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“The cost of living crisis pushes women with chronic conditions into poverty – I am one of them”

By Isabella Fricker, women’s health advocate

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Isabella Fricker, yoga teacher and women’s health advocate
Social isolation, stigma and discrimination might describe how many women with long-term health conditions are feeling during the austerity of the cost of living crisis.

I am one of the hundreds of thousands of young women in the UK living with long-term health conditions that affect their abilities to live independently during the cost of living crisis.

In the past eight years, I have been struggling with chronic conditions like endometriosis, chronic fatigue and vulvodynia, alongside many other unpredictable and debilitating symptoms. I have been unable to work full-time, in-person or remotely.

The co-morbidity of endometriosis, alongside chronic fatigue, has affected my ability to work, even part-time, resulting in a huge loss of income and lost career opportunities, especially when recovering from surgery and managing extended periods of post-exertional malaise (PEM). My heart goes out to all the women experiencing long Covid, chronic fatigue syndrome and other similar conditions.

My life as a young woman trying to forge a creative career in London after university took an unexpected turn. In 2014, I was diagnosed with a borderline ovarian tumour, losing my left ovary at the age of 25. Signed off, I took out a loan to survive, followed by laparoscopic surgeries in 2019 and 2021 for severe endometriosis and IVF preservation funded by the NHS.

When my health has allowed me, I have worked part-time as a visual stylist, customer service executive, creative packer, housekeeper, copy editor and proofreader. I decided to train as a yoga teacher and women’s health therapist, in the hope that one day I could support women at all stages of their life.

Over the years, I have budgeted for counselling, acupuncture and supplements to support the management of my health which has been a huge financial strain.

Loneliness and social isolation, low self-esteem, stigma and discrimination might describe how many women with long-term health conditions are feeling during the austerity of the cost of living crisis.

The security of affordable housing and the lack of properties are making it impossible for women to meet the rise in prices and rental criteria, especially since the local housing allowance has been frozen for the past three years.

I have moved 12 times in over a year which has taken a huge emotional and physical toll. Agencies require a guarantor who is earning 36 times the monthly rent. In some cases, they even ask for six months rent upfront. How can women with long-term health conditions afford that?

Living at home has never been an option for me because my sister has severe myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome. Therefore, over the past 18 months, I have stayed with extended family and friends, house-sat, rented Airbnb’s and short-term summer rentals, before securing a one-bed annexe in the summer of 2023.

Women need social independence and financial security. We can’t expect every woman to have savings, or to rely on partners and family.

Furthermore, women who can carry out part-time work won’t always be earning enough to reach economic independence. Women have always been overrepresented in part-time jobs, zero-hour contracts, fewer career opportunities and lower pensions. Not to mention the gender pay gap.

I have been on government support due to my low income. However, the support is not enough to meet the rise in inflation.

If this continues, women with long term-health conditions and disabilities will be pushed into further poverty, resulting in worsening health, preventing them from saving and trying to work in the future.

Women shouldn’t have to cut back on essentials, especially if they require heating to aid any pain or discomfort relating to their condition.

In November 2023, it was announced by the government that hundreds of thousands of people will be told to look for work they can do from home, or face having their benefits cut.

I would like to put questions forward to the government:

Will there be enough, if any, part-time, remote roles for women with long-term health conditions?

Where is the support to find these specific roles?

How can someone with a long-term health condition be expected to work remotely full-time or even part-time if they are unable to?

For those women, trying to enter back into work, support should be offered without any threats to benefits.

Since the world of flexible-hybrid working started post-pandemic, the job market has become increasingly competitive. Reading many online forums, women are failing health assessments. In my opinion, the government and assessors need to understand that people’s symptoms with long-term health conditions vary from day to day.

Navigating the benefits system has made me feel like a third-class citizen. The Department of Work and Pensions (DWP) Health Assessments for UC, ESA and PIP are gruelling. I wouldn’t wish anymore to enter the system to just get a small amount of money that financially only covers the bare minimum. The system needs a total overhaul due to the systemic failings of a broken benefit system.

Femtech companies and women’s health charities need to lead, support, campaign and even employ women with long-term health conditions.

Not every woman will be able to work a part-time 30-hour week. Women have so much potential, but they need the opportunity to thrive in flexible and supportive working environments.

Everyone deserves a warm place to live, nutritious food, fair work, government support and a sense of independence and security – these are the fundamental building blocks of a happy and healthy life.

Isabella Fricker is a UK-based women’s health advocate and yoga teacher at yogawithizy.co.uk.

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How to raise money for your women’s health or femtech start-up in 2024

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Sabrina Johnson, president and CEO of Daré Bioscience   

Despite significant growth in women’s health investment, start-ups in the women’s health and femtech sectors still face substantial barriers to entry and growth.

SiS sat down with successful start-up innovator Sabrina Johnson, president and CEO of Daré Bioscience, lawyer Sophie McGrath, partner at Goodwin Law and Triin Linamagi, a leading investor and founding partner at Sie Ventures, to find out how to navigate these challenges.

