Episode 113: The Vagina Business

Suzanne Noble: I'm very excited to welcome our new sponsor, Higher Nature, who have created Rekindle, which I'm currently trying out and is working a treat. A 100% natural libido-enhancing supplement for women, which contains clinically backed ingredients to give your sex life a boost. And who doesn't want that? Hi, I'm Suzanne Noble, and you're listening to Sex Advice for Seniors. And this week we're delving into the topic of femtech. Probably a lot of people are going to think, what the hell is femtech? And we're going to explain it to you. And I'm really lucky today because I've actually got an author of a new book called The Vagina Business, which is talking all about femtech, about the world of Technology that's devoted to female pleasure and fertility and all sorts of other things that we'll be talking about. Welcome, Marina Gerner.

Thank you so much for having me. It's a pleasure talking to you. And I think we can define femtech right away by saying it stands for female technology, and that's technology focused on female bodies and women's health.

And why did you write this book? I'm curious to know.

So it all began with a bra about 5 years ago. I went to a conference that was organized by MIT and King's College here in London, and I learned that when most of us picture a person who's having a heart attack, we tend to think of an old man who feels a lot of pressure on his chest and pain radiating down the left-hand side. And I learned that those symptoms are typical for men but not for women. So women are more likely to have long-term fatigue and jaw pain, for instance. And so as a result of that, as a result of our knowledge being shaped by the male body, women are 50% more likely to be misdiagnosed after having a heart attack. And women also tend to wait longer before seeking help. And so there's this huge problem. And I met the founder of a company called Bloomer Tech, and she's called Alicia Chung Rodriguez. I guess, and they've created the coolest thing. They've created a smart bra that can help you measure and track your heart health. Um, you know, it's for women at risk. And so I thought, this is so great because not only is there a problem, but there's also a solution, or there are people who are trying to work on an innovative new product that can be part of the solution. And so I ran downstairs to ask for her business card, and we met very briefly. I really wanted to write about her, and I'm a journalist, so I pitched all of my editors. And initially, nobody was really interested, and I got the sense that people think it's a bit niche, even though, you know, this is obviously an issue that concerns over 50% of the population. So that is definitely not niche. But at the time, that was the impression I got. And then COVID happened. And I think a few things shifted where we started paying more attention to the sex differences in health. And I think partly that's because men were more affected by COVID initially. Now we know that women are more likely to have long COVID, but initially the symptoms that men had were worse. So people started to pay attention. And I managed to write the story about the smart bra for The Guardian. It came out, and I was invited to chair a panel at a conference organized by Women of Wearables. It was the first ever femtech conference. And after my panel had finished, I stayed and I listened to all of the other panels because I was really drawn into this world of women's health because We all think we know about our bodies, but in reality, there's just so much more to learn and so much more to discover. And I was in my early 30s at the time. I knew I wanted to have children soon, um, so I was, you know, thinking about that and preparing for that.

Wow. I mean, I've—

I—

the more I delve into the topic of, you know, the differences between how medical profession deal with women's health versus men's health, the more we realize how much of what we know about health in general is shaped by studies that have been done with men, fundamentally. And that it's only quite recently that women were involved in any clinical studies at all, which is unbelievable when you think about it for, you know, how many great medical discoveries there are out there and how few were actually women were actually considered even as part of these studies. So clearly there's like a huge requirement for us to understand not just vascular health, but so many different aspects of health from the way women experience them versus men. And I think we all, you know, when you said that, it's interesting that you should say that when we think about a heart attack, we only think about men having heart attacks. Because I'd never really considered that until you said that. But it's almost— even in the TV shows that we watch, almost always men, the male actor who's having the big heart attack, right? And the woman who's coming in to rescue him in some way, or, or to tend to his needs, or to care for him, or to do all of that. So, so exactly, we really don't think about this at all. And, and And as you said, it's only because, you know, some woman said we need to deal with this and created something like a smart bra. But of course, there are so many other amazing inventions going on out there. And I know that your book has covered so many interesting things that even I, as I was reading them, were thinking, God, one of the things that, you know, you can talk about, which I— because I started reading it— was about easier births.

