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The femtech pioneers revolutionising contraception
Since the pill was invented in the 1960s, there has been little progress in the world of female contraception, and many of the methods currently on the market come with unwanted side effects. With the rise of femtech, however, comes renewed focus on providing contraceptive solutions that work for women.
When it comes to contraception, the options for women haven’t changed for decades. From the hormonal pill to the IUD implant, many come with unwanted side effects and are not suitable for everyone.
Furthermore, women’s healthcare, of which contraception is a key part, has historically been under-funded and under-researched.
It’s a market ripe for disruption and innovation, which is exactly what the new breed of femtech pioneers are doing.
Period tracking apps
Tech to track menstrual cycles and symptoms is popular with both those women who are planning to conceive and those who definitely aren’t.
While tracking cycle lengths and ovulation times can help women decode the best time to get pregnant, it can also help those women who want a less invasive method of contraception, without having to use hormones.
One such app is Clue, one of the earliest entrants into the period tracking space, with around 13 million people. The team behind the app are preparing to launch a digital contraceptive, which will use a statistical prediction of ovulation as a birth control tool. This will let users know when they are more likely to fall pregnant so they can use birth control or abstain.
In the same vein is Natural Cycles, billed as the world’s first and only CE and FDA approved hormone-free, digital contraception solution.
With 1.5 million registered users it has shown to be 93 per cent effective with typical use, which rose to 98 per cent with perfect use – a similar level to the Pill, with none of the side effects.
Home delivery
In the US, access to contraception can be difficult, especially in more rural areas; around 1.5 million American women live in a county without a single health centre offering the full range of methods.
And the problem was only exacerbated during the Covid-19 lockdowns.
During the pandemic, digital health practice Nurx experienced a surge in requests for at-home delivery of contraception, with a 50 per cent spike in birth control requests, and 40 per cent for emergency contraception.
Following an initial online consultation, the firm delivers most types of birth control, from pills, rings, shots, and patches. It also offers an overnight home delivery of the morning-after pill, an emergency contraceptive that can help reduce chances of pregnancy if taken within three days of unprotected sex.
The perfect match
There are nearly 250 types of contraception available, so it can be hard for women (and prescribers) to have the time to find the right one.
London-based femtech start-up Tuune’s research found that 85 per cent of women did not feel that their doctor spent enough time to find the best birth control for them, 52 per cent of women, globally, experience side effects from their birth control, and 43 per cent of women believe they have a hormone imbalance but can’t get a doctor to diagnose it.
These findings were the catalyst for its innovative product, which uses AI and biological testing to match women with the most suitable contraception for them.
A topical treatment
Away from apps and deliveries, merging technologies have also found a new way to prevent pregnancy, in what its founders say is the biggest revolution in contraception since the Pill.
Copenhagen-based start-up Cirqle Biomedical has developed mucus engineering as a new alternative to hormonal birth control.
The first product based on the technology, named OUI, aims to be as effective as the pill with minimal side effects. It works by using small biopolymers to reinforce the natural mucus barrier in the cervix to make it impenetrable to sperm, preventing it from passing through the cervix and fertilising an egg.
The biopolymer used is derived from either mushrooms or the shell of crustaceans and is known to be biodegradable, non-toxic and already used in other FDA-approved medical devices.
An animal study demonstrated 100 per cent effectiveness and the firm is looking to start human trials in the near future.
Review platform
Contraceptive side effects are common, yet often not talked about or highlighted by medics. The Lowdown, an online review platform for contraception, aims to change that and allow women to make an informed choice.
It was developed by Alice Pelton, who, after being prescribed the Pill at 16, suffered a decade of mood swings before she connected her emotional state with her medication.
By collecting huge amounts of data through user-generated feedback, the site also allows women to check any symptoms they may be experiencing against their method of contraception, and search for alternatives by connecting users with expert advice.
Small bowel microbiome differences between women and men may help explain why some conditions are more common in women, a study suggests.
The small bowel microbiome is the community of microorganisms living in this part of the digestive tract, where they play vital roles in immune function, metabolism and hormonal regulation.
Researchers found differences between women and men in the composition and organisation of these microbial communities. One bacterial community containing Granulicatella was found only in women.
The study was conducted by investigators at Cedars-Sinai Health Sciences University.
Ruchi Mathur, director of clinical research and clinical operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study, said: “One intriguing finding was a bacterial community containing Granulicatella, which we found only in women.
“Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”
The researchers also identified differences between women and men in how microbes in the small bowel produce fructans, complex carbohydrates known to trigger digestive symptoms in irritable bowel syndrome (IBS).
