go some way toward dispelling these perceptions, there might also be an argument for more education and better communication to promote wider acceptance of existing gynecology practices.
Women are turning away from the contraceptive pill in droves following a string of high-profile scandals over harmful side-effects. In 1992, 52% of women took the pill. By 2017, that figure had fallen to just 33%, according to a study by the Swiss Federal Statistical Office. As the birth control pill falls out of favor, women are increasingly turning to period-tracking apps as their preferred contraceptive method. “This trend is mainly driven by a preference for more natural alternatives,” says Laetitia Della Bianca, who leads research at the University of Lausanne’s ColLaboratory. Period-tracking apps, which were the subject of Della Bianca’s thesis, use algorithms to predict menstrual cycles and fertile periods based on user-provided data. “These apps typically base their predictions on the date and duration of previous periods,” she explains. “Some also use other data, such as temperature readings and the appearance of cervical mucus.”
Heteronormative design
As part of her research, Della Bianca examined various period-tracking apps to determine what made some more reliable than others. She found that developers disagreed over which data and parameters to include or exclude, and over which algorithms produced the most dependable predictions. “As you add more data, the apps become more accurate, but it gets harder to convince women to use them,” she explains. “An app with a simpler interface might not be quite as reliable but will attract more users.” Another problem is that these mobile apps tend to reinforce dominant norms and exclude minorities. “Women sometimes find that these apps fail to reflect how they self-identify,” says Jessica Pidoux, a postdoctoral researcher at Sciences Po in Paris and the director of personal data protection nonprofit personaldata.io, who wrote her thesis on online dating platforms. “That’s especially true when they draw on heteronormative conventions that leave no room for diversity.”
Using the apps for other purposes
Functional and design issues aside, women are increasingly using period-tracking apps — which are intended merely as a way to monitor the user’s menstrual cycle — for other purposes. “Some women use these apps to manage their sex lives and communicate with their partners,” explains Della Bianca. “They aren’t just interested in contraception — they also want to learn more about their bodies, especially if they have conditions such as endometriosis or polycystic ovary syndrome. Others use them when they’re going through menopause.”
Some women use these apps to manage their sex lives…”
The body as a reproductive machine
Period-tracking apps are also ushering in a new perception of women’s bodies as reproductive machines. “By focusing on women’s fertility, we run the risk of overlooking men, even though they play an equally important role in reproduction,” says Della Bianca. This risk is further compounded by the fact that “MenTech” — technology geared toward men’s sexual health — is almost non-existent, as evidenced by the lack of investment in developing and marketing a male contraceptive pill. “It’s striking that we still don’t have a viable alternative for men,” says Hélène Legardeur, a gynecologist at Lausanne University Hospital (CHUV). “We’ve designed a drug that prevents women from ovulating, so surely we can develop something that stops men from producing sperm.” In the meantime, those who champion period-tracking apps as a more natural contraceptive method may be overlooking a key point: there’s nothing “natural” about technology permeating even more areas of our lives.
It’s striking that we still don’t have a viable alternative for men”
The term “femtech” first appeared in 2016. Short for “female technology,” it was coined by Ida Tin, the Danish entrepreneur behind period-tracking app Clue. “Femtech covers a wide range of innovative products and services, including diagnostics, medical devices, e-health, equipment, drugs, online platforms, and apps and software,” says Maria Shmelova, Head of UK-based strategic analytical agency FemTech Analytics.
Using algorithms to track fertility
Despite their promise of improved health, some of these technologies — especially apps and software that use algorithms to process users’ data — are raising privacy fears. Period-tracking apps are a case in point. “These algorithms predict when a woman is likely to be fertile, but the way they work is opaque,” says Laetitia Della Bianca, who leads research at the University of Lausanne’s ColLaboratory and wrote her thesis on these types of apps. During the course of her research, she found that developers disagreed over how to design the algorithms, and over which data and parameters to include or exclude in order to generate reliable predictions. “It became clear that developers have different ideas about women and their sexual health,” she explains.
