From The Straits Times    |

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There’s an app for everything these days. Femtech (or female technology) is aimed at improving women’s health and wellness through various digital products or services. With technology, you can track menstruation and fertility cycles, or monitor sexual health and menopause.

The women’s health market is estimated to reach nearly US$1.19 trillion (SG$1.6 trillion) globally by 2027, according to the Femtech Landscape Report 2021, co-authored by non-profit Femtech Focus and Coyote Ventures, a venture capital company that invests in women’s health and wellness start-ups.

Meanwhile, market research firm Frost and Sullivan predicts the femtech sector will reach a market potential of US$50 billion (SG$69 billion) by 2025. In fact, Singapore is building a reputation as a centre for femtech in Asia: In 2021, Singapore hosted more than 24 femtech companies, out of the 41 based in South-east Asia.

“Over the last year, Singapore has started to receive recognition as the ‘hub of femtech’, most likely due to the fact that we hold half of what is available in the region,” says Francesca Geary-Stingl, PR and marketing lead at Fermata Singapore, an Asian femtech ecosystem that provides
solutions on marketplace, localisation support and B2B consulting.

And yet, the recent results of Her World’s What Women Want 2022 survey, a collaboration with Milieu Insight that surveyed more than 6,000 women in Singapore, appeared to indicate that tech-based solutions for women’s health haven’t yet gained the traction you’d expect in a technologically knowledgeable and well-connected nation. Asked what kinds of femtech products or services they use: 52 per cent of survey respondents don’t use femtech at all, 39 per cent use period-related ones, and between 3 and 7 per cent reported using products or services targeting fertility, breastfeeding,
pregnancy, sexual wellness and menopause.

Between the promising potential of the femtech industry, and data that seems to point to a less enthusiastic adoption of femtech among women in Singapore so far, what gives?

According to our survey, the most-used category of femtech is period-related products or services. Milieu Insight’s own report issued this April on the use of femtech in South-east Asia revealed results in a similar vein: Those who’ve adopted femtech for period health account for 72 per cent of femtech users in the region.

Emma Lenzer is one such example. The 23-year-old began using Clue, a period and ovulation tracking app, about a year ago, around the time she was diagnosed with polycystic ovary syndrome (PCOS), and
was looking for a way to stay on top of her health by tracking her irregular cycles. The app can keep track of information such as spotting, energy levels, the presence of pain or cramps, mood and sleep.

“It’s definitely been helpful to be able to visualise my ovulation cycle, and although I am not looking to have children anytime soon, I do worry about the fertility difficulties that come with PCOS,” Emma says. “So I think it’s important, especially in these kinds of cases, to keep an eye on your cycle, in case other anomalies present themselves.”

And within the period-related femtech space, the range of offerings has expanded in recent years to include items such as menstrual cups and discs, and period underwear, made with materials such as medical- grade silicone, and innovative moisture-wicking or liquid-locking fabrics.

With period health being one of the more widely known categories of femtech, Francesca says: “It’s been great to see (that it has) grown in terms of innovation and technology.”

Developing better solutions for women

Beyond period trackers, there exists a wide array of technologies and product types that tackle the same health concerns from various angles.

Take the fertility space for example – not only are there apps and kits that track ovulation cycles based on monitoring basal temperature or measuring hormone levels, there are even physical devices designed to boost the odds of conception, such as the Sperm Guide by Twoplus, a brand of products that cater to fertility health. Launched by Stanford University’s Biodesign Innovation Fellows Prusothman Raja and Benjamin Tee, the silicone insert is designed to “help retain maximum sperm throughout the vaginal tract, so more can reach the egg for fertilisation to take place”.

“One in six couples face infertility globally. Moreover, a lot of subfertility burden is placed on females in many cultures, and I wanted to be able to alleviate the burden on females through setting up Twoplus,” says Benjamin.

In addition to shipping thousands of its first product in Singapore and the UK within nine months of Twoplus’ launch late last year, he notes that the platform has introduced products such as at-home hormone tests, artificial insemination kits, ovulation kits, and supplements such as CoQ10 and
folic acid.

“We think there is very strong demand for fertility technologies and services via online channels,” says Benjamin.

How femtech can help, but also deter your health

Accuracy and reliability could vary depending on how femtech is used, and that might influence how secure users feel about their health. Emma’s experience with Clue points to potential for lapses to appear.

