‘Hormone Health’ - The Next Big Market Within FemTech
More people are looking to their hormones for greater health
FemTech is a huge market, estimated to be $50bn by 2025 (1). In this piece, I discussed how FemTech has evolved from menstrual and reproductive health to health solutions for older women, to sexual wellness. The next major trend in the FemTech market is going to be companies addressing ‘Hormone Health’.
Why ‘Hormone Health’?
“Hormones are the invisible force that shapes our body’s feelings and behaviours.” Inne
For women and people assigned female at birth, our reproductive hormones play a huge part in how we feel day to day. Fluctuating hormone levels throughout the menstrual cycle can affect sleep, mood, hunger, libido, the list goes on.
A small change in these hormones, even when they are still within the ‘normal range’, can cause symptoms such as tiredness, skin breakouts, bloating, mood changes, weight changes and more (2). It is estimated that over 50% of women will experience some form of symptoms from hormonal imbalance.
More severe hormonal imbalances have been associated with a number of different diseases including endometriosis, PCOS and uterine fibroids. Hormonal imbalance can also impact existing chronic conditions such as multiple sclerosis, rheumatoid arthritis and systemic lupus erythematosus (Lupus or SLE) through the effect of sex hormones on the immune system (3).
Our bodies work hard to keep our reproductive hormones in fine balance. Despite this we’re experiencing, as one study put it, an ‘unprecedented escalation’ in diseases caused or promoted (made worse) by hormone imbalance(4). It seems our modern lifestyles may be the cause.
Oestrogen seems to be a particularly sensitive and problematic hormone and I discuss the potential consequences below:
- High Oestrogen
High oestrogen has been associated with conditions such as Polycystic Ovarian Syndrome (PCOS) and is thought to contribute to some forms of female infertility, endometriosis, adenomyosis, uterine fibroids and others.
Studies have suggested many factors could contribute to high oestrogen levels including; the rising levels of obesity; our exposure to endocrine-disrupting chemicals such as bisphenol A, parabens, phthalates etc; inflammation; alcohol and marijuana. The gut microbiome also forms a crucial part of the way oestrogen is handled by the body and changes in the gut microbiome may influence hormone levels (4).
- Low Oestrogen
It’s not only high oestrogen levels that can cause women to experience health problems. Low oestrogen levels have been associated with osteoporosis, Alzheimer's disease, Parkinson’s disease and diabetes.
Factors thought to decrease oestrogen levels include some antidepressants, exogenous estrogens (such as birth control pills), some blood pressure medication and others. Smoking is thought to decrease the efficacy of oestrogens in the body (4).
Delaying menopause, which is associated with the declining production of oestrogen, can give significant health benefits.
Women are More Aware
Women are increasingly aware of the importance of hormones for health and wellbeing and are looking for solutions. The graph below shows the incredible rise in searches for ‘hormonal imbalance’ over the last 15 years.
Where is the Market Now?
The impact and the prevalence of hormonal imbalance, along with the rising consumer demand makes this an exciting market.
The market can be broadly split into education, products, wellness, diagnostics and treatments however it feels like we’re only just scratching the surface in each of these categories.
In the education space Hormone University is looking to educate women on different aspects of hormone health.
There are a number of natural products entering the market aiming to help women with hormonal imbalance. The research is still patchy on some ingredients but will hopefully catch up.
In hormonal wellness, Moody app is seeking to give women a deep understanding of the daily fluctuations that happen across the menstrual cycle so they can recognise and improve symptoms. Wild AI is helping athletes train better based on their cycle. Alicia Vitti in her book In The Flo describes how women can optimise their month based on their cycling hormones.
In diagnostics, companies such as Hormona and Inne are using urine and saliva respectively to test for sex hormones. Hertility, Screen Me and Parla are looking at hormonal causes of infertility. Feminade in the US is looking to commercialise the DUTCH test — the most advanced hormone test currently on the market.
In terms of treatments, there are a number of medications that modulate hormones and bioidentical hormones* are used in some cases. However, there is a notable lack of evidence-based non-pharmaceutical interventions.
*Bioidentical hormone therapy is widely marketed for a number of the conditions above but currently, there is limited evidence to substantiate these claims. Worryingly as they are regulated as a supplement they don’t undergo the same scrutiny as a drug.
‘Hormone Health’ represents an attractive and exciting part of the overall FemTech market.
However, there are still some challenges. Sex hormone metabolism and the way they interact with the body is incredibly complex. Our understanding is incomplete and full of misleading information. For instance, oestrogen can prevent inflammation in certain circumstances but can mediate inflammation as well. Medications that aim to target oestrogen receptors often fail because of the complex nature of oestrogens interactions with the body (5).
Despite these challenges, with growing consumer demand and evolving research, this area will see large and impactful companies being created. The possibilities are wide-ranging but could include companies looking to help women optimise their hormones through lifestyle changes, including through digital therapeutics, or companies looking at the genetic and epigenetic causes of sex hormone imbalance as a basis for providing personalised care for many disease types.
There is tremendous opportunity to build and invest in Hormone Health companies and solve a significant problem within women’s health. If you are an investor or startup founder and want to discuss please reach out at firstname.lastname@example.org
- Significant effects of mild endogenous hormonal changes in humans: considerations for low-dose testing. F Brucker-Davis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1240539/
- Sex Hormones in Acquired Immunity and Autoimmune Disease. Vaishali R Moulton https://pubmed.ncbi.nlm.nih.gov/30337927/
- Estrogen: The necessary evil for human health, and ways to tame it. Seema Patel et al. https://pubmed.ncbi.nlm.nih.gov/29573619/
- Estrogen signalling and the DNA damage response in hormone-dependent breast cancers. C Elizabeth Caldon https://pubmed.ncbi.nlm.nih.gov/24860786/