The next FemTech frontier: personalized and innovative birth control

“When I tell people that I do research on hormonal contraception, usually they say I have a story to share with you,” began Dr. Yael Maizels, an adjunct lecturer in anatomy and embryology at Ariel University, speaking to a crowd at FemTech Israel’s annual conference this month. “People tell me stories all the time. Everyone has a story. And, usually, they’re not great.”

Maizels spoke about a recent study she conducted during her tenure as Senior Scientist at the Institute for Personalized and Translational Medicine at Ariel University, which found that 76% of women using hormonal contraception suffer from non-lethal side effects. Her study on more than 500 Israeli women showed that the vast majority listed at least one side effect, and some as many as 13. Considering that 87% of all women use hormonal contraception during their lifetime, this is a shocking statistic.

Dr. Yael Maizels.

“Non-lethal,” refers to “side effects that won’t kill you or send you to the hospital,” but can still severely impact quality of life, Maizels told CTech. Her study is among the first to focus on such side effects which include nausea, migraines, vaginal dryness, reduced sex drive, weight gain, fatigue, anxiety, and depression.

Maizels says that for most doctors, whose main priority when prescribing contraceptives are efficacy and lethal side effects, non-lethal side effects are rarely taken into account or discussed thoroughly with patients. According to the study there is a major communication breakdown between doctors, the majority of whom do not mention side effects when counseling patients, and their patients, who by and large do not tell their doctors when they suffer from side effects.

“Doctors aren’t speaking to women and women aren’t speaking to doctors. Therefore, 60% of women said that when they suffered side effects from hormonal contraception which severely impacted their quality of life, they just kept going with the same thing,” says Maizels.

She adds that this is partly informed by a trend within medicine that dismisses women’s pain because it is viewed as inevitable and normal. By contrast, the male birth control pill has long been deadlocked because it contains the very same non-lethal side effects considered routine and acceptable for women but beyond the pale for men.

This has meant that, while the technology is capable of providing a male birth control pill of the same quality as women’s birth control, the lack of a societal appetite for male pain and discomfort has prevented it.

An untapped market

For the time being, the burden of preventing pregnancy continues to be shouldered by and large by women, with very few alternatives on the market. “We have hormones through your mouth, your vagina, your uterus or on your skin. There isn’t a lot of variety here. They’re the same thing in many different ways,” Maizels says. “Women don’t know what’s out there. They have no solutions.”

So what’s the solution? Maizels doesn’t advocate any particular contraceptive. There are existing non-hormonal options such as the copper IUD but they possess their own side effects. There is also a new male contraception called ADAM which is currently undergoing clinical trials.

However, in terms of actionable tasks to improve healthcare for women Maizels says that data is queen. More data is needed to innovate and create new, better solutions for women and also to personalize and improve existing ones. Maizels would like to see both things occur in tandem. “We do have the ability to collect the data to make better tools and better solutions. They can be developed, but they need money. The need is there. Why isn’t there proper investment?”

“There is a significant lack of data and knowledge about women's daily issues such as hormonal contraception,” says Shelly Bloch, founder and head of FemTech IL. Lack of data is an issue across FemTech initiatives, due to the historical lack of inclusion of women in research and clinical trials. Women have been historically excluded from drug trials precisely due to their distinct biology, including hormonal fluctuations caused by menstrual cycles, as well as the possibility of pregnancy.

In terms of investment in this field, the lion’s share of the investment made into Israel’s burgeoning FemTech industry, which is already miniscule compared to other tech sectors, goes to birth and fertility solutions. According to a report last year by Startup Nation Central, nearly half of all Israeli FemTech companies are related to pregnancy, fertility and natal solutions.

And yet, it seems remarkable that Israel’s dynamic tech industry has next to nothing to offer for an issue that affects 87% of women. It is also shockingly shortsighted considering that whereas birth and pregnancy are isolated life events, the vast majority of women will easily spend years of their lives using hormonal contraception. The market for innovative solutions is massive and evidently untapped.

“This is a business opportunity that can position Israel in the international high-tech industry as a leading player in promoting women's needs,” says Bloch. “The demand was always significant, as women have always constituted half of the population and also desired an improvement in quality of life that innovation can provide.”