Fibromyalgia is a poorly understood condition causing chronic, widespread pain in sufferers – the majority of which are women.
According to the NHS, the condition affects around seven times more women than men, and typically starts between the ages of 30 and 50, although it can affect any age.
It is not known what causes it, although theories suggest its onset often coincides with periods of stress, such as bereavement, injury or giving birth. There is also thought to be a hereditary aspect too.
The main symptom is generalised pain, which may be accompanied by extreme tiredness, muscle stiffness, difficulty sleeping and problems with memory and concentration, which is known as fibro-fog.
There is no cure for fibromyalgia, rather a number of ways of treating the symptoms, including anti-depressants, painkillers and lifestyle changes.
However, with advances in technology that focuses on female-specific conditions, known as femtech, could there be more solutions on the horizon?
Digital pain relief
Pain is often the most debilitating symptom of fibromyalgia, and, understandably, many women don’t want to be wholly reliant on painkillers, which can themselves bring unwanted side effects.
A number of developments in the femtech world have led to the creation of digital solutions, such as NeuroMetrix’s Quell device, which was last year granted breakthrough device designation by the US Food and Drug Administration (FDA) to treat the symptoms of fibromyalgia in adults.
The device uses transcutaneous electrical nerve stimulator (TENS) technology to offer symptomatic relief and management of chronic pain in the lower extremities.
Designed for over-the-counter use, Quell is a non-invasive, wearable device which is enabled by a tailored microchip that offers flexible, accurate nerve stimulation at increased power, providing targeted pain relief without the need for drugs.
Another treatment that is often offered to fibromyalgia patients alongside medication is some form of talking therapy, but these can be inconvenient to access and attend.
Another technology that received Breakthrough Device Designation from the FDA last year is Swing Therapeutics’ programme of digital therapy.
It offers simple-to-use, daily digital therapeutic lessons and interactive exercises to help patients apply well-established principles to their own specific circumstances and symptoms, giving them the tools to manage their condition.
The self-guided program is designed to foster patients’ understanding and acceptance of their symptoms, while teaching powerful condition management skills via acceptance and commitment therapy (ACT). The program, which is currently being researched and trialled, also incorporates a tool to help users manage their symptom flare-ups – a common occurrence with fibromyalgia.
While not designed to cure or manage pain, symptom trackers can help fibromyalgia sufferers by noticing their triggers or any patterns to their flare-ups.
Taking a more careful note of how the condition affects them can help patients learn how best to manage the condition, minimising the pain and the disruption.
There are a variety of symptom tracking apps on the market, including Manage My Pain and PainScale, and all work in a broadly similar way.
While not specifically for fibromyalgia, PainScale, which was created with advice from doctors and chronic pain patients, tracks and organises all symptoms.
It also provides personalised pain management education, with more than 800 articles, health tips, exercises, and information about a whole range of programmes and treatment options. It can also be used to log and track pain so patients can identify triggers, helping them manage their condition.
Similarly, Manage My Pain helps patients keep detailed notes on their symptoms, which not only put them in more control of the condition, but can also help when seeking medical advice or treatment.
Because fibromyalgia is so widely misunderstood and under-researched, with vague if debilitating symptoms, there has traditionally been a tendency to dismiss it – especially bearing in mind long-standing issues with medical practitioners dismissing women’s pain.
However, in recent years, AI (artificial intelligence) and machine learning have been used to prove the condition exists – and may have a neurological cause.
In 2017, researchers used machine learning to distinguish the brain scans of those with fibromyalgia from those without, and had 93 per cent accuracy.
In the study, MRI machines were used to capture images of the brain signals of 37 fibromyalgia patients and 35 healthy people as a control. All participants had pressure applied to their right thumbnail to cause “severe but tolerable pain,” explained the researchers in their paper, which was published in the journal Pain.
Those with fibromyalgia were seen on the MRI to experience more pain than the healthy controls, according to a neurological marker of physical pain, as well as showing different activity in the insula area of the brain, related to sensory integration, and the medial prefrontal cortex, which is important for emotional regulation.
These different neurological responses created a brain signature for fibromyalgia patients, which a machine-learning algorithm was then able to use to predict which brain scans showed fibromyalgia and which did not.
While the research did not attempt to study the cause of the pain, for many fibromyalgia sufferers, simply knowing that it was real was cause for relief.
Femtech must acknowledge the risk of perpetuating medical racism, say campaigners
Campaigners have warned that health tools could overlook women from marginalised communities
Femtech must acknowledge the risk of perpetuating medical racism, campaigners have warned, amid concern that the sector could perpetuate long-standing racial inequities.