Standardized innovation
The data collected via period-tracking apps are processed by artificial intelligence (AI) systems owned by tech giants such as Google, Meta (Facebook), Amazon and Apple. “Their application development kits are extremely popular among entrepreneurs looking to launch a new app,” says Jessica Pidoux, a postdoctoral researcher at Sciences Po in Paris and the director of personal data protection nonprofit personaldata.io, who wrote her thesis on online dating platforms. “As a result, innovation becomes standardized — tied to the business models of these big companies. What’s more, these models are often heteronormative, since the stereotypes held by the people who create these standards become embedded in the apps themselves. In my view, this way of working stifles creativity and leaves little room for diversity.” As ever more data-breach scandals hit the headlines, femtech firms that rely on collecting women’s most intimate data will have to provide cast-iron privacy guarantees in order to grow their business and offer genuine value to users.
Innovation becomes standardized — tied to the business models of these big companies.”
Many men, and nearly just as many women, don’t know what a tenaculum is. It’s an instrument used by gynecologists to grasp and hold the cervix during procedures such as IUD insertion; it resembles a long pair of scissors with sharp-pointed hooks at the end. Tenacula are used frequently — some 80 million times a year worldwide — and without anesthesia. Although they can be painful and cause bleeding or even perforation of the cervix, the design has not changed since the instrument was invented in the late 19th century. This latter fact should not be so surprising, as only 4% of research spending on healthcare is devoted to the many medical concerns specific to women (such as pregnancy, menstruation, contraception, fertility, menopause, and certain types of cancer and mental-health issues).
Femtech aims to address this inequality, aberration and injustice by developing systems and devices intended specifically for women’s health. EPFL Innovation Park, through a joint initiative with Groupe Mutuel, is supporting femtech entrepreneurs with the new Tech4Eva program. Introduced on 8 March 2021, the program aims to serve as a femtech startup accelerator and is the first of its kind in continental Europe. For nine months, it gave entrepreneurs from 58 high-potential startups the opportunity to take part in seminars, receive coaching from a mentor, meet with investors, and go on roadshows — this year to France, Korea, USA and two Swiss cities (Basel and Lausanne). On 28 November, the partners will hold the second annual Swiss FemTech Conference at the Rolex Learning Center on the EPFL campus.
“With Tech4Eva, we have built up a strong femtech business network and ecosystem including not only startups, but also corporates, research centers and healthcare providers,” says Ursula Oesterle, president of EPFL Innovation Park. “We aspire to become Switzerland’s innovation hub for women’s health, and to take femtech R&D to the next level.”
The Tech4Eva program aims to serve as a femtech startup accelerator
We have built up a strong femtech business network and ecosystem”
Confirmed success
The success of the initiative is confirmed. For the second year of the programme, 124 startups applied, compared to 110 for the first edition. The programme selected 28 startups, including six from Switzerland: 14 early-stage startups and projects and 14 growth-stage startups and projects. Five areas are concerned, in descending order: mental health and wellbeing, pregnancy and post-partum, fertility and infertility, prevention and diagnostics, and menopause.
The startup of the Tech4Eva program 2021 have raised USD 62 million to date. The femtech market is big and growing — women spend more on healthcare than men do and the market is expected to swell to USD 60 billion by 2025. But the primary motivation for these entrepreneurs isn’t financial. Women die every day due to a lack of research on diseases specific to their needs. By creating a femtech ecosystem, Tech4Eva hopes to build awareness about the importance of this kind of R&D — not just among startups, but in healthcare systems more broadly — and of compiling the necessary data and providing the requisite training in medical schools. Not to mention the need to break down the taboos about discussing fertility, menstruation and menopause.
Illustration © Elyn
Some of the selected startups for the 2022 program
Pregnolia
Pregnolia, an ETH Zurich spin-off, has developed a diagnostic device to evaluate the risk of preterme birth. It measures the stiffness of cervical tissue of a pregnant women and detects changes.
Moona
This French startup has created the first smart cooling pillow that helps reduce the onset of hot flashes and night sweats due to perimenopause.
Dana
The Spanish startup offers an app for young mothers to support them through motherhood by improving their mental and physical well-being.
