Your Guide to Starting a Women's Health Company From Someone Who Has Done It (Twice)
Women’s Health, FemTech, Women+ Health— whatever you want to call it— is the intersection of gender, biology, society, and the environment that shapes the well-being of half the global population. Yet it has long been relegated to the periphery of healthcare innovation. Recently, however, this sector has begun to take its rightful center stage, thanks to a new wave of founders, investors, and supporters. If you're aspiring to be part of this wave by starting a women's health company, you've chosen a field that's not only ripe for innovation but also plays a crucial role in advancing global health equity. Welcome!
I have started two women’s health companies, Natalist (sold in 2021) and Cofertility. I have backed and advised many more, including KindBody, Tia, Poppyseed Health, Conceive, Celmatix, Alife, Wildflower Health, Milkstork, Loom, Veracity, Aunt Flow, and Aavia. I was the Founder & Managing Director of Rock Health, where I helped start the Rock Health Women’s Summit and author our very first report on gender diversity in healthcare. And I have my MPH with a concentration in women’s and reproductive health. So you can say I’m very committed to this cause.
I put together this guide to share thoughts and resources as you get started. It includes:
The urgency of women’s health
Women’s health: all are welcome
Getting started: the most helpful women’s health resources
Funding options for your women’s health startup
Women’s health market facts to go in your pitch deck
Final thoughts: let’s promise to do this differently
The urgency of women's health
Gender bias in healthcare is as old as healthcare itself.
From the underrepresentation of women in clinical trials to pervasive gaslighting and misdiagnoses, the gender gap in healthcare is vast and very real.
If you’re working in this space, then you know this. But let’s review some of the glaring problems women face today:
On average, women live longer than men but suffer more years of poor health
70% of those affected by chronic pain conditions are women, but 80% of pain research is conducted on males
Maternal mortality in the US is higher than our peer countries and actually *worsening*, especially for Black women
Women face barriers to reproductive health services, with more and more women stating difficulty finding reproductive health clinics
Nine million women in the US are diagnosed with an STI each year, and often have more serious health problems from STIs than men
Cardiovascular disease is the number one killer of women in the US, but only a third of participants in clinical trials for new treatments for cardiovascular disease are female
Women have up to a 4x increase in risk for autoimmune disease compared to men
Essential product shortages, such as those of tampons and infant formula, disproportionately impact women and exacerbate existing inequalities
Even though 100% of women living into late life experience menopause, it is woefully under-researched and poorly understood
Endometriosis, a condition of the uterus lining that 30% to 50% of infertile women experience, can take up to 10 years to diagnose
Polycystic Ovary Syndrome (PCOS), affecting ~5M American women, takes up to two years, and multiple doctors, to diagnose
An estimated 18 million women of reproductive age live in locations without access to fertility care
The US lacks federally mandated paid maternity leave, placing undue financial and emotional stress on new mothers
The rising incidence of domestic violence poses significant physical, emotional, and psychological threats to women
A lack of comprehensive sex education in the country often leaves young women misinformed and inadequately equipped to make decisions about their sexual health
The study of the human body is still largely based on a “Reference Man,” and it wasn’t until last year that a complete female anatomy model was created
A 2021 analysis from the NIH concluded that the organization disproportionately funds studies on diseases that primarily affect men
There are 5x as many studies into erectile dysfunction as PMS. Despite the fact that only 19% of men suffer from erectile dysfunction versus 90% of women that experience symptoms of PMS
Just 4% of all biopharma R&D spending goes toward female-specific conditions. And of 37 total prescription drugs the FDA approved in 2022, only two were for female-specific health conditions
Despite advances in women's rights, there remains a persistent pay gap, which negatively impacts women's socioeconomic status and, consequently, their access to healthcare
I could go on, and on, and on.
Each of these issues is a clarion call for action. And each one of them also represents an opportunity—an opportunity for entrepreneurs and innovators to step in and make a significant difference.
The time is now. Society is increasingly recognizing and acknowledging these gaps and injustices. The discourse around women's health and gender equity has never been more active or more visible. This momentum, combined with advances in technology and an expanding body of research about women's health, sets the stage for unprecedented progress in this space.
