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Are we witnessing a revolution in the treatment of endometriosis?

Meet the Israeli biotech start-up paving the way towards a next-generation treatment for endometriosis



March marks Endometriosis Awareness Month, an opportunity to raise awareness, demand change, and show support for the 200 million women of reproductive age affected by the condition globally.

The symptoms of endometriosis can begin in early adolescence and include pelvic pain, painful periods, painful bowel movements, excessive bleeding and, in some cases, infertility.

Currently, there is no cure for it. The most common treatment options are conventional painkillers and hormonal contraceptives.

Though there is no clinical evidence of the efficacy of birth control pills for endometriosis, superficial improvements in symptoms such as dysmenorrhea have prompted healthcare providers to offer them as the first line of treatment.

“One of the first things doctors do is give women the contraceptive pill,” says Paula Keusch, vice president of business development at Gynica Healthcare, an Israeli biotech company developing cannabinoid-based solutions for endometriosis.

“However, the birth control pill is not an ibuprofen. It’s not an aspirin. These are hormones and no one should automatically be given the pill.”

Previous research on the use of illicit cannabis in women with endometriosis has shown promise.

“The endocannabinoid system – a widespread neuromodulatory system that plays important roles in the central nervous system – is crucial in many functions, including body homeostasis, immune system and reproductive functions,” explains Dr Sari Prutchi Sagiv, Gynica VP of research and development.

“The female reproductive tract is full of this endocannabinoid system. The thing with endometriosis is that there is an association between a low function of this endocannabinoid system and endometriosis development and maintenance. So this makes it a very good target for external cannabinoids.

Yotam Hod and Sari Prutchi Sagiv

“Inflammation is a mechanism that triggers endometriosis. There are a lot of agents called pro-inflammatory agents, also known as cytokines, which make the condition worse. On the other hand, many cannabinoids are known for their anti-inflammatory action and can act as good pain relievers.”

In some countries, women have already tried cannabis-based products to treat their symptoms. However, none of the companies commercialising these products seem to have any clinical or preclinical validation.

“Based on a regulatory loophole, all the companies in this sector have brought to market products with no safety validation, no efficacy validation and no standard of care that is expected from a medical product,” says Yotam Hod, co-founder and CEO of Gynica.

“They provide the much needed relief women are looking for, but not a single one of them is validated with preclinical or clinical studies. With Gynica, we’re doing the reverse engineering.

“We are researching the best ingredients, the best concentrations and the ratio of specific ingredients alongside a proprietary intra-vaginal drug delivery method to help us provide an end product that would allow to control the release of those ingredients and help us reach the target organs.”

Gynica is the global first company to run clinical studies using cannabinoids specifically for gynaecological conditions in compliance with pharmaceutical standards and protocols.

But gathering clinical evidence requires a very rigorous process. Clinical studies can take years to be approved and the stigma around medical cannabis does not help.

“Cannabis does come with a lot of stigmas and taboos,” says Hod.

“However, according to pharmaceutical standards, examining the safety and efficacy of cannabinoids and coming up with clinically validated products will help us reduce some of that stigma and empower health professionals.”

“The awareness around endometriosis has allowed women to open up about their excruciating pain, but doctors don’t have a clinically validated medication they can prescribe,” adds Keusch.

“So when these women come across cannabis-based products, they simply want to get that much needed relief without thinking about the risks. But the risks exist.

“Our aim at Gynica is to go through all the necessary clinical trials that would allow us to come up with a safe, pharmaceutical solution.

“Yes, the process is slow and frustrating at times, but in order to get to the best and safest end product possible, we need to follow all the necessary steps,” she continues.

“With the help of our colleagues from this space, who are working on early diagnosis solutions, we can change the way we diagnose and treat this condition.”

The coming 18 months are exciting for Gynica. The start-up will enter its clinical phase and will run two clinical studies – phase one for examining safety and toxicity and phase two for examining product efficacy.

“The clinical phase is the most significant milestone we’ve been waiting for,” says Hod.

“These are our biggest steps forward and I think they will put us in a whole different position.”

The team is also hoping to explore other women’s health conditions.

“We have gained a lot of experience in the past few years when it comes to product development for gynaecological conditions, and we want to explore this space more.

“We can’t talk that much about it, but we’re not stopping at endometriosis.”

“We’re on the right path, but we just need a little bit more time,” adds Keusch.