The successful start-ups journey
Sabrina Johnson, president and CEO of Daré Bioscience   

Q: In a nutshell, what challenge is Daré solving?

Sabrina: We focus on significant unmet needs such as hormone-free contraception, female sexual arousal disorder, and non-oral combination hormone therapy. These areas demand new solutions.

Q: What initial challenges did you face when setting up Daré?

Sabrina: Educating investors about women’s health issues and market opportunities was the biggest challenge. Initial investors believed in us as a management team, which helped establish the company.

Q: What hurdles did you face in securing investment?

Sabrina: Given the lack of historical data on women’s health investments, securing traditional venture capital was challenging. We opted for a reverse merger, providing us with US$10m to advance our portfolio.

Q: Lessons for those starting their women’s health journey?

Sabrina: Tenacity is essential. Each investor meeting is an opportunity to increase awareness about unmet needs and market potential.

Q: Is there a culture problem or biases in the investor community?

Sabrina: It’s more about a lack of awareness than bias. Educating the investment community on the social and financial returns of investing in women’s health is crucial.

Q: How important is partnering with the right people for a startup?

Sabrina: Surrounding yourself with credible advisors and aligned investors is critical. Ensuring shared vision and mutual respect with investors is essential.

Lessons from the lawyer 

Sophie McGrath +44 (0) 20 7447 4821
[email protected]

Sophie McGrath, partner at Goodwin Law  

Q: Tell us about your background and what led you to a career in life sciences and women’s health.

Sophie: I come from a medical family and as a result was naturally inclined towards life sciences law. This field blends my legal expertise with my interest in medical advancements.

Q: Could you explain the relationship between a start-up and a law firm?

Sophie: A good start-up lawyer brings sector knowledge, pragmatism, and cost sensitivity. At Goodwin, we understand and have the capacity to support the journey from start-up to global business.

Q: What commercial challenges might an entrepreneur face, and how can a law firm help?

Sophie: Challenges include capital, people, and technology. Ensuring alignment of incentives for people and protecting technology with strong IP strategies are key. A law firm can help navigate these hurdles.

Q: When should a start-up speak to a law firm like Goodwin?

Sophie: Start-ups should speak to us early. We offer various fee structures to accommodate early-stage companies and provide valuable guidance for future growth.

Q: Hopes for commercial growth in women’s health?

Sophie: I hope the conversation about women’s health expands beyond fertility to include conditions like cardiac disease and dementia, where women are affected differently. This can shift perception from niche to critical sector.

Bringing passion to investing

Triin Linamagi, founding partner at SIE Ventures

Q: Tell us about yourself and why you got into women’s health.

Triin: My personal mission to support women’s health led me to focus on this underserved market. While there are still significant gaps in funding and research, I can see a huge commercial opportunity.

Q: How does SIE Ventures support start-ups?

Triin: We support start-ups through Catalyst Programs, Founder Community, and Syndicate Investments, providing access to capital, investor networks, and support.

Q: Common mistakes founders make when raising investment?

Triin: Mistakes include targeting the wrong investors and lacking a strong narrative and long-term vision. Understanding the venture capitalist’s mindset is crucial.

Q: Challenges for the women’s health sector?

Triin: Key challenges include access to capital, economic slowdown, insufficient R&D funding, and lack of public support. Raising capital remains imbalanced, with female-founded startups raising less on average.

Q: Importance of legal advice when raising investment or entering partnerships?

Triin: Legal advice is crucial, especially for IP-heavy businesses and large contracts. Overlooking legal advice can be costly in the long run.

Q: Hopes for women’s health over the next five years?

Triin: I hope to see more funding for women’s health companies, improving health outcomes for women and boosting economic participation. More healthcare funds focusing on women’s health and healthcare in general would be a significant advancement.

So what can we take from these interviews:

Both Sabrina (Daré) and Sophie (Goodwin) emphasise the critical role of legal advice and strategic partnerships. Sabrina highlights the importance of credible advisors and aligned investors, while Sophie underscores the value of engaging a law firm early to protect IP and align team incentives.

Understanding the investor landscape

Triin and Sabrina offer similar views on understanding the investor landscape. Triin points out the importance of targeting the right investors and building a strong narrative, while Sabrina stresses tenacity and continuous investor education.

Challenges in securing investment

All three leaders acknowledge the challenges in securing investment but offer different solutions. There are also creative approaches like reverse mergers, so long as we have the right legal advice and we know when and from whom to raise funds, there are a range of different ways to secure the investment you need.

Future of women’s health

Each leader envisions a broader recognition and investment in women’s health. Sophie hopes for a shift in perception, Triin anticipates more funding and specialised healthcare funds, and Sabrina aims to increase awareness and secure substantial investments.

Navigating the women’s health start-up landscape requires tenacity, strategic legal advice, and an understanding of the investor mindset.

Insights from Sabrina, Sophie, and Triin offer a comprehensive guide for start-ups aiming to break through barriers and achieve commercial success.

By aligning with the right partners, educating investors, and continuously innovating, women’s health and femtech start-ups can pave the way for a brighter future in women’s health.