Yeah, exactly. That's— that was on my mind. I've covered all life stages. It was really important for me to go really broad. But in terms of where I was coming from at the time, I knew I wanted to have children. And so I also knew that 9 in 10 first-time mothers end up with a birth injury, which is just I mean, it's a mind-boggling statistic to think that we accept that and that we don't really do much about it. So I was really excited to come across a company in California called Materna Medical. And I spoke to the CEO, Tracy McNeill, and I learned two things. I learned that the last big innovation in the standard of care of birth was the epidural. Which was popularized in the 1950s. But if you are to give birth tomorrow, and you're going to a hospital, you know, in the UK, US, or anywhere, you'll be told the epidural is a great option. And there's no other area of technology where we take something that old, and we pretend that it's cutting-edge technology. You know, we don't say, look at this incredible floppy disk. That's just That's just not how progress has happened in other areas of society and in other areas of technology. So that was mind-blowing. The forceps is also really old. Yeah. Plus, it's basically a set of salad forks. And then vacuum delivery, you know, made me think of a toilet plunger. So all of these devices are quite basic in a way. And the other thing I learned is that companies like Materna Medical— so what they are developing is a dilator that can pre-stretch the muscles of the vaginal canal in the first stage of labor so that once the baby comes through, the muscles are pre-stretched and less likely to tear. So it's in clinical trials right now. It's not on the market yet. We don't know whether it's going to make it to the market. But I thought that was such a— it was such a good idea. And it's great and unusual that it's a preventative device.

Yeah, amazing.

It's not something— yeah, exactly. It's not something that, you know, will try to repair damage afterwards. And there aren't enough of those devices either. But I thought it was great that it was preventative. And I learned that companies like that and other companies that focus on vaginas, that they all struggle to raise money. Because investors who are predominantly male are unfortunately too embarrassed to talk about vaginas. And I have this quote from one VC investor who says, I don't want to talk about vaginas in my Monday morning partner meeting. Yeah. So in other words, a bunch of guys are sitting there in a boardroom, and they don't want to talk about vaginas to each other. You know, men not wanting to talk about things in front of other men. And I found that really shocking. And it's something that kept coming up again and again. So I turned my anger into an article, and I wrote an article for Wired magazine. It was called "We Need to Talk About Investors' Problem with Vaginas." And the article went viral. Thank you. It really hit a nerve. It was so well received and shared by lots of people. And I had Cindy Gallup messaging me on LinkedIn. Uh, it was great. And so I realized that there's a real, um, hunger for, for those topics. And I found myself being so curious and so drawn into this topic, and I, I felt really passionate about it, and I felt like my background or the topics that I've covered in the past, which is a really wild combination of finance and tech and culture, would be that it would be good to bring together, um, my various areas of expertise to, to write about this topic. Because if you only looked at the cultural side of things, you would miss the financial fundamentals. And if you only looked at the business side of things, you wouldn't really understand why, why this isn't happening. There's a clear business case for many of these companies.

Yeah, I mean, just in my, um, with my other hat on, I'm, I'm representing a company in the UK called FirmTech that have a tech ring for men that measures their firmness and, and duration of their erections to determine vascular health. And they're currently producing a female equivalent of that product that we're prototyping that does very similar around the clitoris, which has a similar arousal pattern during— while we sleep. It engorges it, you know, it can be measured in terms of how it responds in the night to determine again female vascular health. And I'm just going out to talk to investors now. And it's, you know, and I've applied for a grant and stuff. And it's interesting. To work on— firstly, to talk to investors about a company that the first thing they did was develop a product for men, right?

Yeah.

Because the founder's a man and the first product was for a man, and they understand that problem because it's a man's problem, right? Erectile dysfunction, lots of people familiar with that. But I'm gonna— I, I'm just at the very early stages of this, but it's curious to see how they respond to a company co-founded by man that is now launching a femtech product, right? And whether that's gonna provide more opportunity to speak to people that will be like, well, the male product is already doing well, it's already making money, so we've already got something here that's kind of a bit of a safe investment, it's already got traction, so this female product, maybe it's going to have a little bit of an easier ride. Because, you know, my history of raising investment, although it wasn't in femtech previously, is as an older woman that it's really difficult and it's really difficult to raise money as a woman, full stop. I mean, we know the statistics around raising money as a woman are just, just abysmal. Something like, I think it's like 2.7% of all funds are towards women. It's just, it's, it's a ridiculously small number. So, you know, when we look at that and then we consider Not only is it difficult for a woman to raise money, but on top of that, they're trying to raise money for a product that men have absolutely no knowledge about. No knowledge, you know. And the only way— we've all spoken about this in the, in the world of investment— is to get more women investing. Because, because without that, I suspect, you know, most of the products that you've mentioned in your book that are coming out of Europe at least are going to rely almost exclusively on grant funding. There's almost no money in VC investment for these sorts of products. And I suspect, and I'm just making, hazarding a guess, that the ones who do get money probably are more aligned with fertility because that's a problem that a guy who wants to have a baby with, you know, is going to get. He's going to get the challenges that young women face in around their fertility issues, around birth, fertility. But, you know, as we said when we started this, once we get into older age, which is what this podcast is about, um, once we get into older age, the money starts— not just the vaginas start drying up, but the money starts— money start drying up as well, you know. Um, and I know you mentioned something that I found really fascinating, and I'd love you to speak about more, which is something that's you know, some of the stuff that is going on around older people and, and, and, you know, what technology innovations are happening in that space.