To find out more, visit

Sorina Mihaila is the Femtech World editor, covering technology, research and innovation in women's health. Sorina is also a contributor for the neuro-rehabilitation magazine NR Times.


The slippery slope of presumed consent in post-humous reproductive health cases

By Bethany Corbin, healthcare innovation and femtech attorney



It sounds like something out of a sci-fi film: A young man, on the cusp of starting a family with his wife, suffers a serious accident that renders him brain dead.

His wife, longing for the family they never started, requests access to his post-humous sperm to become pregnant and build the family she was denied.

After a long and arduous battle with the court system, the wife is granted permission to use her dead husband’s sperm to create her family, even though her husband never stated his family-building preferences in a will or otherwise provided consent to the use of his sperm.

If the situation seems fantastical (and a bit scary), beware: This is a true and landmark case that has shifted the consent paradigm for reproductive health on its head in the UK.

While the Human Fertilisation and Embryology Act of 1990 (as amended in 2008) requires written, informed consent to the use of a person’s reproductive materials, the case of Y v A Healthcare NHS Trust [2018] EWCOP18 (affirmed by the Court of Protection in Re X (Catastrophic Injury: Collection and Storage of Sper) [2022] EWCOP 48) departed significantly from this requirement to allow “presumed consent” as an alternative to informed consent.

This trend by the UK courts does not align with the strict letter of the law and is more akin to an opt-out organ donation framework for reproductive health. It begs two questions: (1) What is really in the best interests of a patient who lacks capacity to procreate? (2) Should gametes be treated the same as all other organs?

These are heavy questions that have sparked global debate. On one end of the spectrum, a 2016 article published in the journal Reproductive Biomedicine & Society Online argues that gametes, similar to organs, are resources that should be considered for use after death, given their life-creating properties.

The authors contend that once an individual is dead, they no longer have a meaningful interest in the use of their reproductive material and post-humous conception should follow a framework of presumed consent.

The authors base their argument in large part on studies conducted showing that the majority of men support their partners accessing their sperm for post-humous conception.

On the other end of the spectrum, however, is the fundamental need to protect the best interests of the patient, who is no longer capable of understanding or consenting to the creation of life.

Numerous situations may arise where a partner seeks to exploit a vulnerable individual for their reproductive materials. For example, imagine the situation where a husband has repeatedly said “no” to creating a family. If he then suffers a life-threatening accident, his spouse could claim that he had agreed to start a family and that his consent should be presumed.

The same rationale could apply to an abusive boyfriend seeking to exploit his girlfriend’s reproductive materials and demanding the post-humous harvesting of her eggs to be used in the future. This creates an environment that can easily result in exploitation of incapacitated individuals who do not have the ability to defend their own interests.

The rights and wishes of the deceased must have meaning if we are to respect human autonomy. These individuals are vulnerable, unable to protect their own interests, and at the mercy of others who may try to exploit them.

This becomes particularly concerning when we add in the scenarios of abusive relationships, suicide, and reproductive coercion. If the law does not protect the rights of the vulnerable, who will? In essence, the trending case law prioritises the interests of the living over the rights of the dead.

Presumed consent for post-humous conception is an incredibly slippery slope. Reproductive material is fundamentally different from other organs in that it is not lifesaving, but rather life-creating. If we allow an individual’s partner or family to make their post-humous reproductive choices, where do we draw the line?

In the case of Y v A Healthcare NHS Trust, the court relied on circumstantial evidence to presume the husband’s consent – such as the early fertility treatments undertaken by the husband. But what about cases in which such evidence is fabricated or in which consent has been withdrawn prior to the accident?

The fact of the matter is, there will always be factual permutations and attempts by individuals to manipulate existing legal frameworks to obtain the outcome they want. It won’t always be clear what the deceased wanted or whether the evidence of their desires has been forged.

As a society, our laws have historically protected the most vulnerable. Any decision to depart from this history should be made by a body of elected representatives that can carefully consider the broader ethical implications of this decision and its downstream impacts, not the courts.

Bethany Corbin is a healthcare innovation and femtech attorney on a mission to help thought-leading companies revolutionise women’s health. Through her company, FemInnovation, Corbin partners with emerging companies at the forefront of healthcare transformation to ensure they are building robust, scalable, and legally compliant businesses focused on enhancing health equity. 

