Hot flash trackers and pelvic floor exercisers: the rise of femtech for menopause

“There is a revolution at the moment. Women are demanding better healthcare and demanding understanding of female body.”

Entrepreneur Heidi Davis is passionate about ensuring that women have access to the right healthcare for their needs. Her start-up, IdentifyHer, is aiming to improve healthcare for women experiencing perimenopause and menopause symptoms, improving their current quality of life and also helping with potential future health needs through the use of wearable sensors that track your symptoms.

This is one of a flurry of new start-ups that have been established in recent years aiming to look at an issue that affects roughly half the population at some point in their lives.

Menopause is on the menu these days. Once euphemistically referred to as “the change”, spoken about in hushed tones, it has become acceptable – and encouraged – to discuss the menopause experience. When Joe Duffy dedicates days of Liveline shows to the subject, as he did in May 2021, you know things have started to change. And not before time too.

Menopause support must tread a fine line between awareness and stigma

---

Menopause: ‘We need to swing the pendulum to the middle and normalise it’

---

Playwright Marie Jones: ‘My mother told me there was no such thing as menopause in her day’

---

If you aren’t prepared for menopause, it might come as a shock. Hot flashes and night sweats are commonly identified as symptoms of the hormonal changes in your body. But disturbed sleep, aches and pains, anxiety, digestive issues and brain fog may not immediately lead you to the conclusion that your hormones are responsible. And for those who suffer from vaginal dryness and atrophy – the result of reduced oestrogen production – the discomfort and distress can have a real impact on quality of life.

The controversy over hormone replacement therapy may have turned many women off seeking the treatment from their doctor too, adding another layer of anxiety to an already fraught time.

But things are changing. Bio-identical HRT, where the hormones are similar to what the body produces, has improved life for many women who have sought hormone therapy. There is still some way to go though, particularly around access to treatments.

“We’ve come a long way,” says Dr Tanya Mulcahy, director of the Health Innovation Hub in Cork. “But a lot of women can’t get HRT mainly because our GP system isn’t trained to treat women, to administer this. It’s improving, but some people really have to struggle to get it.”

[ The secrecy of . . . menopause ]

There are specialised private HRT clinics which offer a valuable service, but can be expensive. The HSE has set up a network of specialist menopause clinics, but the average perimenopausal woman, struggling with disturbed sleep and brain fog, may not fit into the category that qualifies for treatment, or even realise that they need it. That women can be perimenopausal – which covers the time leading up to the final cessation of their periods – for several years may also be news to some.

But as the experts point out, dismissing the potential impact of the menopause on your body isn’t the best approach to take.

“Ignoring it really is a very bad solution, because we know that symptoms that happen during perimenopause are linked to chronic disease post-menopause,” says Davis. “So not only are you not solving your quality of life [issues] as you go through perimenopause and menopause, but you’re also putting yourself at a higher risk of cardiovascular disease and osteoporosis post-menopause if you don’t manage it.”

[ ‘There’s too much talk about menopause? We’re just making up for the last 20 goddamn years when women suffered in silence’ ]

IdentifyHer is helping to address that situation. The company has devised a wearable sensor that women can wear daily to track potential symptoms of perimenopause, providing them and their doctor if needed with data that can be used to hit on the correct treatment.

“You don’t have to manually enter anything. You get data sent from the sensor, like you would get from a Fitbit,” she said. “There is an issue with women going into clinics and not getting a diagnosis and treatments currently, or taking a very long time to get the treatment that works.”

The company is planning to launch a direct-to-consumer device next year that women can wear long-term and help identify patterns that could indicate they are in perimenopause.

“You can really get actionable insights to personalise your health journey through perimenopause – lifestyle changes, activity changes, diet – as well as going to the doctor and get treatment and management there,” says Davis.

“We’re aiming at perimenopause initially because the diagnosis is harder there, but when it comes to treatment and the treatment efficacy, that’s really relevant for any period during that menopausal transition. It’s really to get the right treatment for the right woman at the right time.”