I can't overstate how optimistic I am to see our community rise to this challenge. The problems are enormous, yes. But so too is our potential to effect change. I've seen firsthand the transformative power of mission-driven entrepreneurship. I am confident that as we band together, drawing on our collective passion, creativity, and resilience, we can redefine the landscape of women's health for the better.
In every challenge, I see a chance for innovation. In every setback, an opportunity for advocacy. In every story of struggle, a spark of potential waiting to be ignited.
This is our time to stand up, to step forward, and to shape a new era of equity, justice, and wellness in women's health.
Women’s health: all are welcome
In a field as behind as this one, it is imperative that we pool every ounce of talent and perspective we can.
I recognize that the term 'women's health' carries complexities and can appear exclusive. I co-authored an article for Harvard Business School on this topic that I encourage you to read. In it we discuss the biggest issue we’re tackling: existing within a system that was designed by and for men. The cost of simply being a woman in our society, and certainly in our healthcare system, is high.
The problems we face have more to do with our gender (being a woman) than our sex (being female). In fact, just looking at the problems listed above, they are more social justice issues than scientific complexities due to our sex. It is because of our gender that we suffer more years of poor health. It is because this space has for too long been underfunded and under-researched.
We have to move beyond the biomedical model and begin to acknowledge the social determinants of women’s health and wellbeing in our society.
Health is a product of cultural, social, and psychological factors, and the impact of navigating a patriarchal society and healthcare system. One tool we have to do that is the biopsychosocial model, which gives us an expanded lens of health that focuses on social and psychosocial factors as well as biology.
It’s also important we’re inclusive of people who have female reproductive organs, but don’t identify as women, as well as those who may not have female sex organs, but experience oppression due to their gender identity, along with anyone else impacted by the baseline inequities that exist in the healthcare system today. One solution for renaming this category to be more inclusive was suggested in September 2021 by Rock Health, which now uses the term “women+ health” to encompass the full spectrum of health needs experienced by cisgender women, as well as transgender individuals, nonbinary individuals, and others whose health needs relate to those of cisgender women.
Men and non-binary individuals are not just welcome but actively encouraged to join our ranks in addressing these gender- and sex-specific health issues. While we operate under the moniker of 'women's health' as it encapsulates the gender bias at the heart of the challenges we face, our goal should be to foster an inclusive environment where every voice is heard, and every perspective is valued.
Getting started: the most helpful women’s health resources
A wide and growing range of resources exist to provide guidance, support, and networking opportunities for those embarking on this journey. Here are a few key resources I recommend:
Women in Women’s Health: A new LinkedIn group for women innovating in women’s health
FemTech Insider: The best newsletter specifically dedicated to this space
Women of Wearables: An international organization supporting women in wearable tech, digital health, and women’s health
FamTech: An active slack group focused for innovators and partners delivering solutions to power and transform the care economy
Heart of Healthcare Podcast: Here’s my shameless plug for my podcast, with many episodes dedicated to the topic of women’s health
Women’s Health Access Matters (WHAM): A non-profit dedicated to funding women’s health research and investment to transform women’s lives
AthenaDAO: A decentralized community of researchers, funders, and advocates working to advance women’s health research, education, and funding
Theia: A non-profit dedicated to empowering the next generation of women entrepreneurs and investors in healthcare
Femtech Focus Podcast: A podcast amplifying innovation in female health & wellness
Health Matters for Women: A monthly newsletter from the CDC that provides information on what is happening in women’s health around CDC and other agencies.
FemTech: An international group that publishes a newsletter and hosts an annual conference
The Society for Women’s Health Research (SWHR): A thought leader in promoting research on biological sex differences in disease and improving women’s health through science, policy, and education
Commonwealth Foundation Maternal Health: Important research on the topic of maternal health in the US and globally.