Haemetrics
Still in early stage is this Singapore-based startup that has developed a diagnostic platform to test a range of hormones in 30 minutes from a blood sample.
FimmCyte
Also in its early stages, this Swiss startup is tackling endometriosis by developing a new treatment that selectively destroys diseased endometriotic tissue with precision.
She’s a co-founder and manager of Tech4Eva, a femtech startup acceleration program introduced two years ago in association with Swiss insurer Groupe Mutuel. The program aims to support young businesses worldwide that are developing breakthrough technology to improve women’s health.
Where does femtech come from? What was the trigger?
Femtech emerged from a combination of factors. First, today’s young women aren’t shy about speaking about their problems, and they’re demanding to be treated on a par with men. Femtech is truly a movement by women, for women, as 80% of its investors are female. Second, digital healthcare is gaining traction. For now, just 3% of new digital healthcare businesses address women specifically, but some femtech startups are exploring the healthcare potential of digital technology (through the Internet of Things and sensors, for example) and will be part of the growing trend. And third, personalized medicine is becoming more and more popular. Today women want their differences to be acknowledged. Until now, most R&D protocols for new treatments have been designed for men, since data collected from women were often considered unreliable because of their menstrual cycles. Personalized medicine will let doctors and scientists better account for the specific features of a woman’s body.
Lan Zuo Gillet is Deputy Director of the EPFL Innovation Park, responsible for startups and training, incubation and acceleration programs. © Elyn
How do investors generally react to femtech-labeled businesses?
Most investors are men. And since femtech relates directly to women’s health, it’s unknown territory for these investors. They sometimes have trouble understanding femtech business models or giving femtech startups due attention. But things are clearly changing. As one of several movements by women, for women, femtech is gaining in visibility and drawing more attention. Several femtech-focused investment funds are being set up, often managed by women. But conventional funds investing in healthcare and life science are also becoming interested in femtech. The most important thing for any fund manager is the potential gain on an investment, and these fund managers see potential in femtech.
Could we call it a femtech boom?
The field has definitely grown rapidly over the past five years. The figures may look impressive because we’re starting from a low base, but recent estimates put the number of femtech investors globally at over 1,400. The total amount invested is still relatively small, although that’s also due to the low number of startups available to invest in.
How has femtech improved women’s healthcare?
Until recently, women’s healthcare has focused mainly on the most visible diseases – namely breast and cervical cancer. And many of the solutions developed targeted common issues like menstruation, fertility and menopause. With femtech, however, technological development is also oriented towards diagnostics, prevention and overall wellness. For instance, menopause isn’t a disease, but investors are becoming more interested in menopause-related businesses. That can be explained in part by the fact that 50-year-old women are at the peak of their careers, and the hot flushes caused by menopause can impact their daily lives, lead to insomnia and depression, and even cause some of them to stop working – which is a huge loss for society. Here we’re moving beyond a purely medical perspective to one that encompasses a woman’s overall well-being. Three startups that have gone through our Tech4Eva program are good examples of this. The first has developed a connected bracelet that can ease hot flushes; its device has been hugely successful in the US because it provides effective relief to busy working women. The other two startups have introduced products that are harder to market because they address particularly personal problems. One has created a smart Kegel trainer for exercising and strengthening the pelvic floor after birth; the other has designed an intimate gel stick for strengthening the vaginal muscles and improving sexual health after birth or menopause. Some femtech products and methods may relate to taboo subjects, but a growing number of men and women are comfortable with the idea that women are leveraging new technology to better care for their bodies, including their sexual health. And I have no doubt that will continue.
Can technology offer an alternative to drug treatments?
As far as menopause is concerned, hormone replacement therapy is clearly the primary option. But some women don’t like that option, and technology can be used to find alternatives, such as through online communities. Another startup we’re supporting is researching food supplements that can help women through menopause. Solutions based on digital technology are attractive because they’re not invasive.
What types of technology do the startups in your program generally develop?