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The future of women’s health is in collaboration

By Jessica Aird, manufacturing manager at Abingdon Health



Jessica Aird, manufacturing manager at Abingdon Health

Abingdon’s Health’s manufacturing manager, Jessica Aird, takes a look at all things women’s health with a particular focus on how the organisation in which she operates so effectively – an expert lateral flow CRO & CDMO business –  works together to deliver innovation and change in this area on a daily basis.

On March 8, 2021, the government launched a call for evidence to inform the development of England’s first Women’s Health Strategy, with two main aims:

  1. First, to improve the way in which the health and care system listens to women, and to reset our approach to women’s health by placing women’s voices at the centre of this work.
  2. Second, to improve women’s health outcomes.

As part of this launch, the government called for organisations with expertise in women’s health to submit written evidence into the following:

  • Current medicines and medical devices.
  • Geographical differences in women’s life expectancy and access to services.

Women’s specific health can be categorised in two main stems of health needs: general and reproductive specific. The diagram below explores these two stems and how these needs change during the course of a woman’s life.

Two main stems of women’s health needs (Department of Health and Social Care, 2021)

Abingdon Health’s vision is to become the leading rapid test business globally and share our mission – to improve life by making rapid testing accessible to all – with all industries. This includes improvement to current women’s health testing solutions through the development and manufacture of new, innovative, and creative medical devices.

The role of Abingdon Health in the improvement of women’s health strategy does not just lie within the manufacturing process.

There are many supporting departments working in unison to ensure any devices which successfully enter the market are the best solution available for women to further improve their knowledge and understanding of their health and wellbeing.


Abingdon’s R&D team are either approached by commercial on behalf of a customer with a bespoke women’s health testing solution, or the idea comes from within the organisation.

The process of progressing the idea from a concept to small scale manufacture relies heavily on R&D. The team must develop the device with key focuses on:

  • Selecting the most efficient and appreciate materials
  • Testing for cross-reactivity
  • Optimisation and repeatability of performance
  • Scalability considerations are also considered at this stage.
Technical transfer

The key role of the technical transfer department is to take each R&D-proven small-scale manufacturable assay to a full-scale production batch; this could be up to 30,000 devices per batch run. This is achieved through the following processes:

  • Understanding potential failure modes, risk to assay performance and what current controls are in place in order to mitigate the risks. This is done predominantly by the technical transfer team, but also reviewed and adjusted collaboratively through input of many departments, including production, quality control, quality assurance and technical specialists.
  • Transferring the processes from small scale equipment to large production equipment within the production laboratories whilst understanding the how the process parameters must change to keep product performance optimised and results, sensitivity and specificity within range at scale.
  • Robustness testing of assay capacity and the assay performance in terms of scaling up the batches. This is done in order to understand the limitations of an assay. Robustness testing typically includes studies of treated materials, stability on part-processed components and stacked tolerances to determine optimal performance going forward.

Product regulatory compliance plays a significant role in bringing the concept of a new product in women’s health to reality and onto the market as fully reproducible manufactured product.

The regulatory team are part of development of the new assay from the very beginning; this is crucial as it helps the team to understand the regulatory requirements and anticipate where potential Quality Assurance and Regulatory Affairs (QARA) issues may arise.

The implications of a non-conformance at any stage of product development can cause significant timing delays, product redesign requirements and increased costs, so it is essential for QARA functions to have input at all stages of development of a new product.

Regulatory approvals are the last step before product launch to market. Obtaining official approval for a product to go to market, particularly in the case of a medical device, requires immense planning with manufacturing, quality assurance and commercial to ensure the product to be launched is viable and has the best chance of success in its newly obtained distribution regions and channels.

Customer services and commercial

Keeping the customer intimately involved in the product development process is essential to successful project and product performance and launch onto market.

The commercial team and customer services functions work hand in hand with both the new product development internal project team members and customer stakeholders to ensure direct interaction between both parties is maintained and expectations are managed.

Ensuring customers sign off at project stage gates, review quality control data and approve operating procedures and product process parameters all require commercial and customer service organisation.

Production and shipping

Once the product is ready for launch, customer service work closely with our quality, regulatory and warehousing teams to ship products to customer on time and in full. This can involve booking shipments with couriers, completing the product release process, and managing customer expectations of timelines.

