Insight
Why investing in women’s health innovation is a smart bet
By David Buller, Managing Partner at KELES
The macro opportunity: women are half of the population
In 2024 alone, women’s health start-ups raised a record $2.6 billion, up 55 per cent from the previous year.
In addition to increasingly recognised health needs in menopause, fertility and female-specific cancers, there are conditions such as cardiovascular disease, diabetes and Alzheimer’s, to name a few, that affect women disproportionately as compared to men, which then leads to the creation of large care gaps.
Whilst conventional care pathways, medications, dosages and treatments are often geared to accommodate males, this has created gaps in clinical pathway guidelines for women and their health.
The opportunity for transforming and investing in women’s health is growing. Where should investors focus capital, and what will substantially improve women’s health for the future?
Venture Capital will back scalable, system-level solutions
Despite the growing attention on women’s health and FemTech, successful venture-backed companies need to attract the female healthcare population.
The technologies that do this will be those that are payor-reimbursed (government, insurance or employer), can embed into patient care pathways, address wide-scale unmet needs, and have a clear exit strategy. Women’s health companies, just like any other digital health venture, need to consider how they integrate with the health system as a whole and forge a clear route to market.
The best companies will drive the new standard of care and address critical needs, for example, those improving essential surgeries, or developing new therapies, and those that substantially increase quality of life for a significant number of women.
With these considerations about scaling and prevalence in mind, the opportunities for founders and investors are great. What kind of technologies should we consider?
- Those combating major gaps in existing care pathways. For example, endometriosis affects an estimated 10 per cent of women, yet diagnostic delay still averages eight years. Technologies that shorten diagnosis transform millions of lives and are rapidly adopted by payers.
- AI and platform technologies. Utilising the latest AI capabilities can improve accuracy and speed in health, especially in diagnostics and drug development, and support the vision of care for women. We must ensure that data is representative of women and female patient groups. Greater assimilation and integration of truly representative datasets can allow more informed care decisions, and can enhance female patient selection for clinical trials.
- High-prevalence conditions and health issues. Some conditions affect a startling number of women and can contribute to significant strains on global health systems. Fertility and pregnancy, post-partum depression, endometriosis, menopause and osteoporosis, breast cancer and diabetes are just some examples of highly prevalent and widespread health needs. AI and tech enable a huge step change in addressing issues that were completely undertreated.
Building a women’s health ecosystem that thrives: future innovation will originate from women
Achieving a healthy ecosystem of market-ready innovations in women’s health requires more than collaboration between start-ups, healthcare providers and investors. It needs a momentum of female-led founders to break the barriers, and get the right tech, innovation and products to the women who need them.
Breakthrough ideas often come from those who have experienced the pain points firsthand. Yet, if we look at women’s health, fewer than one in five digital-health start-ups is founded by a woman, and the percentage drops further in med-tech and biotech.
Encouragingly, the raw talent already exists. Across Europe, women already dominate many healthcare practitioner positions and master’s level qualifications in health and life sciences, and in many EU countries, they hold a slight majority of PhDs in these fields. Cities such as Lisbon, Copenhagen and Barcelona are making progress on gender balance among principal research investigators.
The challenge is in the translation: channeling the expertise into biotech and health companies that will scale well and make a significant impact on women’s health. So we should continue:
- Encouraging women in the scientific and healthcare ecosystem to experiment and innovate, and bring new technologies to market.
- Building an inclusive environment for female founders.
- Investing in female-led companies producing scalable solutions for women’s health.
Measuring returns by better health: an investor’s framework
Adhering to strong ethical principles is a core foundation of any good investment in healthcare. By embedding these principles into an investment framework, we are more likely to see capital deliver sustainable, long-term value.
At KELES, we evaluate our portfolio companies against core criteria. Applying these criteria to solutions for women’s health, companies can drive significant innovation and progress to support equitable healthcare. Many women’s health companies have the opportunity to meet and exceed these principles, and drive significant innovation and progress to support equitable healthcare.
- Accessibility – does the solution broaden access and availability of healthcare for women?
- Ethical use of data – is sensitive health data handled with the highest standards of privacy and fairness, and includes truly representative data?
- Improved outcomes – does the technology enhance healthcare outcomes for women?
By tying capital to these measurable goals in women’s health, and prioritising investments in women-led ventures that show clear market value, we can accelerate innovation that truly meets women’s healthcare needs – and has real impact worldwide.
The Women and Equalities Committee (WEC) has warned against “financial half measures” on women’s health as the government published its response to the report.