Yeah, absolutely. But first, I thought it was really insightful what you said about the second product having an easier way to the market potentially. I think that's true because the femtech founders I've spoken to who've had the reverse, who had a female-focused product first and then a male-focused product afterwards. So Elaida is one example. For instance, they focus on urinary incontinence, and they have brought out a male-focused product after. And the founder said to me, well, it would have been so much easier had we started with the male use case. Yeah. And I agree with you, we need more women as investors. But I also think we can't We can't afford to wait for, for those numbers to, um, become more proportionate because that would just take 250 years.

Literally, I think they've worked out it will take 250 years.

Yes, the World Economic Forum. Yes, exactly, to fill those, uh, the economic gender data gap. So yeah, uh, the economic gender gap. So We do need to convince men and everybody else, um, and as you say, sometimes that's for a personal reason, which is a double-edged sword because on the one hand you have investors who've experienced something, you know, their sister or their wife might have experienced something, and so they can relate to it. But on the other hand, entrepreneurs often tell me that investors will say to them you know, 'Oh, that's an interesting product you've got. Let me go home and ask my wife.' Yeah, which, you know, if you're investing in space, you're not going to say, 'Let me go and ask an astronaut,' because you wouldn't base your decision on the opinion of one person. And women are obviously not a monolith. We have so many different needs and life stages and preferences and so on that You know, if you want to figure out if something is really an unmet need or a worthy business area, business opportunity, then you would look at statistics and at the market and so on, just like you would.

Well, that's what you would think, Marina.

Well, exactly.

In the equitable world in which we clearly do not live, that's what you would think.

Yeah, yeah.

But my experience will tell you that that is not the way the world works, unfortunately.

No, exactly. And so what other femtech founders have told me is that they have come up with ways to explain hot flashes, for example, to men so that they can relate, or they have found use cases focused on men to explain their products. And they've done studies addressing the same issue in men to then make the case for their femtech products. Yeah, so there are all these different strategies. But, but absolutely, I think there has definitely been a focus on fertility and periods.

Yes.

Whereas in reality, the menopause segment is the biggest opportunity of all, just in terms of demographics, because we'll all go through menopause, but not every woman is going to have a child, right? But everybody will. Go through menopause and so on. And in the chapter that I have on innovation and menopause, I say that menopause is where sexism and ageism meet. So there's definitely a lot more that, that needs to happen there. And I have various products that focus on vaginal dryness, for example. And also, um, a belt that focuses on bone health.

All right, interesting.

So that can be worn across your back, and then it, it helps to retain bone density. It's called the OsteoBoost.

Oh wow, that's very cool.

Um, what else? I've also spoken to a French community called Sex Tech for Good. And they do various things. Among others, they, they're leading a research program on sexuality at old age homes. And Christelle Bonny, who's leading the organization, she told me that she has been met with reticence from healthcare professionals, because for them, sexual pleasure is not part of health. But she told me, we know that when you allow people to have sexual lives with intimacy, they eat better, and they require less medication. So it only makes sense. And it's great. And it's natural to think about that and to encourage that. But it's definitely still a taboo area.

Oh, completely. And There's, you know, there are a few, there are people that I've spoken to that have worked in those environments that have said that typically, especially when they're working with people with cognitive decline, that those people are separated if they're seen to be engaging in any form of intimacy, mainly because they receive no training in how to cope with that from the staff and they're worried about consent. I mean, you know, there's some logic to that.

Yeah.

