Why biology is catalyzing breakthroughs in women’s health

Women’s health has long been neglected, and the consequences are devastating, with women spending more of their lives in poor health compared to men. This inattention has consequences for society: A recent McKinsey report found that by 2040, investments targeting the women’s health gap could boost the global economy by $1 trillion annually.

Women’s health should not be considered a niche or singular therapeutic category. Still, so much remains unknown because of a lack of research on female biology. Until 1993, women were largely excluded from clinical trials, so there is much we don’t know about the female body and diseases that affect women differently or disproportionately. We need innovative treatments and diagnostics to address this gap and better serve women’s health. This includes incorporating cutting-edge technology rooted in biology to target unmet needs in women’s health like pregnancy health and ovarian aging.

The prevalence of pregnancy complications like preeclampsia—a leading cause of maternal and fetal mortality and morbidity—terrifyingly continues to rise. Preeclampsia rates have doubled in the last 15 years and will soon impact 1 in 10 mothers. In the United States, our prenatal care model (12-14 doctor visits) was instituted in the 1930s to manage symptoms of preeclampsia. However, 100 years later, we still do not have a sufficient preventive care model for expecting mothers, as we continue to lack the understanding to reliably predict which patients carry a higher risk of life-threatening symptoms. Even after delivery, women and their babies can experience lingering trauma and lifelong morbidity from pregnancy complications.

Women are born with all the eggs they’ll ever have. As women age, the number and quality of these eggs decline, causing infertility and leading to menopause. This process, termed ovarian aging, is thought to only occur in humans and five whale species. Animal models poorly represent the human female reproductive system, limiting our understanding of ovarian aging and, therefore, the efficacy of available treatments. Though 1 in 6 people experience infertility and many women are exploring fertility preservation, the female patient journey has barely changed since the first IVF birth in 1978. Women are still subject to a long, intensive, and expensive hormonal stimulation protocol, often yielding limited efficacy. Similarly, while over 70% of age-related diseases are thought to be influenced by menopause, less than 1% of preclinical biology research in aging studies consider menopause.

Startups address the biology of women’s health

The first wave of women’s health startups focused on scaling digital service models to create access to healthcare. They’ve paved the way by eliminating the taboo surrounding women’s health and emphasizing the tremendous unmet need in areas like fertility care access, family planning, and menopause care, to support women throughout their lives.

Building on these foundations, a new crop of startups has invested in biological research to advance the field and better serve women. Companies like ours aim to address the root causes of diseases, rather than simply managing symptoms, and to integrate therapeutics into the body’s natural processes, rather than treating an impaired system.

For example, Mirvie’s proprietary RNA platform and actionable test represent a clear opportunity to answer the “why” behind which moms are at highest risk for pregnancy complications. The simple blood test predicts the risk of preeclampsia by tapping into each pregnancy’s underlying biology. The team is also researching how to predict risk of preterm birth and restricted fetal growth.

Gameto is pioneering a biology-first approach to reproductive health with stem cell-derived ovarian cells that are used to create an “ovary in a dish.” This shortens the IVF and egg freezing processes from two weeks to two days by maturing eggs outside the body and reducing the burdensome hormone injections. The technology is also being assessed as a cell therapy implant for ovarian failure and menopause.

Momentum shift on investing in women’s health

Women’s health is one of the most exciting areas in life sciences right now. Melinda French Gates is backing $250 million in initiatives focused on women’s health, and the White House committed $200 million to fund under-researched areas like menopause. Some of the first wave of women’s health companies have become unicorns—like Flo, Kindbody, Progyny, and Maven Clinic. Many biology-first women’s health companies have raised significant funding and are pursuing advanced clinical validation of their technologies. There’s finally some real momentum to tackle the gaps in women’s health.

If we keep driving innovation forward, it will only be a matter of time before we have novel diagnostics and treatments accelerating breakthroughs in the field. Hopefully, in the not-so-distant future, we can catch up and women’s health can be just health, in sync with other areas of medicine. We are excited and hopeful that solutions that tap into biology will shatter the status quo and create better standards of care across women’s and family health.

Maneesh Jain, PhD is CEO and cofounder of Mirvie. Dina Radenkovic, MBBS, is CEO and cofounder of Gameto.