Ministers launched the renewed Women’s Health Strategy in April after the committee’s March report concluded it was not convinced that the menstrual and gynaecological needs of young women and girls had been sufficiently prioritised in wider healthcare reforms.
It followed the committee’s 2024 “medical misogyny” report, which found women with painful reproductive health conditions such as endometriosis, adenomyosis and heavy menstrual bleeding were frequently finding their symptoms “normalised” and their “pain dismissed” when seeking help.
In both reports, MPs called on the government to recognise the benefits of increased investment in early diagnosis and treatment of women’s reproductive health conditions and provide additional funding needed to transform the support available to millions of women.
In its response, published on 26 May as a command paper, the Department of Health and Social Care outlined action on reducing gynae waiting times, ensuring procedures are conducted with women’s full consent and adequate pain relief, and improving access to contraception for menstrual healthcare in line with the committee’s recommendations.
It said: “The government agrees with the committee’s overarching findings and recommendations for improving women’s health outcomes and experiences.
“We acknowledge the impact that menstrual health conditions can have on women’s lives, relationships, and participation in education and the workforce.
“We recognise that more needs to be done to support women with menstrual health conditions, particularly around listening to women, improving information and education, and enhancing patient experience.”
However, there was no commitment to increase school nurse provision, no measurable actions and targets on countering online misinformation, no new commitments to end inappropriate censorship of women’s online health content, and no further initiatives on tackling racial discrimination or understanding the menstrual wellbeing needs of young disabled and Deaf women.
The response comes after analysis by The Times suggested the government is allocating 60 per cent more funding to its men’s health strategy than to its renewed strategy for women’s health.
Sarah Owen, chair of the Women and Equalities Committee and Labour MP, said: “WEC’s 2024 ‘medical misogyny’ report warned 18 months ago of women in unnecessary pain and undiagnosed for years and called on the Government to recognise the benefits of increased investment in early diagnosis and treatment.
“Our follow up report this March cautioned girls’ and women’s health are not being sufficiently prioritised in system-wide NHS reforms, while initiatives which have proven to be successful in reducing waiting lists and improving women’s healthcare access, such as women’s health hubs, risked being scaled back or discontinued.
“While it’s welcome to see a focus on tackling ‘medical misogyny’ in April’s renewed Women’s Health Strategy and an emphasis on women’s voices being heard, this must be backed by adequate funding, not financial half measures, particularly when compared to men’s health.
“Significant questions remain following today’s response publication over the adequacy of investment being provided, including for workforce training, menstrual health education in schools, research and additional ring-fenced funding for women’s health hubs to deliver services within the emerging neighbourhood health framework.
“There are both opportunities and risks when it comes to increasing use of technology in women’s healthcare.
“As the Committee’s report set out, social media companies should be held to account for inappropriate and disgraceful ‘shadow banning’ censorship of important women’s health content and there should be a rigorous approach to tackling the risks from ineffective, unsafe and exploitative for-profit FemTech apps.
“The Government should take the problem of ‘shadow banning’ more seriously.
“A strategy which does not fully address the concerns set out in WEC’s report, alongside measurable actions and timescales, will only scratch the surface of the issues facing women’s health.
“WEC will keep a close eye on progress and continue to push for long overdue tangible change for women and girls.”
An early PET scan after one cycle of chemotherapy may help predict how aggressive breast cancer responds to treatment, a study suggests.
Research led by The Institute of Cancer Research, London and King’s College London suggests that an early scan taken after one cycle of chemotherapy could help predict how well a patient’s cancer will respond to treatment.
The study focused on patients with triple-negative breast cancer (TNBC), an aggressive form of the disease in which cancer cells lack receptors for the hormones oestrogen and progesterone, as well as the HER2 protein.
Patients with TNBC are usually treated with chemotherapy prior to surgery. While many respond well, residual disease at surgery, typically around six months later, is associated with a significantly poorer prognosis. Identifying people sooner who are unlikely to respond remains a major clinical challenge.
The research explored whether using PET imaging shortly after treatment begins, rather than relying only on MRI scans later in the treatment process, could provide earlier insight into how a patient’s cancer is responding. Twenty-two patients were recruited, with fourteen undergoing FDG-PET scans before treatment and after the first cycle of chemotherapy.
The findings, published in Clinical Cancer Research, showed that changes seen on PET scans after just one cycle of chemotherapy were strongly associated with subsequent response, including whether there was no detectable cancer, known as a complete response, by the end of treatment. Importantly, early PET response showed stronger associations with treatment outcomes than standard mid-treatment MRI scans in this study.