That could help eliminate some of the guesswork around menopausal symptoms. The device is designed to distinguish between a raise in temperature due to a hot flash, or an increase in body temperature because it’s a warm night or the woman has just done some exercise.

[ How to have great sex during the menopause and beyond ]

The biosensor is planned for launch in September next year, with IdentifyHer currently raising money to support that launch.

That in itself has proven a challenge. It is not that people aren’t willing to listen, just that it can take a lot longer to explain an issue that investors – mostly currently men – may have limited experience of.

“My experience is that it is a problem that affects women and not men; therefore, it naturally takes more effort for a man to understand their problem. We have loads of men that are very willing to understand; maybe they’ve had wives that have gone through it, or have daughters that have gone through it, and they’re asking questions,” says Davis. “But what very often happens is that we tend to spend so much time then on the problem. Once we get to the commercialisation and all the other metrics that really matter to investors, we’re tight on time since we spent 10 minutes on the problem – we would normally spend 30 seconds if it was a woman.”

Some companies are now offering menopause support to staff, with Vodafone Ireland and Diageo among them. It is not surprising that they have; globally, the economic impact of menopause has been estimated at $150 billion (€143 billion) due to productivity losses.

Business has woken up to the opportunity presented by the sector too. This is a largely untapped market that could present an opportunity. There are more supplements and gadgets aimed at helping alleviate the symptoms of menopause than there have ever been in the past.

Wouldn’t it be great if Ireland could lead the way in femtech? It hasn’t happened anywhere yet, that it has really taken over

—  Heidi Davis, entrepreneur

But separating out the genuinely helpful products from those proffered by opportunists is a task in itself. One area that can cause confusion is the world of nutritional supplements. The shelf in your local health shop may be stuffed full of products designed to boost your health, but simply downing enough tablets each day to make you rattle isn’t a guarantee that you are getting the best out of your expensive nutritional supplements. There are some that have to be taken together to work, and others that need to be at a certain concentration. And there are products that promise a lot but may not deliver.

“Particularly in Ireland, there’s a lot of work in this space and some really good products coming out that are evidence-based,” says Dr Mulcahy. “There are a lot of supplements out there, everything from mushrooms to the microbiome to multivitamins. But what I would be looking at when I’m looking at those supplements is: what’s the evidence that what’s in them is actually working?”

That was a key factor for Sisterly founders Aoife Matthews, Jennifer O’Connell and Louise O’Riordan. The trio set up their company to bring targeted nutritional supplements to women for all stages of their life. The one thing the supplements had to be was backed by evidence.

“This is no placebo. It’s all tried and tested clinical trials. We’re using the doses that reflect what has been found in clinical trials to show a benefit,” says O’Connell. “It’s about consistency – can you make it easy for people so that they’re not knocking back nine tablets a day? We’ve spent three years thinking about [it] – how can we make it consistent? How can we ensure that people take up a new habit so that they can then unlock the benefits of nutrition?”

Cecelia Ahern on empathy, rage and menopause

Listen | 47:54

In an ideal world, that nutrition would come from a balanced diet. But there are many reasons why that may not be possible for many women. The nutrient content of food these days can be less dense than in the decades before, according to different studies published in recent years. Add in the busy lifestyles we have these days, and it’s not difficult to see why women may need some extra help.

“We’re just not getting the same nutritional benefits that we used to,” says Matthews, who moved away from a career in investment banking in recent years to retrain as a nutrition and health coach. “As women get older our bodies produce less as well, and it’s tricky for our bodies to absorb the nutrients themselves, so we find you have to supplement – no matter how good you are doing.”

The company has just released its first supplement, the Elevator, which will be the foundation for subsequent add-on products. Sisterly is planning to add “accelerators” such as high quality Omega 3, or a supplement to help aid brain health, with a nod to perimenopausal brain fog.