But as excitement grows, campaigners have warned that these powerful tools could overlook women from marginalised communities and perpetuate long-standing racial inequities in how care is delivered.
“Any technology meant to help people track and improve women’s health outcomes must be inclusive and anti-racist,” Dr Regina Davis Moss, president and CEO of In Our Own Voice, told Femtech World.
“Black women have historically been disregarded, overlooked and undermined by the medical technology industry. It is past time for our interests and needs to be prioritised in clinical trials and other forms of scientific research.
“Femtech companies must ensure that their research and clinical trials equitably involve communities of all backgrounds.”
Around 2,000 femtech companies and apps have sprung up in the last decade to address women’s needs, including tracking apps, fertility solutions and menopause platforms.
These new tools are often built using machine learning, a subset of AI where algorithms are trained to find patterns in large data sets like billing information and test results.
The data these algorithms are built on, however, often reflect inequities and bias that have long plagued the healthcare system. Research shows clinicians often provide different care to white patients and patients of colour. Those differences in how patients are treated get immortalised in data, which are then used to train algorithms.
“When our research omits subsets of the population, the accuracy and potential benefits of that research do not extend to those who disproportionately bear the burden of disease,” said Dr Monique Gary, breast surgical oncologist at Grand View Health.
“We are seeing already how AI can harm marginalised communities, where biased algorithms require racial or ethnic minorities to be considerably ‘more ill’ than their white counterparts to receive the same diagnosis, treatment, or resource. This is perilous and avoidable.”
To create responsible and equitable technologies that include BIPOC (Black, Indigenous, and people of colour) women, Gary said companies could start identifying and recruiting experts of colour, via pipeline programmes and incubators.
“We need to start listening to, believing and supporting the voices of Black women,” she said.
“In 2024, women of all ages and races, ethnicities and orientations are telling us out loud what they need to actualise a better version of healthcare which incorporates significant tech utilisation. It’s now up to us to listen.”
Ashley Jones, creative director of Tones of Melanin, said femtech must acknowledge the risk of perpetuating medical racism and prioritise inclusivity.
“Companies in femtech should actively seek out diverse perspectives and experiences, particularly from BIPOC women, in both their datasets and research.
“This includes collaborating with BIPOC brands, stakeholders and organisations to ensure that their products address the specific needs and concerns of BIPOC women.”
Tech developers, Jones said, could address racism by implementing robust diversity and inclusion initiatives within their teams, actively seeking out BIPOC voices in decision-making processes and educating themselves on the unique experiences of BIPOC women in healthcare.
Sylvia Kang, co-founder and CEO at Mira, pointed out that femtech companies should also focus on affordability, as cost can be preventing women from marginalised communities from accessing healthcare.
“Most of the people that can access femtech tools for their health are white mid-to-high income women,” Kang explained.
“Unfortunately, there are some communities, including BIPOC that do not have enough resources to purchase these tools.
“I believe it’s our responsibility to take action and democratise our data and tools in specific ways.”
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US start-up raises US$4.3m to address maternal mental health
The funding is hoped to help FamilyWell scale throughout New England and expand nationally
The US mental health start-up FamilyWell Health has raised US$4.3m in seed financing to support women facing maternal mental health challenges.
FamilyWell Health is a behavioural health company that integrates specialised mental health services, such as coaching, therapy and psychiatry, into OB/GYN practices.
The platform aims to provide pregnant and postpartum patients with specialised support for depression, anxiety and other perinatal mental health concerns.
Individuals who seek treatment typically wait for months to be seen by a mental health provider and instead turn to their obstetricians, who are often hesitant to screen for mental health conditions knowing there is a shortage of therapists and psychiatrists.
“I had difficulty finding support when I experienced postpartum depression and have cared for countless new moms struggling to access mental health care during one of the most vulnerable periods of their lives,” said Dr Jessica Gaulton, founder and CEO of FamilyWell.
“My experience, both as a survivor and as a practicing neonatologist, inspired me to start FamilyWell to provide equitable, affordable, and accessible mental healthcare for new mothers.”
By partnering with OB providers, Gaulton said FamilyWell would increase access to mental health support for pregnant and postpartum individuals where and when they need it.
The funding, led by .406 Ventures with participation from GreyMatter Capital and Mother Ventures, is hoped to help the start-up scale throughout New England and expand nationally.
Payal Divakaran, partner at .406 Ventures, said: “Given our team’s deep experience backing innovative behavioural health and women’s health companies, we had been looking at this intersection for quite some time.