You can meet Sabrina, Sophie and Triin at the SiS series of global summits, join the waitlist here.

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Everything you need to know about fibroids

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Fibroids, non-cancerous growths that develop in or around the womb, are the most common tumours in women worldwide. Here, we look at everything you need to know about them.

 

What are fibroids?

Fibroids are non-cancerous growths that develop in or around the womb. They often appear during the fertile years and they are also known as uterine myomas or leiomyomas.

Fibroids vary in number and size. You can have a single fibroid or more than one. Some of these growths are too small to see with the eyes. Others can grow to the size of a grapefruit or larger.

A fibroid that gets very big can distort the inside and the outside of the uterus. In extreme cases, some fibroids grow large enough to fill the pelvis or stomach area.

Many women are unaware they have fibroids as they do not have any symptoms.

What are the symptoms?

Around one in three women with fibroids may experience:

  • heavy periods or painful periods
  • abdominal pain
  • lower back pain
  • a frequent need to urinate
  • constipation
  • pain or discomfort during sex

In rare cases, further complications caused by fibroids can affect pregnancy or cause infertility.

Why do fibroids develop?

The exact cause of fibroids is unknown, but they have been linked to the hormone oestrogen. Fibroids usually develop during a woman’s reproductive years when oestrogen levels are at their highest.

They tend to shrink when oestrogen levels are low, such as after the menopause, when a woman’s monthly period stops.

Who gets fibroids?

Fibroids are common, with around one in three women in the UK developing them at some point in their life. They most often occur in women aged 30 to 50.

They are thought to develop more often in women of African-Caribbean origin. It’s also thought they occur more often in women who are overweight because being overweight increases the level of oestrogen in the body.

Women who have had children have a lower risk of developing fibroids.

How are fibroids treated?

Fibroids do not need to be treated if they are not causing symptoms. After the menopause, they will often shrink without treatment.

If you do have symptoms caused by fibroids, the NHS recommends medicine to help relieve the symptoms first.

There are also medications available to help shrink fibroids. If these prove ineffective, surgery or other, less invasive procedures may be recommended.

When should I see a doctor?

See your doctor if you have:

  • Pelvic pain that does not go away
  • Heavy or painful periods that limit what you can do
  • Spotting or bleeding between periods
  • Trouble emptying your bladder
  • Ongoing tiredness and weakness, which can be symptoms of anemia

Get medical care right away if you experience severe bleeding or sharp pelvic pain.

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Everything you need to know about adenomyosis

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Adenomyosis, a condition that causes the lining of the womb to bury into the muscular wall of the womb, affects as many as one in 10 women of reproductive age in the UK. Here, we look at everything you need to know about it.

 

What is adenomyosis?

Adenomyosis is a condition where the lining of the womb starts growing into the muscle in the wall of the womb.

The displaced tissue continues to act normally — thickening, breaking down and bleeding — during each menstrual cycle, leading in some cases to enlarged uterus and painful, heavy periods.

The condition is more commonly diagnosed in women over the age of 30, but it can affect anyone who has periods.

What are the symptoms of adenomyosis?

Sometimes, adenomyosis causes no signs or symptoms or only mild discomfort. However, according to the NHS, common symptoms can include:

  • Heavy or prolonged menstrual bleeding
  • Severe cramping or sharp pelvic pain during menstruation (dysmenorrhea)
  • Chronic pelvic pain
  • Painful intercourse
What causes adenomyosis?

The cause of adenomyosis isn’t known. You may be more likely to get it if you are over the age of 30 and have given birth.

There have been many theories, including:

  • Invasive tissue growth. Some experts believe that endometrial cells from the lining of the uterus invade the muscle that forms the uterine walls. Uterine incisions made during an operation such as a cesarean section (C-section) might promote the direct invasion of the endometrial cells into the wall of the uterus.
  • Developmental origins. Other experts suspect that endometrial tissue is deposited in the uterine muscle when the uterus is first formed in the fetus.
  • Uterine inflammation related to childbirth. Another theory suggests a link between adenomyosis and childbirth. Inflammation of the uterine lining during the postpartum period might cause a break in the normal boundary of cells that line the uterus.
  • Stem cell origins. A recent theory proposes that bone marrow stem cells might invade the uterine muscle, causing adenomyosis.

Regardless of how the condition develops, its growth depends on the body’s circulating oestrogen.

How is adenomyosis treated?

Treatments include:

If these treatments do not work, women may need surgery. This could be a hysterectomy, or surgery to remove the lining of the womb, also known as endometrial ablation.

What is the difference between adenomyosis and endometriosis?

Adenomyosis and endometriosis are disorders that involve endometrial-like tissue. Both conditions can be painful. Adenomyosis is more likely to cause heavy menstrual bleeding. The difference between these conditions is where the tissue grows.

Adenomyosis occurs when endometrial tissue grows deep in the muscle of the womb, whereas endometriosis occurs when endometrial tissue grows outside the womb in places, such as the ovaries and fallopian tubes.

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