“There is a gap that needs to be filled, and women in particular because of everything that their bodies are going through need to be really mindful of how they’re supporting themselves, because we have challenges from the time we have our first period to when we go through menopause. That whole cycle requires support, or we end up struggling,” says O’Connell.

At the high-tech end of the market, alongside IdentifyHer, the interest in Ireland is growing. Aveta Medical, for example, has developed a solution to help with vaginal atrophy. The wand-like device is prescribed by clinicians, but can be used at home, in private, for a non-hormonal treatment for vaginal atrophy.

Atlantic Therapeutics and its pelvic floor exerciser Innovo is also getting some attention. The company developed a wearable device that looks similar to a pair of cycling shorts, but uses electrodes to stimulate the pelvic floor in a non-invasive way. The company was bought last month by US-based Caldera Medical for an undisclosed sum.

[ Menopause: ‘I thought I was developing early onset dementia’ ]

There may be more to come. Last year, a new initiative aimed at stimulating the development of products, services and start-ups among femtech founders was announced, backed by the UCC-based Health Innovation Hub Ireland.

The State-backed organisation is trying to stimulate the creation of an ecosystem of experts and entrepreneurs, leading to more women founders in Ireland and attracting more investors here.

“Wouldn’t it be great if Ireland could lead the way in femtech? It hasn’t happened anywhere yet, that it has really taken over,” said Davis. “With the kind of medical device background that you have in Ireland, there is a chance there. It’s just about getting the funds in.”

Products and apps

Embr Wave 2

The second generation of Embr’s temperature control device makes some big promises. It is backed by clinical research, which gives it a leg up on some other solutions. Worn on the wrist, the Wave 2 is designed to give immediate relief from hot flashes at the touch of a button using calibrated cooling or warming sensations, and has a mode to manage night-time hot flashes and chills to help improve your sleep.

Designed to be aesthetically subtle, available in rose gold and black, it looks more like a watch than a medical device. €350 from embrlabs.com

Stella

Digital health app Stella offers personalised healthcare that targets the symptoms that bother you the most. In other words, it’s not a one-size-fits-all approach.

To get started, you fill out a survey, telling the app what symptoms you are experiencing, and what impact that is having on your life. From there, Stella will pinpoint the session that will help you the most; perhaps your mood is the most bothersome, or it could be changes to your body. The app will then take you through some guided sessions and provide you with lifestyle advice and techniques that have been proven to work.

The plan adapts as your symptoms change, and your priorities along with them.

The app is based in the UK, but is open to users in Ireland. It is a subscription service, at €23.50 a month, significantly cheaper than some other options on offer.

Elvie Trainer

Pelvic floor weakness can hit during menopause, leading to some distressing symptoms. The Elvie Trainer is a smart pelvic floor trainer that pairs a physical device with your smartphone to give you real feedback on how well you are exercising your pelvic floor muscles.

The trainer itself is worn internally, and connects wirelessly to your smartphone. As you progress through the workout, you will get feedback on how you are doing. As you squeeze your pelvic floor muscles, you can follow on your phone as it responds to the strength of the contraction. The app also allows you to track your progress, so you can see how far you have progressed and improved. €200 from Boots.

Clarity

A meditation app aimed firmly at women, Clarity (€8 per month) can help bring some much-needed calm to your life.

The guided meditation and sleep app is intended to help calm any anxiety that people may be suffering through different stages of their lives. That includes menopause and the anxiety it may bring.

It offers different meditation sessions, including specific short programmes that combat a hot flash or anxiety attack.

Bladder Boss

A bladder management app for women, Bladder Boss isn’t strictly just for those going through menopause. It is aimed at anyone with overactive bladder through an eight-week digital programme. The app includes pelvic health pilates classes, a digital bladder diary, and urge-suppression techniques that can help women to take control of their bladder health. Dietary guidance and bladder retraining are also part of the programme.

It is an Irish-developed app, too, so you have the added boost of supporting a home-grown enterprise.