“Based on what you log into the calendar, the app is supposed to predict when your next period and ovulation cycle will begin. However, as I am unfortunately a bit all over the place, I feel like I never get a fully accurate result, or at least I’m never 100 per cent confident in what they tell me. Although it’s very helpful for me to keep track, in terms of prediction, I have my doubts about how efficient it really is – but that just may be my fault.”

Benjamin personally went through the struggles of unexplained infertility with his wife. The couple tried doing basal temperature monitoring for ovulation, but it was somewhat troublesome to do and hard to get accurate readings.

“You had to measure (your temperature) immediately first thing in the morning when you wake up. If you forget to, you get missing data points,” he explains. “Such incidences may also increase baseline stress levels, which are probably already elevated when trying to conceive for a few months.”

Using femtech as a preliminary guide, in conjunction with advice from medical experts, could be a
way to boost health benefits.

“It certainly helps to make data-driven decisions, but only if the dataset is robust and sufficient. I think it helps to give a baseline read of whether your menstrual cycle is regular, and if not, it gives some impetus to perform more thorough checks earlier through a fertility specialist,” Benjamin adds.

Dr Christopher Chong, a urogynaecologist and obstetrician & gynaecologist at Gleneagles Hospital, says that while it’s beneficial that his patients are educating themselves, empowered and trying femtech on their own – ovulation-and period-tracking products are the most common types of femtech he’s noticed among his patients – it can sometimes interfere with his work. “I would tell patients that if they can get all the answers they need on the Internet, they will not need doctors anymore,” he quips.

“Doctors make the difference as they can examine the patient – this is most crucial. (Femtech) is of some good, as it can give patients an idea, but it’s (not helpful when) patients don’t know enough to fully understand (medical) conditions. Then, they worry unnecessarily, or reject doctors’ advice because they read too much, but without proper understanding.”

He recounts an episode where he spent a long time explaining to a patient and her husband that vaginal hormone insertion was not the same as hormone replacement therapy; she had refused his recommendation of the former, after reading up on the latter and its side effects and complications, and conflating the two treatments.

“The practice of medicine is very different from [using] apps,” Dr Chong explains. “Doctors need to examine the patient, and there can be subtle findings that affect the type and course of treatment. It’s not uncommon that [femtech] can be more of a hindrance than a help!”

Femtech can help to widen the conversation around women’s health issues

Milieu Insight’s April report on the use of femtech in South-east Asia showed that just 23 per cent of women in Singapore are using a femtech product or service.

A possible explanation for the seemingly modest adoption of femtech could be a difference in understanding of what’s even considered femtech in the first place. “The industry does open itself further than solely being software or strictly medical diagnostics – it also includes innovative technology that goes into improving certain products to better a woman’s life,” says Francesca.

On its marketplace platform, femtech available include items like a hands-free massage bra, menstrual cups and period underwear. “I personally would be curious to know whether there would be a change of response from the (What Women Want 2022 survey) participants and whether they use or have used (such) products,” she adds.

And while femtech aimed at period health, sexual wellness, sexual health and fertility are becoming increasingly popular, the conversation around the full spectrum of femtech products and services could be hampered by the perception that still persists among some that talking about women’s health issues, such as discussing one’s period or fertility, is taboo.

“What femtech companies are trying to do is not only sell a product or a service; they are primarily trying to bridge the knowledge gap and create a safe space for the community to lean into during their
time of need – and also for those who are looking to be allies or supporters,” says Francesca.

In spite of how femtech has yet to attain maximum (ahem) penetration, it could serve as a good start to opening up the conversation to all the ways that technology can support women in achieving their health goals.

“I feel that we know so little about women’s reproductive, sexual or overall health in general – it hasn’t been talked about enough. It only started gaining momentum over the past few years, especially through social media, which I think is extremely important. I’ve learnt so much about it since,”
says Emma.

“I think that femtech products and services are definitely going to be a part of my future, especially as I get older. I will always look for ways to learn more about my health, and also how to take better
care of it.”

Francesca agrees: “Women’s health has always been under-represented and under-researched – femtech presents itself as an opportunity and a solution for women to arm themselves with knowledge about their bodies. The more people that use femtech, the more data points can be collected to determine what other challenges or solutions are needed to overcome (knowledge gaps).”