IBS is far more common in women than men.
Mathur, who is also a professor of medicine, said: “Our findings show that biological sex is a critical variable in the small bowel microbiome.
“We must consider it as we move toward more personalised approaches to understanding and treating disease.”
An experimental cancer drug reduced bone loss and body fat in mice modelling post-menopausal changes, early research suggests.
The compound, CADD522, appeared to strengthen bones and help the animals stay leaner after surgery designed to mimic hormonal changes seen after menopause.
The treatment remains at an early experimental stage and has so far only been tested in animals.
The study, led by the University of East Anglia, investigated CADD522, which was originally developed to block a protein involved in the growth and spread of several cancers.
Mice treated with the compound for eight weeks showed significant improvements in bone health. Scans found increased bone volume and better preservation of the honeycomb-like structures inside bones that are crucial for strength and resilience.
Blood tests suggested the treatment stimulated new bone growth without interfering with the body’s normal process of breaking down and rebuilding bone.
Dr Darrell Green, lead researcher from UEA’s Norwich Medical School, said: “Osteoporosis affects around one in three women over the age of 50, leaving sufferers vulnerable to painful fractures that can seriously impact quality of life.
“Current treatments exist, but many are plagued by side effects, safety concerns or inconvenient dosing schedules that make long-term use difficult.”
The researchers also found that mice receiving CADD522 weighed less than untreated mice despite eating the same amount of food.
They had less body fat and fewer fat deposits in their bone marrow, a process commonly seen after menopause and linked to declining bone health.
The team also examined brain tissue and found that the drug appeared to reverse several menopause-related changes in fatty acids.
Levels of omega-3 fats including DHA remained largely intact, while several other lipid abnormalities shifted back towards healthier patterns.
Green said: “We didn’t directly test for memory or thinking ability, but our work raises questions about whether this drug could one day help address wider menopause-related health problems.”
Safety experiments in mice, rats and dogs found that CADD522 could be taken orally and was well tolerated.
The compound also appeared to be metabolised more slowly in human tissue than in rodents, potentially improving its performance in people.
“This is still in the early stages and has so far only been tested in animals but we hope that the benefits will translate to humans to ultimately reduce fracture rates,” added Green.
The research was led by UEA in collaboration with the University of Maryland, the Scintillon Research Institute in San Diego and the University of Stirling.
Safety testing was funded by The Sir William Coxen Trust as part of the development of CADD522 as a childhood cancer treatment.
Weight loss surgery was linked to more regular periods and fewer polyendocrine metabolic ovarian syndrome (PMOS) symptoms in women aged 18 to 45 living with obesity in a recent study.
The researchers recommend that women undergoing the procedure have access to preconception care and reproductive counselling to support their reproductive health.
Researchers at the University of Surrey analysed data over 24 months from 84 women who underwent bariatric surgery and 18 women living with obesity who did not have surgery.
Of those who underwent surgery, 49 had gastric bypass procedures and 35 had gastric sleeve surgery.
Women who underwent metabolic bariatric surgery lost more than 30kg on average at 12 and 24 months after the procedure.
Among women with polycystic ovaries, the condition persisted in only 10 per cent after 24 months.
Women also reported a resolution of clinical hirsutism, or excess body hair, by 12 months.
Women who had previously experienced irregular periods reported more regular menstrual cycles after surgery.
Professor Martin Whyte, co-author of the study and professor of metabolic medicine at the University of Surrey, said: “A large proportion of those undergoing bariatric surgery are women of reproductive age, who may be planning a pregnancy in the coming years.
“So much remains unknown about the impact of this type of surgery on women who are planning to have children.
“This raises the question of when the ideal time after surgery is to conceive.”
Women have a higher prevalence of obesity than men, with 57 per cent of women in the UK classified as overweight and 27 per cent living with obesity, which can affect fertility and the health of an unborn baby.
The researchers said 17 women had healthy pregnancies following surgery.
Although this was not specifically examined in the study, no difference in birth weight was observed between babies conceived within or after the first year.
Dr Kathryn Hart, co-author of the study and associate professor in nutrition and dietetics at the University of Surrey, said: “What we have found is that bariatric surgery positively affects the reproductive health of women living with obesity and can improve the likelihood of them having a healthy pregnancy after surgery.
“Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are affected by obesity.
“By reducing this, what we have seen is that it can lead to improvements without the need for medication.
“We would suggest that clinicians consider medical intervention for obesity to treat irregularities in the menstrual cycle and issues with fertility.”
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