Resolve: A large non-profit supporting family-building (disclosure: I am on the board)
American College of Obstetricians and Gynecologists (ACOG): A professional association of obstetricians and gynecologists dedicated to improving the health of women. Their annual event is a popular spot for women’s health founders
American Society for Reproductive Medicine (ASRM): An organization devoted to advancing knowledge and expertise in reproductive medicine. Their annual event is must for founders working in fertility
Funding options for your women’s health startup
Women’s health founders, who are more likely to be women, face an uphill battle from the outset. While funding for our sector has increased considerably in recent years, it falls short of what's needed for a sector that serves half of the world’s population.
Plus, woman-founded startups get just 2% of venture dollars overall, a number that has actually worsened over the last five years. So if you’re struggling to figure out the funding piece, know that it’s probably not you or your business. It’s the system.
Bootstrapping
Self-financing or 'bootstrapping' your startup, using personal savings or business revenue, is an option for some founders. A huge perk here is that it allows you to retain complete autonomy and ownership of your business.
The founder of Ruby Love, Crystal Etienne, developed their product and bootstrapped her company to $10M in sales within two years. With this traction she was able to raise $15M in venture funding, and actually went on to start a VC fund herself.
Another woman's health startup that was bootstrapped is Thermaband. The founder Markea Dickinson told Crunchbase, “Hitting several early milestones made our pre-seed investment opportunity more attractive and the terms more favorable”.
Crowdfunding
Crowdfunding is another viable avenue for raising capital for your startup. Through this model, a large number of people each contribute a relatively small amount, allowing you to amass significant capital without ceding equity or control over your company. One study found that women are actually more successful at crowdfunding than men, because they are perceived as more trustworthy.
This year Clue set a record for number of investors as well as female investor participation on Crowdcube. They were able to crowdfund €8.5 ($9.2M) from 5,224 investors. Co-CEO Carrie Walter told Forbes, “It’s a real community moment - we hope that the crowd investors who also use Clue will become even more engaged in helping us develop the app in future.”
Crowdfunding platforms include:
Start Engine: One of the largest equity crowdfunding platforms, helping startups to raise capital from the public
Republic: A more hands-on equity crowdfunding platform, 90% of their campaigns meet their minimum funding goal
IFundWomen: A funding marketplace for women-owned businesses that offers crowdfunding as well as coaching and support
AngelList: A site where investors can create a syndicate to help you fundraise.
Crowdcube: A UK-based equity crowdfunding platform (this is the one Clue used)
Kickstarter: One of the most well-known crowdfunding platforms, Kickstarter is perfect for startups making physical products (although they do not allow medical products)
Indiegogo: Another platform that’s perfect for physical products, they are generally more friendly to healthcare and medical products
Fundable: Offers both perks-based and equity crowdfunding.
Venture capital
VC funding is not for every startup, nor is it for every founder. VCs are generally looking to invest in a company that can 100x+ their initial investment (i.e. 100x a $10M valuation is $1B). Expectations are high, including exponential growth in revenue. Pressure to deliver high returns on investment can steer your company towards hyper-growth, which might not align with your original vision or pace.
But VC funding can also help propel your company to new heights. And the right VC can be your partner in growth, supporting you on everything from hiring to customer introductions.