In summary, the future of women’s health is indeed in collaboration: working closely cross-departmentally to take a concept or idea through to developing a product ready for marketing which can improve women’s access to healthcare, all the way through the research and development to technical transfer and production, is critical to success.

Working collaboratively will ensure better access to healthcare for women and inspire others to come forward with innovative solutions to everyday issues in women’s healthcare today and throughout the course of our lives.

To find out more, visit

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Mental health

The femtech founder’s stress toolkit: how to make wellbeing a non-negotiable

By Kate Hesk, founder and CPO at Cognomie



Stress – as anyone in femtech will know – manifests in many forms. As humans, each of us has different triggers, vulnerabilities and tolerances to it.

And while many of us will claim to “thrive under stress” (hi A-types, I see you), we know that too much will flood our nervous systems, accelerate burnout, and ultimately, lead to longer-term health issues if left unchecked.

Recent HSE figures found that 51 per cent of the 1.8 million work-related illnesses in Great Britain are a result of stress, depression or anxiety. An estimated 17 million working days were lost due to work-related stress, depression, or anxiety in 2021/22.

As female founders, we’re excellent at investing our time and energy in the vital work of supporting our teams, building our businesses, keeping investors happy. Often taking on more stress as a result.

You know the saying “You can’t pour from an empty cup?” How can you manage stress levels as a female founder, doing All The Things, while staying replenished and in touch with your own wellbeing?

Perspective as a superpower

Harnessing your perspective as issues arise can help you create distance from stress – or stressful situations. Notice when it’s happening, pause and try to delineate your thoughts and response.

When you step back, and look inwards, you can acknowledge the situation rather than be consumed by it. Know you are not your thoughts.

Connection plays a huge part in perspective. Invest in connections with peers and likeminded founders to build community, support and accountability. The femtech community is a hugely supportive one – reach out, build those links.

Understand your stress

Where does your stress come from? Is it environmental – the expected pressures of building a business and all that comes with it? Or could it be physiological? For instance, could it be the reality of peri/ menopausal symptoms adding another layer of stress?

While femtech is a brilliant example of the strides made in the menopause conversation, we can’t underestimate how it impacts our emotional, mental and physical health. Investing in coaching and wellbeing support to create a personal plan is a powerful way to navigate this transitional time.

Seeking support as radical courage

You know the deal. As women, there’s a legacy of nurturing others while putting our own needs to the bottom of the list. Between team check-ins, investor updates, and life admin, it can feel uncomfortable to ask for something for yourself.

Years of coaching has taught me that overwhelm is a fast-track to burnout. And because it’s cumulative, it compounds everything we’re dealing with – breaking points can happen in the boardroom or the playground.

Stress is not a failing, it’s a normal part of a full life. Take courage in asking for help.

Build your own trusted support team. Engage coach or a thinking partner who is committed to holding space for quality conversations helping you support and expand your own self-awareness, understanding and personal development.

Come back to your values

Reconnecting with values is a huge part of the resilience work I do with clients. When stress escalates, we need to get back to our why, and refocus on our sense of purpose.

Start small, perhaps by setting a daily intention aligned to your values. Then build this into your working day. Ask: what do I want from this meeting? What can I bring to this conversation? What’s the one thing I need to accomplish today?

Break it down into micro-steps. What’s the next positive step I can take to bring me back to my goals?

Anchor into your own wellbeing

Making wellbeing a non-negotiable can be one of the most powerful things you can do – especially as a femtech founder.

Identify your personal wellbeing pillars – hydration, meditation, 10k steps, a weekly yoga class, 9pm bedtimes – with the knowledge these will vary from season to season.

Heading into summer, I’m committing to more white space in my day, building in thinking and creative time. Choose what works for you. Attend to it daily.

Embodying wellbeing as a femtech founder shouldn’t be considered a privilege; it’s neither frivolous or a nice to have. It’s how we shape new possibilities for what we’re building with our companies, helping us all to be more authentic and whole in our work.

This isn’t about adding yet another “to do” to the list. It’s how you access powerful resources to support you through the sticky, stressful moments that come with the founder territory.

A bonus is that modelling this behaviour for your team means you can give the people around you permission to do the same, and reset the culture around stress at work.

Kate Hesk is the founder and CPO at the HRtech platform Cognomie. Prior to Cognomie, Kate’s career spanned 15 years in leadership development and coaching consultancy after 12 years in management and leadership roles in the pharmaceutical and healthcare industry.

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