Kearney’s global healthcare and life sciences lead talks about the structural barriers that face femtech founders.
Paula Bellostas Muguerza is Kearney’s global healthcare and life sciences lead, and leader of the firm’s [w]Health initiative – a platform that aims to move the dial on women’s health. Here she talks to Healthcare Today about the glaring gap in mid-stage/late-stage funding for femtech, the barriers that femtech entrepreneurs face and why investors neglect the sector.
“Endometriosis remains poorly understood, largely due to chronic underinvestment.”
You’ve highlighted the “missing middle” in femtech funding. Why do you think growth-stage funding is so scarce despite strong early-stage interest?
I would argue that there are roughly four key considerations at play here. Firstly, once we move beyond venture capital, the burden of proof regarding revenue potential becomes significantly heavier – and it is here that we encounter some of the most substantial structural challenges. Take endometriosis, for example. It is widely recognised as an area with immense potential, not only in terms of alleviating disease burden and improving lives but also in generating substantial revenue, given the vast, untapped market.
However, we quickly run into a fundamental problem: a glaring research gap. Endometriosis remains poorly understood, largely due to chronic underinvestment. Currently, diagnosis is heavily reliant on invasive, costly surgical procedures and the process is notoriously slow. Compounding this issue is the inherent gender bias within healthcare systems, where women with endometriosis are often passed from one clinician to another, leading to diagnostic delays that can stretch to seven or even ten years.
From an investor’s perspective, the potential is evident – but so too are the barriers. The market size is not yet fully established, the diagnostic pathway remains fraught with inefficiency, and systemic biases persist. As a result, even if a promising treatment were developed, the lengthy and convoluted diagnostic process would hinder its commercial viability. The market potential may exist, but the path to realising it is prohibitively complex.
This same pattern repeats across other conditions, such as polycystic ovary syndrome (PCOS) and numerous others. The systemic failures are so pervasive that, as an investor, it becomes difficult to justify deploying growth capital unless these structural issues are streamlined and resolved. Without tangible progress, the risks simply outweigh the opportunities.
Why do you think the perception persists that femtech is more about impact than commercial viability?
This is undoubtedly one of the key issues. If we, as investors, lack a fundamental understanding of female biology, we are essentially operating in the dark. The question then becomes: why take the risk? Why invest in a field riddled with unknowns when there are safer, more established alternatives – erectile dysfunction, diabetes, or obesity, the latter of which is currently the subject of intense commercial interest?
The same uncertainty plagues research into menopause. We know that declining progesterone and oestrogen levels affect bone density, the immune system and cardiovascular health – but we don’t fully understand why. Without substantial investment in basic research to unravel female biology, making informed investment decisions will remain incredibly difficult.
This circles back to a deeper, systemic issue: why is such research so chronically underfunded when women make up 51% of the population? Are we, consciously or not, undervaluing women’s health compared to men’s? Until recently, this might have been a uncomfortable but abstract question. Yet given recent events – and the broader cultural reckoning they’ve sparked – I suspect we now have our answer.
From your conversations with investors, why do they hesitate to fund femtech companies at the growth stage?
The core issue is this: the system is fractured at every level, making the path to unlocking commercial potential in women’s health anything but straightforward. We lack the necessary diagnostic tools. Biomarkers – which may differ significantly between men and women – remain poorly defined. And persistent biases linger, both in healthcare delivery and investment committees, where underrepresentation skews decision-making.
The challenges compound at each stage. Too few women in STEM mean that when clinical trials are designed or biomarker protocols drafted, the female perspective is often an afterthought. Compounding this is the historical exclusion of women from clinical trials, a practice that only ended in 1993. We are now playing catch-up with a decades-long data gap – a fundamental handicap.
Then there’s the healthcare system itself: access is uneven, and treatment is too often marred by ingrained prejudice. Meanwhile, the investment community still dismisses women’s health as “niche”, reductively framing it as limited to reproductive biology.
There is no quick fix. No magic wand to wave before investors that will suddenly rectify decades of neglect. Progress demands coordinated action across research, investment, medical education, technology, care pathways and policy advocacy.
“Some of the most inspiring work is emerging from the Global South.”
Beyond the Flo app, are there other femtech companies or initiatives that you see as potential success stories or models for scaling?
Maven Clinic is a really great example and highlights an important principle. When evaluating women’s health innovations, we must look beyond isolated therapies, diagnostics or point solutions. The critical question is: how will these integrate with existing systems?
Another we should all be watching closely is UK-based Aneira Health, which is now expanding into the US market. Its approach represents a fundamental redesign of healthcare delivery, placing women at the absolute centre of the care model.
This paradigm shift could finally break the vicious cycle of misdiagnosis and delayed treatment that plagues women’s healthcare – with all the well-documented consequences that entails. By addressing multiple potential concerns simultaneously within a coordinated framework, we can prevent the diagnostic odysseys that currently characterise so many women’s healthcare journeys.
Is the lack of investment interest consistent around the globe?
I would say, it is consistently rubbish, though there are glimmers of progress. I had genuine hope when high-income nations in the Global North began making strides.
Some of the most inspiring work is emerging from the Global South. In Kenya, we’re seeing pharmaceutical coalitions revolutionise women-centred care through integrated cervical, breast and lipid screening programmes. My personal favourite example is Pakistan’s Sehat Kahani which addresses a uniquely local challenge through brilliant social innovation.
Pakistan faces the phenomenon of “Doctor Brides”, female clinicians who graduate but leave practice after marriage. The founder created a solution that enables these “Doctor Brides” to deliver both remote and in-person consultations flexibly. Having already treated approximately 500,000 women, this model represents exactly the kind of context-specific innovation that gives me hope.
“There’s too much noise about initiatives before they’ve demonstrated real impact.”
Partnerships is the buzzword something trumpeted by organisations like Microsoft, Salesforce, and UCB. Will they achieve anything?
There’s too much noise about initiatives before they’ve demonstrated real impact. I’d prefer we invert this approach: stay quiet until we have tangible proof points.
This philosophy extends to our work at [w]Health. Partnerships are absolutely critical. No single entity can solve these challenges alone. That’s precisely why we launched the initiative: to foster collaboration at scale. But what ultimately matters isn’t the fanfare of announcements, but demonstrable change where it matters most – in the lives of women navigating these broken systems every day.
If I come and talk to you in five years’ time, are we going to have the same conversation again?
I sincerely hope not though the fight does often feel exhausting.
My hope rests on three fundamental changes. First, we must revolutionise our approach through data and science. This isn’t merely about diversity. It’s about rigorous research. When 80% of autoimmune disease patients are women, clinical trials must reflect that reality. Otherwise, we’re developing therapies that may fail in actual clinical practice. Let’s stop framing this as political correctness and recognise it as scientific necessity.
Second, we need systemic reforms to diagnostic pathways. No more of this endless referral cycle where women ricochet between specialists without answers. Through the pilot programmes we’re currently implementing, we’re demonstrating how revised guidelines can break this vicious circle.
Finally, we require dedicated funding streams – capital allocation that mirrors the focused investment we’ve seen in areas like antimicrobial resistance (AMR).
When these three elements converge, I believe we could see transformative change within just five years.