Here’s a non-comprehensive list of investors who have made *at least 5* investments in women’s health (or are solely dedicated to women’s health):
Steelsky Ventures: Cayaba Care, Lark, Twentyeight, Origin, Ruby, Proov, Mae, Bend Health, Midi Health, Joylux
Supernode Ventures: Chill Pill, Endometrics, Fertilidad Integral
Serena Ventures: Teal Health, Wile, Lola, Mahmee, Virtue Health, Every Mother
Portfolia: Nest, Rosy, Willow, Everly Health, Maven, Proov, Joylux, Future Family, Attn: Grace, Hey Jane
RH Capital: Eli Health, Thirty Madison, Ovia Health, Seven Starlings, Vitralabs, Your Choice Therapeutcs, Twentyeight, Planera
The Helm: Tia, Oova, AOA, Mahmee, Hey Jane
Avestria: Mae, Madorra, Midi Health, Raydiant Oximetry, Genome Medical, Alydia Health, Uqora, AOA, Viu Health
Coyote Ventures: Flex, Gabbi, Maude, HERA Biotech, Malama, Wile
Able Partners: Rae, Maven, Alma, Midi, Needed, Ianacare
Springbank: Summer Health, Little Otter, Alife, Origin, Natalist
Muse Capital: Eli Health, Cofertility, Mahmee, Midi Health, Noula, Oath
SevenSevenSix: PoppySeed Health, Aavia, Anja, Elektra Health
Female Founders Fund: Maven, Oula, Kindra, Real, Gabbi, Kama
FemHealth Ventures: BioAesthetics, Nymbl Science, Rejoin, Raydiant Oximetry, Trefoil Therapeutics
Lux Capital: Maven, Adyn, Alife, Everly Health, Gameto
Astia: Cooler Heads, Prima Temp, Ocon, Madorra, Alydia Health
Goddess Gaia Ventures: Aura, Syrona Health, &Sisters, Anya, Nabta Health, Biorithm
Overwater Ventures: Overture, Gameto, Conceive (and three others unannounced)
Recharge Capital: Generation Prime, Fertilidad Integral, Embryonics, Elix Healing
Amboy Street: gennev, Dame, contraline, HeyJane, Evvy, HerMD, Aunt Flow
Check out the replies on this tweet for even more. And check out this blog post for a larger list of my favorite healthcare investors.
And there are amazing angel investors backing women’s health including Brit Morin, Lauren Berson Sugarman, Chelsea Clinton, Leslie Schrock, Fiona Pathiraja, and Emilė Radytė.
Femtech accelerators
Startup incubators and accelerators are programs that provide early-stage companies with mentorship, resources, and often some form of capital, usually in exchange for equity. The value of these types of programs varies widely, so do your homework and definitely talk to someone who has gone through the program!
51 Labs: An accelerator for women’s health backed by a slew of corporate sponsors
Impact 51: A new startup studio to exclusively address women’s health
Springboard Enterprise: Springboard’s Women’s Health Innovation Program is for women-led companies in women’s health
FemTechLab: A 12-week program for early-stage women’s health companies
FemTech Accelerator: An accelerator for women’s health founders in Oklahoma City
Series R: They provide pro bono 3-month customized package of marketing services, mentorship, and networking opportunities to women’s health founders
Y Combinator: The original startup accelerator that has helped launch over 4,000 companies including women’s health startups Ruth Health, Syrona Health, BellaBeat, Modern Fertility, Ananya Health, and iSono Health
BioInnovation Institute: established by the Novo Nordisk Foundation, they help provide long-term and ambitious support for innovation in life sciences.
Loans
Loans, usually provided by banks or financial institutions, must be repaid over time with interest. Some entities offer special loan programs for startups or businesses led by women or minorities. Although taking on debt can be daunting, it can also give you a substantial cash infusion while allowing you to retain full ownership of your company. If you’re making a physical product, CircleUp offers equity and credit financing to CPG companies.
NerdWallet has a good resource for startup loans.
Grants
Grants are essentially 'free money,' typically provided by governments, corporations, or foundations to foster innovation and growth in specific areas. Although grants can be challenging to secure (especially as a for-profit), they don't require repayment and don't dilute ownership. Here are a few to look into:
Cartier Women’s Initiative: $100K women-owned and women-led impact-driven businesses grants
Women Who Tech: $15,000 FemTech grant
Tory Burch Foundation: $10K - $20K grants for women of color-owned businesses
SoGal: $5K - 10K cash grants to Black women or nonbinary entrepreneurs
FFC Inc. x Boss Beauties Foundation: $10,000 grant opportunity for female-founded businesses making an impact on the future of parents, families, and children
The best kind of capital
The most compelling validation of your business comes from a source closer to home: your customers. And every hour spent pitching a VC or writing a grant proposal is an hour not spent with them.
Revenue from satisfied, paying customers is a solid testament to the value your startup provides and arguably the best kind of capital there is.