“FamilyWell offers an elegant solution that is a win-win for all stakeholders, including obstetric practices. Dr Gaulton and her team have built an incredible, mission-driven company poised to address a critical need in women’s mental health.”
Dr Melissa Sherman, medical director and obstetrician at Essex OB/GYN Associates, a FamilyWell customer, added: “When you’re pregnant or caring for a newborn, you can’t afford to wait months for help.
“With FamilyWell, patients get help within days and have ongoing support through one of the biggest transitions of their lives.”
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‘Women crave the quick fix of a silver bullet’: menopause experts have their say on talking therapies
Talking therapies could reduce symptoms that may not be otherwise relieved through HRT, specialists have argued
The recent research showing talking therapies could help women through menopause is a “fantastic step forward” in the advocation of choice, experts have said, warning that HRT alone will not reduce all symptoms.
Talking therapies, such as mindfulness and cognitive behavioural therapy, have been found to effectively treat menopause symptoms, such as low mood and anxiety.
Researchers from University College London have shown that the practices, which focus on developing behavioural patterns, coping strategies and relaxation techniques, could have benefits beyond those of HRT, including improved sleep, memory and concentration.
The techniques, experts told Femtech World, could help dampen down women’s physiological system, reducing symptoms that may not be otherwise relieved through HRT.
“Our ability to regulate the stress hormone is hampered during menopause, meaning we sit further up the stress scale than we did before,” said Dr Bev Taylor, psychologist and menopause educator.
“Stress also makes many menopausal symptoms worse, either in frequency or severity. These techniques reduce symptoms by dampening down our physiological system and bringing us back down the stress scale.”
The beauty of them, Taylor said, is that they can be used by anyone.
“Whether you can or want to take HRT or whether you want to use them alongside treatments like HRT, you can. This research is a fantastic step forward in the advocation of choice.”
Catherine Harland, menopause educator, coach and founder member of MenoClarity, said talking therapies had received a lot of backlash since the UK’s National Institute for Health and Care Excellence (NICE) recommended them in their updated guidelines.
“Whilst I understand how life-changing talking therapies can be, I fully appreciate why so many women crave the ‘quick fix of a silver bullet’ in the form of HRT as we have been taught this from a young age,” she said. “We have been taught to turn to pharmaceuticals for any symptoms we experience.”
Modern women, Harland said, live stressful, fast-paced lives, juggling a multitude of things and often feel too busy to fit talking therapies into the mix.
“Menopause is a highly sensitive time and it’s vital women begin to understand the importance of self-care which includes talking therapies and mindfulness.
“HRT alone will not reduce symptoms of stress, trauma and metabolic disease caused by living in a high cortisol state for long periods of time.”
Around 15 per cent of women aged 45 to 64 in England are currently prescribed HRT, which has increased rapidly in the last two years from around 11 per cent and continues to increase.
The main benefit of HRT, according to the NHS website, is that it can help relieve most menopause and perimenopause symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.
Draft NHS guidelines recommend offering cognitive behavioural therapy, alongside or instead of HRT.
Dr Shahzadi Harper, menopause specialist and founder of The Harper Clinic, said talking therapies could benefit women experiencing menopause symptoms and help them feel more in control. However, she said they should not be it at the forefront of the menopause conversation.
“Talking therapies do not address the inherent hormone deficiency that arises due to perimenopause and menopause and the long-term consequences of declining hormone levels,” Harper explained.
“I don’t think they should be at the forefront and definitely not instead of HRT. However, I do think they could be a useful tool, especially as the symptoms of menopause can be quite debilitating and affect mental health and mood.”
Dr Clare Spencer, menopause specialist, GP and co-founder of My Menopause Centre, said while HRT could help many women manage symptoms of the menopause, there would be some women who may continue to experience symptoms, such as poor sleep, low mood and anxiety, despite being on it.
“Women may face other difficulties at the time of the menopause that may be additional causes of stress which can also impact on experience of symptoms of the menopause.
“In these cases, there is a place for talking therapies, such as cognitive behavioural therapy and mindfulness, to help break some of the vicious cycles that can then exist.
“There is also a role for talking therapies in helping women who have been advised not to take HRT or do not wish to.”
She said, however, that long NHS waiting lists could prevent women from getting the support they need.
“There is an issue with access to cognitive behavioural therapy and mindfulness-based therapies through the NHS which does need resolving to allow more women access timely support,” she added.
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- US start-up raises US$4.3m to address maternal mental health
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