Being able to identify patients who are not responding well at an early stage could allow clinicians to adjust treatment sooner or consider alternative approaches. These findings may also support future strategies to better tailor treatment intensity to individual patients.
The study also compared two types of PET tracers, FDG and FLT, to determine which was most suitable. While both met the study’s technical criteria, FDG-PET was selected for further evaluation due to its better image quality, greater consistency and wider use in clinical practice.
The research also explored how imaging changes after just one cycle of chemotherapy relate to the body’s immune response to treatment. Biopsies taken before and after the first cycle of chemotherapy showed that an increase in immune cells within the tumour was strongly associated with both early PET changes and improved treatment outcomes.
The researchers emphasise that these findings now need to be validated in larger studies. Future work will aim to confirm these results in broader patient groups and explore more accessible imaging approaches, such as ultrasound, alongside PET and MRI.
Sheeba Irshad, professor of cancer immunology at King’s College London and lead of the Breast Cancer Now KCL Research Unit, said:
“In patients who had PET scans both before treatment and after the first cycle, we found that this early scan could predict whether they were likely to achieve a complete response by the end of treatment. These findings highlight the potential of early imaging to guide treatment decisions, and now need to be validated in larger, modern clinical trials.”
Andrew Tutt, professor of breast oncology at The Institute of Cancer Research, London, said:
“Research that helps us determine early who is already benefitting from standard neoadjuvant chemotherapy and who might benefit from clinical trials to find better treatments is vital. This study shows that FDG-PET may have great value in this regard. We hope to be able to design studies that further investigate and validate these findings.”
The study was supported by funding from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, Breast Cancer Now, Cancer Research UK, and Guy’s and St Thomas’ Charity.
Ki-67, a protein used to measure tumour growth, may also help prevent chromosome errors that drive cancer, a study suggests.
The findings could change how scientists view Ki-67, a marker commonly used in breast cancer and other tumours to assess how quickly cancer cells are growing.
Researchers found the protein may help preserve genome stability by maintaining the structural integrity of centromeres, key parts of chromosomes that help ensure DNA is shared correctly during cell division.
The research was led by professor Paola Vagnarelli at Brunel University of London in collaboration with scientists at the University of Edinburgh and the Technical University of Berlin.
Professor Vagnarelli said: “Doctors already measure Ki-67 to see how aggressive a cancer might be. But our results suggest it is actually helping maintain genome stability.
“That means it may be more than a marker. It could potentially also be a therapeutic target.”
The study examined three proteins that attach to chromosomes during cell division and help rebuild the molecular system that tells each new cell what kind of cell it is.
Every human cell carries identical DNA. What makes a liver cell different from a brain cell is which genes are switched on and which are kept inactive.
When a cell divides, that entire system of switches must be rebuilt. The three proteins involved in this process were Ki-67, Repo-Man and PNUTS.
Vagnarelli’s team developed a method that individually removes each protein from a living cell at the precise point of division. Older techniques could not isolate that moment cleanly.
They found that cells rely on all three proteins to reset themselves after division, but each failed in a different way when removed.
Without PNUTS, gene activity spiralled out of control and thousands of genes switched on at once.
Without Repo-Man, cells escaped safety checkpoints that usually stop damaged or abnormal cells from continuing to divide.
“What we didn’t expect was how clean the separation was,” said Vagnarelli.
Each protein fails in its own specific way. There is no redundancy, no safety net. Which means there are three separate points at which this process can go wrong.
“When the system breaks down, cells can emerge with the wrong number of chromosomes. That condition, called aneuploidy, is seen in disorders such as Down syndrome and in many cancers.
“We also found that these chromosome errors can trigger inflammatory signals inside the cell.”
Aneuploidy means a cell has too many or too few chromosomes, which can disrupt normal growth and function.
Inflammatory signals are chemical messages that can make a cell behave as if it is responding to injury or infection.
“These cells behave almost as if they are under attack,” said Vagnarelli.
“The immune response switches on because the genome is unstable.
“That link between chromosome imbalance and inflammation could help explain patterns we see in several diseases.”
The researchers said the findings may help cancer scientists better understand how chromosome instability, loss of gene regulation and cells dividing before they are ready contribute to tumour growth.
They said understanding the normal machinery that prevents these errors may help researchers find ways to push cancer cells into making mistakes they cannot survive.
“We now have a clearer map of the machinery that resets the cell after division,” said Vagnarelli.
“That knowledge gives us a starting point for thinking about new therapeutic approaches.”
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