We have no control over what comes into our pipeline, but over half of the Tech4Eva startups operate in the field of digital technology. This is often the easiest kind of technology to take to market, and not just in femtech. That’s because deeptech systems and therapeutic protocols require more time and money and a different kind of support from what we currently offer. So we began by supporting digital technology startups – that’s what we do best at Innovation Park. But we hope to expand Tech4Eva to assist entrepreneurs earlier on in the process and team up with researchers to help new business ideas emerge and facilitate technology transfer.
Some women don’t like that option, and technology can be used to find alternatives”
What kind of femtechs apply to the Tech4Eva program?
We get a little of everything, including applications from people who don’t have a tech background. These include people, mainly women, who feel strongly about a given health concern. They may have a female friend, family member or acquaintance who’s suffered from a disease, for example. But around 20% of the people who apply are men. They usually have some experience with women’s health, through their spouse or a career in medicine, for example.
Are men generally reticent about femtech?
Not always. But if we’re holding an event and looking for a high-level speaker, a male executive will often refer us to a female colleague. Too many CEOs still think femtech doesn’t concern them. And that’s a shame! You mostly see only women in femtech today, and we want to break the stereotype and get more men involved. If people think of femtech as just a women’s issue, then we’ve lost the battle.
Can femtech help improve women’s health and well-being in the developing world?
Our vocation is international, even though so far we haven’t really focused our efforts on developing countries. But we clearly want to develop femtech applications for women in these regions. We’ll obviously need a different approach – one that not only includes international organizations like the WHO but that also clues us into the specific problems these women face. It’s one of our goals for the next few years.
Could femtech also be used to address women’s issues beyond healthcare, like gender equality?
We made a conscious decision to not take a stand on gender equality. But women’s healthcare is associated with equality in some ways. For instance, if a company introduces policies to support pregnant women, or women with painful periods or suffering from menopause, then the company is also improving the condition of female employees more broadly. We’re hoping to work with the HR departments of large organizations and encourage them to buy systems that can help women at different stages of their lives. I’d say that femtech is more about acknowledging differences than imposing equality. Women are biologically different from men and should therefore be treated differently. Today’s youth is aware of that.
Is femtech destined to be viewed as a separate industry for the long term?
Ideally femtech would become a subset of medtech or digital healthcare. For now it’s a movement that’s seeking to drive change, and it’ll most certainly stay that way for the next five years.
…a growing number of men and women are comfortable with the idea that women are leveraging new technology to better care for their bodies.”
Tearing down roadblocks in women’s careers
The Tech4Eva program is sponsored by Groupe Mutuel, one of Switzerland’s largest health insurers with over a million customers across the country. “Supporting the program was a no-brainer for us,” says Sophie Revaz, a member of the company’s executive board. “Half of our policyholders are women, and less than 4% of business investment worldwide is dedicated to women’s health. We believe that has to change.”
The reasons behind Groupe Mutuel’s decision are not only financial. The insurance company considers itself to be more than just a bill payer: part of its mission is to specifically address its customers’ primary concerns. “Startups that go through Tech4Eva could one day develop products and services that fill a real unmet need for our female policyholders,” says Revaz.
While it’s too early to give any specifics, one idea she cites is to design health-insurance policies that make femtech products more affordable for customers. “Even in this early stage of business development, when new technology is still being explored, it’s a win-win situation,” says Revaz. “Tech4Eva lets us see what innovative technology will hit the market in the coming years and gives entrepreneurs an opportunity to benefit from our first-hand knowledge of the healthcare industry and of our policyholders’ needs. We also help startups take their technology to market by giving them industry-insider feedback on their business models.”
The issue of women’s health is particularly important to Revaz, who notes that Groupe Mutuel is sponsoring Tech4Eva as part of a long-term perspective. “Subjects that companies had to tiptoe around, like female employees taking extended leave or career breaks because of pregnancy or menopause, are now something many HR managers are dealing with head on. We hope that through Tech4Eva, we can help more women climb the career ladder by providing products and services designed specifically for the problems they face – problems that are still throwing up roadblocks in their careers.”
Groupe Mutuel is a Swiss insurance company
Subjects that companies had to tiptoe around, like female employees taking extended leave or career breaks because of pregnancy or menopause, are now something many HR managers are dealing with head on.”