Until five years ago, the term “FemTech” was unheard of. Today, it has grown into a $55 billion dollar industry and is projected to reach $103 billion by 2030. It is widely recognized to have immense potential to improve women’s health. And just to clarify, when referring to the commonly used “women’s health” we mean all health-related care that includes but is not limited to people assigned female at birth, cisgender women and sexual and gender minority people.
One of the reasons for the rise of companies focusing on women’s health is the “historical lack of research focus on women'' which femtech companies often aspire to address. Until 1994, clinical trials routinely excluded women and people assigned female at birth from early studies of drugs. Though this was mainly due to safety reasons and fears of the potential effect of the medication on fertility, it resulted in scarce databases about the effect of drugs on individuals. This lack of research and its subsequent adverse effects on people around the world is often spoken about as the “gender health gap”, “gender research gap”, and “gender data gap”. Why is it important? Research guides medical treatments and guidelines, so if there’s no adequate research and data, it means that the treatment is not optimal.
We like to think of it this way (visual below): the RESEARCH we conduct affects the DATA we have which affects the HEALTH outcomes we see. Phew. Back to reading!
One severe example of the consequences of excluding groups from research that is often highlighted is the Thalidomide scandal of the 60’s. Pregnant people were given medication to prevent nausea that resulted in severe birth defects in the babies they birthed. However, the gender health gap can have a significant burden on people even in less extreme-sounding cases. One example is the fact that women suffering from cardiovascular disease present with different symptoms than men yet healthcare screening has not reflected this difference until recently. Cardiovascular conditions going unrecognised resulted, and continues to result, in women being misdiagnosed and untreated with consequences as grave as preventable death. Another example, this time from psychiatry, was a research study that found that women, compared to their male counterparts, respond to lower doses of antipsychotic drugs due to differences in metabolism. However, they are too often prescribed the same dosage leading them to be over-medicated and so experience unnecessary and possibly harmful side-effects.
While gender is fluid, this type of research does show that sex can impact how bodies process different drugs. Differences in hormone levels can influence how a person’s body processes a drug (also called “pharmacokinetics”) and how a drug acts inside the body (also called “pharmacodynamics”). Even between two individuals of the same sex, drugs can have different effects. This is particularly relevant in the context of hormonal contraceptive use as users have shown to report largely varying responses and side effects on similar treatments.
Factors contributing to these differences are being researched and include but are not limited to genetic backgrounds, environmental and behavioural influences on gene expression (epigenetics), age, lifestyle, and diet. Discovering how these factors influence side effects could not only empower individuals using contraceptives to receive accurate, adaptive, and contextualised information relevant to their unique biology, but also help narrow the gender health gap. This kind of personalised medicine supports all individuals to receive treatment tailored to their specific bodies and needs.
Ignoring certain populations during clinical trials can have lasting generational impacts. It shows us how important it is to create large, inclusive and diverse study cohorts. Some progress has been made by governmental agencies to make research studies more inclusive. In order to see further advances in this area, it is vital to spread awareness on how invaluable people’s participation in research can be in advancing healthcare for women and people assigned female at birth around the world. Additionally, pushing research organisations to include diverse populations within their clinical trials is crucial.
Our Call to Action
At Dama Health, our aim is to advance and increase access to personalised medicine, with a focus on contraception decision making. We want to empower individuals through evidence based insights into how their medical history and genes are influencing the way they react to contraceptives.
So what can you do to help? Participation in research is crucial to gather data that will allow for the creation of treatments that are tailored to the individual.
This is why our upcoming study is so exciting… We are launching the first-of-its-kind contraception study with the aim of understanding what genes might impact hormonal contraceptive efficiency and side effects. We are now actively recruiting 500 participants within the UK for our study. We are looking for 1) women and people assigned female at birth that have experienced one or more side effects on hormonal contraception, and 2) women and people assigned female at birth that have experienced no side effects on hormonal contraception. Participating in this study opens up the opportunity for helping contraception users make better informed decisions that are suited to their individual needs. Additionally, by pursuing this study we hope to gain better data, a better understanding of this complex issue, and help decrease the gender health gap.
Article edited by Fiona Kennedy, MSc
Reviewed by Dr.Paulina Cecula