People who are, you know, struggling with dementia or Alzheimer's, they're one minute they might be lucid and be able to make informed decisions, and the next minute they might find it more challenging. So I can totally understand why those, those, it's a huge, it's a big problem. But, but on the flip side of that, if you walk into somebody's room and they're self-pleasuring, and you tell them to stop, then that makes no sense to me because they're not doing anything to hurt anybody. They're, you know, they're giving themselves pleasure. And I know people that have smuggled sex toys into care homes so that people could experience sexual pleasure. And I, and I think that's a perfectly healthy and valid thing to do. But yeah, I mean, absolutely, what gives anyone the right to interfere with that? Yeah, but again, if you're not trained, if you're working in, you know, we know just generally that talking about sex in later life, at any stage of later life, and I'm talking about my age, which I think is relatively younger in later life than somebody who's in a, in a care home, it's all— that is taboo. And so the, the further you get towards death, the more I think the more taboo it becomes. But I've also seen that Typically, there's very little attention paid in technological terms to some of the challenges that older women, for example, do face. You mentioned vaginal dryness. Similarly, you know, vaginal atrophy affects over 50% of women over 50. It's a massive problem, and I'm not seeing anyone trying to solve that one. And I think generally that because of the difficulty in raising money, I mean, I know for myself through years of trying to raise investment and being successful and also unsuccessful, it's absolutely demoralizing. It is soul destroying. And when you are working on massive global problems that impact 50% of the world's population and you've been told it's not important, It's just, you know, you just think, what is the point of me doing this? I mean, it's so difficult. And I always think about these women that are out there trying to move the needle, how courageous and strong they must be because it is so difficult.

Yeah. So on vaginal atrophy, I have a company called Medora led by Holly Rockweiler, and she's working on exactly that. Um, it's not on the market yet as well because it takes much longer to create those things than you might think, but it's a non-invasive external device, um, that addresses that issue. And she, she started this process at Stanford University. They have something called the biodesign process there. And she said she was looking at, I think, 500 problems at first with her team, then they narrowed them down to 16. And they weren't just women's health issues, but other things as well. And then they realized that vaginal atrophy affects 50 to 70% of all postmenopausal women. And that she noticed a difference when she spoke to the patients for each unmet need, which was that the patient population for vaginal atrophy was just so grateful, she said, that they were working on it and so intrigued and supportive, as opposed to the men that she was talking to who were closed off and defensive. And there was a constant assumption that they were out to profit off them. So I think that was It was interesting that there is clearly an unmet need and that women are, you know, keen to, to find solutions and excited that somebody's addressing them, whereas men in, in similar issues sort of think, oh yeah.

Well, I think also, you know, one of the things I've noticed just doing this, um, is that women are, women are much more, they're much more interested in sharing their problems and their issues and trying to find solutions. And, you know, one of the challenges with talking about erectile dysfunction, for instance, is that there's so much shame around it. There's, there's, there's a real reluctance to want to deal with it. And even, I must be honest, that even when I talk to women that have got older boyfriends, and I'm And I mentioned it, I think there's just a confusion and a lack of understanding about erectile dysfunction doesn't necessarily mean your dick doesn't go hard all the time, you know, isn't hard 24/7. It just means it may not, you know, there may be an unreliability around that, right? So it's more about also understanding what this stuff, what it actually means. I think we've kind of been— there's a lot of assumptions around some of the challenges that we face around our sexual sexual health. And it, and it doesn't mean that we can't do this stuff all the time. It just might mean, for instance, that there's pain associated with it. So we can have penetrative sex, but after a short period of time, it might become quite painful, right? Or you can get an erection, but maybe it doesn't last. So it's, it's also about understanding what some of that terminology means, because we have so few people talking about any of this, that there's vast assumptions made about what, what does all this stuff actually mean? You know, what does it mean to be incontinent? Does it mean that I'm leaking all the time? Or does it mean that I sneeze and it— and I leak?

Yeah.

Does it mean that I, you know, that I have to worry about, like, To be honest, I don't even— because it's not something I struggle with, I don't really understand completely what it means either. But I do know when people have bladder issues and sometimes going to the toilet with some degree of urgency becomes a real problem, right? So it's also about becoming more self-aware around our own health, around our own female bodies, and some of the stuff that goes on. And we're not really— we don't talk about this stuff. We're not told about it. So it's no surprise really that somebody goes, oh, let's look at this vaginal atrophy stuff and see how many people it impacts, and then realize it's half of all women. Like, nobody talks about it.