Generating revenue early can provide some capital for growth and scale. And it can serve as a powerful signal to potential investors. It demonstrates market validation, business viability, and operational efficiency — elements that are critical to long-term success. This also keeps you grounded to your mission: to massively improve the health and wellbeing of women.
Women’s health market facts for your pitch deck
If you go the VC route, you will undoubtedly spend weeks, if not months, of your life in fundraising mode. So here’s a cheat sheet of stats on the business of women’s health that you can pull for your deck.
Investors want to know there’s an unmet need
Investors will want to see that your startup is addressing a significant unmet need. They will be interested in understanding the nature of the need, and how you can shake up the market dynamics, potentially becoming a dominant player or even creating a new market altogether.
Here are some quick facts that may help illustrate this:
Women are the “Chief Medical Officers” of the home, making up just over half the US population but controlling 80% of healthcare decisions
Women use significantly more health services and spend more healthcare dollars than men
During ages 18 to 44, health spending for women is 84% higher than men, from age 44 to 64 spending for women is 24% higher, and even at age 65+ spending for women is 8% higher
Research by Women’s Health Access Matters suggests that a $300 million investment into improving female health could generate around $13 billion for the global economy
Investors want to know the market size for women’s health is enormous
Lots of firms put out market size estimates, and I actually think they underestimate the size of women’s health. For instance, one analyst report claims that the entire maternal health market, globally, was $14.05B in 2021. But in the US alone we spent $69B on maternal health last year ($18,865/birth x 3.6M births). How are they so off? A quick look at the team page explains it.
I think a better way of calculating your total addressable market (TAM) is a bottoms up approach.
Let’s say you’re starting a SaaS company that helps women’s health clinics improve outcomes by 10x while cutting costs in half (ambitious!). They pay a flat annual fee for your product. A quick TAM calculation could look like:
3,600 women's health centers in the US
x $25,000 price of annual contract
= $90M TAM
Now, that’s not exactly a TAM that would get a VC excited, but you get the idea. Maybe this exercise helps you realize that you either need to expand the product to serve a broader customer type, or increase the annual contract amount.
Investors want to know how they’ll get their money back
One question that VCs will want to know is the possibility for an exit— the way in which investors will multiply their initial investment. For VCs, this typically happens through a sale of the company (merger or acquisition) or by the company going public in an Initial Public Offering (IPO).
A FemTech Landscape Report in 2021 reported that there have been 105 femtech exits to date with an average exit value of $301 million.
Partial list of M&A included in the report, shared by Jessica Karr of Coyote Ventures on Twitter
However, looking at some of the companies included in this report, they may not be the best comps for your business. That is because some of these companies were:
public companies at the time of acquisition (Cytyc, Myovant, Third Wave Technologies, Conceptus, Adeza, SenoRx)
owned by a PE firm at the time of acquisition (Ob Hospitalist Group)
purchases of specific assets from another company (Paragard, Cook Medical's Reproductive Health Division, Smith & Nephew’s gynecology business)
not female-specific (like Mobidiag, which makes diagnostics for infectious diseases and antibiotic resistance management)
acquired over 15 years ago (Esprit Pharma Holding Company, Novacept, Suros Surgical Systems, R2)
So while 105 exits is an impressive stat overall, it may be hard to back up if an investor asks for more details. I recommend picking a few comps that are (1) relevant to your business (2) were private companies at the time of exit and (3) exited in the last 10 years.
