Innovation in women’s health comes in small doses

As awareness of women’s specific health needs grows, Swiss researchers and entrepreneurs help counteract a history of neglect.

Women’s health is playing catch-up. The debate about the need for better diagnosis and treatment for the less-researched half of the population has begun. As the focus turns to women’s health, the medical and tech sectors are starting to respond to the opportunities.

One thing you can say for certain about innovation in women’s health is that there hasn’t been enough of it. That applies to female-specific conditions like endometriosis, as well as the major human illnesses from brain diseases to cardiovascular diseases.

Medically speaking, men’s bodies have been taken as the default human, and women’s bodies have consequently been viewed as “atypical”.

The real-world consequences of male-centric healthcare are grave. Women’s heart attack symptoms, for example, are overlooked, women’s pain is dismissed for years, and medicines are released to the market that have disproportionately adverse side effects for women.

The Women’s Brain Project is a Swiss-based non-profit organisation which aims to understand how sex and gender differences have an impact on brain and mental diseases.

Good healthcare needs to be based on good information. It is now clear, that the data collected from studies and clinical trials with exclusively or disproportionally male participants or data that has not been filtered by sex, converts into bad information for the diagnosis and treatment of women.

That’s because so many health conditions show sex-based variation between male and female bodies in a range of areas such as prevalence, age of onset, symptoms, prognosis and treatment effectiveness.  The challenge is to overcome a history of invisibility and indifference.

A painful subject

Let’s talk about pain. When it comes to women’s reproductive health, pain does seem to be part of the deal: period pain, labour pain, endometriosis pain, painful gynaecological and fertility procedures, even painful sex is common.

Perhaps this perceived inevitability of pain has contributed to the fact that women are more often undertreated for pain. One common condition, endometriosis, which affects one in ten women and causes debilitating pain and sometimes infertility, is so poorly recognised that it takes up to ten years to get a diagnosis. “It’s really important that we actively seek out this disease so that we can make a diagnosis and carry out therapies,” says Dr Sara Imboden of the Endometriosis Centre at Bern’s university hospital.  

The intra-uterine device or coil is one of the most effective and widely-used forms of contraception. However, for many women (up to 17%) the procedure for the insertion or removal of their IUD causes “substantial pain”.

Aspivix, a Swiss company, has devised a gentler instrument carry out the procedure which could offer hope to some women.

‘Femtech’

Depending on which consultants’ report you read, the so-called femtech market will be worth anything from $9 billion (CHF7.95 billion) to $50 billion globally by 2025.

Not including the pharma giants, there are few  Swiss companies active in this space but those that do exist are doing interesting work. ObsEva in Geneva and Boston is focused on developing drugs for endometriosis, uterine fibroids, preterm labour, and improving IVF outcomes.

Meanwhile Ava Women, a digital women’s health company with headquarters in Zurich, has been attracting a lot of attention for their main product, a wearable fertility-tracking device worn at night. This ovulation tracking tool measures various parameters to predict a woman’s fertile window.

Although Ava Women had a bumpy year in 2020, laying off staff and cancelling a round of funding, they also announced a partnership to explore using the bracelet for other indications.

There have been two promising contenders in the area of maternal health. One is PregnoliaExternal link, which raised CHF4 million in its latest funding round in 2020. A spin-off of Zurich’s Federal Institute of Technology ETH, the company originated from the PhD thesis of CEO and founder Sabrina Badir who developed a sensor to detect the risk of pre-term birth.

The other is Vibwife, a company co-founded by midwife Anna von Siegenthaler, who had the idea of using ancient techniques to help modern mothers.

In her years as a midwife, Anna observed a lack of innovation for labour and maternal health. Because there is so little research on this vulnerable population, a lot of medicines are used off-label.

“It’s really difficult because it’s such a vulnerable population, pregnant women and babies. We are very limited in what we can do.” 

The relapse rate of women with psychiatric disorders, for instance, who stop their medications during pregnancy is extremely high. And yet, there is no global standard of care for expectant mothers with a history of mental illness. The issue was discussed at an international forum organised by the Women’s Brain Project in September 2020.

President of the Swiss Society for Gynaecology and Obstetrics Dr Irene Dingledein agrees that too little is being done or researched for women-specific needs. But, she says, awareness is increasing and this progress needs to be fostered.

“Lots of women work in research and women can also drive attention to women-specific themes but there are still too few women in decision-making positions for lots of reasons. More money should be given to women’s research. It’s not ill will, it’s just overlooked.”

A final anecdote from Dr Dingeldein shows how far we have to go. “Last week we had a meeting about epidurals in the delivery room and the anaesthetist was using a diagram of a man’s body. He realised how odd it was but said it was really hard to find an image of a woman’s body.”