That's true.

Yeah, I didn't know.

Yeah, the same goes for pelvic organ prolapse as well, another issue that's really prevalent that isn't talked about.

No, completely. I spoke to— I've spoke to a pelvic floor physio like last week or the week before, and she enlightened me about actually how big the pelvic floor actually is. I thought it was just something kind of around the, you know, the kind of vaginal area. She's like, no, no, it's huge. Goes all the way to your rectum. It's like a big, it's like a big hammock. Yeah. It's like, really? Yeah, you know, exactly.

It's like a seatbelt for all your organs, I think, is how somebody explained it to me. Yeah.

Yeah. But like, we're just not told about this, right? We're just not told. And, and so therefore, if we don't educate ourselves about our own bodies, to be honest, you know, like when men say, I don't really get it. It's hardly surprising because, because we don't talk about it.

That's true.

Yeah.

I remember at my pregnancy preparation classes, there were lots of people who had never heard of the pelvic floor before at all. But they had looked into all different kinds of, you know, baby strollers and toys and things. Yeah, it was just mind-blowing.

Yeah, but I, you know, I don't, I don't think it's that unusual. I mean, I feel that partly one of the big issues that we've, that I've got with all of this is that there's a lot of amazing innovation out there, which your book is all about. It's just, you know, it's done a tremendous job of bringing together some of the incredible innovation that's out there, but it's all very disconnected. In terms of everyone's in their silos. And yeah, somebody wants to go and find out about how to fix a problem that they're having. It's not easy. It's not easy. And they have to go and look in lots of different places. And medical professionals know nothing really about any of this. So they're not a great help either. And, and so it's, you know, I just think, like you said, how it's— it may not take another 250 years, but it's definitely going to take a lot to figure out how to bring all of this under an umbrella so that we have access to the information that we need when we need it.

Absolutely. That's why it was so important for me to go really broad.

Yeah.

You know, I've interviewed over 100 people across 15 countries and I've looked at all these different life stages and issues and solutions. And some of them will never apply to me personally. But it actually doesn't take long if, if you're looking into endometriosis, it really doesn't take long to find someone in your own circle who has it. And no, all these things are just very common.

Suzanne Noble: I mean, you know, we're kind of running out of time. But I suppose, you know, one of the things that I've recognized as I've gone further into the rabbit hole of trying to get products to market and understanding about, you know, just medical devices and other things that are related to feminine health or just health in general is that there— the regulatory environment around all of this is so onerous. I mean, I'm on a program at the moment dealing with how to launch into the NHS and my head is honestly spinning. I mean, I just don't know how anything gets done, really. I don't know. I mean, I, I listen to them talk about the different regulations and the, and all of the things that I'd have to do to get these products to market. Firstly, it's incredibly expensive.

Yes.

Incredibly expensive. So there's a financial barrier to entry. The second thing is the regulatory environment is just unbelievably complicated. Like, unbelievably complicated. There are so many agencies making a fortune off this, is just helping them through the regulations. And the third thing is it just takes years, takes years. I mean, so you have to have deep pockets, you have to have like confidence, resilience, you have to 100% believe in what you're doing, and you have to not be as old as I am because I'll be dead.

Don't say that.

Actually comes to market, but it is really, really difficult. So I mean, I think, you know, it's difficult enough when you're just bringing a product to market that mainly applies to men or isn't seen as being a female-centric product. But I think the challenge for women's tech is, is just so hard.

Yes, it really is. Um, I think that's why I'm so inspired by the stories of the people I've interviewed, because they've had so much grit and resilience. And you really have to believe in what you're doing. And oftentimes it is, as you said before, a problem that they've experienced themselves. So they are very passionate about it, uh, and, and they do change, you know, the lives of other people who are in the same position.

Yeah. Yeah. Well, we just have to champion all those amazing people out there and go buy your book so we can learn more about them. Because I think, you know, Your book does a really fantastic job of just giving a spotlight to all of those people who really don't get the opportunity very often to be represented. So well done.

Thank you so much.

It's called Behind the Business. We'll put the link in the bio. And really, it's just such an awesome achievement. And yeah, I just think, you know, I really hope that these women do get get the funding that they need and that we see these project— products eventually come to market because they will change lives.

Absolutely.