Here are some impressive women’s health exits in the last decade:
IPOs
Natera, which offers noninvasive prenatal testing, went public in 2015 for $1.1B (today the market cap is $5.87B)
Progyny, a fertility benefits platform, went public in 2019 valued at approximately $1B (today the market cap is $3.5B)
Minerva Surgical, non-hormonal solution for heavy periods, went public in 2021 at a value of $343M (today the market cap is just $46M)
Invitae, a genetic testing company, went public in 2015 at $516M (today the market cap is $300M)
M&A
Myovant Sciences, a drug development company for women suffering from uterine fibroids, endometriosis, and infertility, was acquired by Sumitovant in 2022 for $1.7B
Theramex, a specialty pharmaceuticals company focused on women's health, was bought by private equity firms in 2022 for $1.4B
Forendo Pharma, a drug development company focused on novel treatments in women’s health, was purchased by Organon in 2021 for up to $954M
Ogeda, maker of a non-hormonal treatment of menopause-related vasomotor symptoms, was acquired by Astellas Pharma in 2017 for $800M
KaNDy Therapeutics, a biotech for menopause-related hot flashes, was acquired by Bayer in 2020 for $425M
Bonafide Health, a menopause supplement company, was acquired by Pharmavite in 2023 for $425
Counsyl, maker of non-invasive genetic testing, was acquired by Myriad Genetics in 2018 for $375M
Verinata Health, a non-invasive prenatal test, was acquired by Illumina in 2013 for $350M
Knix, leakproof apparel for periods and incontinence, was acquired by Essity in 2022 for $320M
nVision, which produces an FDA-cleared device designed to collect cells from fallopian tubes as an early diagnosis of ovarian cancer, was acquired in 2018 by Boston Scientific for $275M
Alydia Health, a medical device company focused on preventing maternal morbidity and mortality caused by postpartum hemorrhage (PPH) or abnormal postpartum uterine bleeding, was acquired in 2021 by Organon for $240M
Biotheranostics, a company that provides molecular diagnostic tests for breast and metastatic cancers, was acquired in 2021 by Hologic for approximately $230M
Modern Fertility, a fertility testing company, was acquired by Ro in 2021 for $225M
This is L., maker of period products, was acquired for P&G in 2019 for $100M
Perigen, applying AI to improve safety in childbirth, was acquired by Halma in 2021 for $58M
There are even more M&A transactions with undisclosed amounts including Ovia Health (LabCorp), Natalist (Everly Health), Naytal (Maven), Nurx (Thirty Madison), and Gennev (Unified Women’s Health).
And there are currently at least five women’s health unicorns (valued at $1B+)
Everly Health, valued at $2.9B
KindBody, valued at $1.8B
Maven Clinic, valued at $1.35B
Thirty Madison, valued at $1B+
Bellabeat, valued at $1B
And several more that have raised $100M and are likely close to unicorn status:
TMRW Life Sciences has raised $154M
Elvie has raised $149M
Tia has raised $132.8M
Carrot Fertility has raised $115M
Final thoughts: let’s promise to do this differently
While the traditional startup world often thrives on fierce competition, as we forge ahead in the women's health sector, I firmly believe we have an opportunity to take a different path—one that's built on collaboration, mutual support, and the understanding that success isn't a zero-sum game.
Many sectors, particularly in technology and healthcare, have been dominated by a competitive mindset, often fostered by a male-centric culture. This mindset has bred exclusivity, stress, and burnout.
But in the realm of women's health, we are not just building companies; we're fostering a community. We are bound together by a common purpose—to advance women's health and gender equity. This shared mission transcends individual company goals, and it provides us with a unique opportunity to shift the narrative from competition to cooperation.
We must realize that in a sector as under-served and as crucial as women's health, a win for one is a win for all. A breakthrough in early detection of ovarian cancer or a new maternal health program doesn't just benefit one organization—it propels the entire field forward. The ripple effects of such advancements extend far and wide, improving countless lives and driving the sector as a whole towards new horizons.
This belief in "a rising tide lifts all boats" should be the guiding principle as we navigate forward. Instead of gatekeeping knowledge, let's foster a culture of knowledge-sharing. Rather than viewing similar companies as threats, let's view them as allies in the fight for better outcomes.
By pooling our resources, sharing our findings, and supporting each other's initiatives, we can catalyze progress in ways competition simply can't. We can create an ecosystem that not only drives innovation but also embodies the values of equity, inclusivity, and collaboration we wish to see in the world.
To that end, I invite all entrepreneurs, innovators, and stakeholders in the women's health space to join in this collaborative approach. The task at hand is immense, and the road ahead may be fraught with challenges. But together, we can build a sector that doesn't just transform women's health, but also redefines the way industries grow and evolve. Let's rise together, for the tide is indeed on our side.
