Banner by Grace Hercik 

From Periods to Policy: Investing in a Better Future for Women’s Health

By Abigail Glezer 

On January 17, 2024, the McKinsey Health Institute published a monumental report detailing the women’s health gap, with the introductory claim being  “the women’s health gap equates to 75 million years of life lost due to poor health or early death—and closing the gap could boost the global economy by at least $1 trillion annually by 2040.” The loose translation stands: focus on improving the current state of women’s health and not only do you save lives, but you actually profit in the process. The contributing gaps are undeniably apparent: the gap between resources and patients, between scientists and industry, between the interests of investors compared to the mission of bettering women’s health. How did this happen in the first place, and more importantly, what are we doing about it now? As Michelle Obama said at the State Department Women of Courage Awards, “Communities and countries and ultimately the world are only as strong as the health of their women.” 

To help navigate these questions, I had the opportunity to interview Dr. Elizabeth Garner (Gynecologic Oncologist, Scientist, Government Policy Advocate, and C-suite Executive for Women’s Health Companies), and Dr. Michal Elovitz (OB-GYN, Scientist, Dean of Women’s Health Research and Director of the Women’s Biomedical Research Institute at Icahn School of Medicine at Mount Sinai). These women have decades of professional experience across clinical, academic, and industry settings and are at the forefront of championing women’s health on a national scale. They have unparalleled expertise and first-hand insight into the current state of women’s health. 

How Did We Get Here? 

Period. Vagina. Menopause. Terms that relate to the daily living experience of over 49% of the world’s population have somehow found their way into the classification of a niche discussion topic. Reserved for conversations conducted with the utmost discretion, natural human functions have developed a social stigma throughout the decades that still heavily permeates today.  

A study by a menstrual retailer, THINX, working to end this stigma, reported that “42% of women have experienced period-shaming, with one in five being made to have these feelings because of comments made by a male friend.” The spotting of a stray tampon by a classmate is on the mild side of the implications that come with period shaming. Dr. Garner presented a more dire case: “For generations, women have been taught to not talk about stuff…the Black community is a great example. With a predisposition for fibroids and heavy heavy bleeding, they’re told by their moms, ‘That’s just the way it is my dear,’ ‘Don’t talk about it,’ ‘No one wants to hear about your bleeding.’” With shame comes silence, and silence can oftentimes have fatal consequences. In the same study by THINX, it was found that 62% of respondents claimed that “they have experienced others failing to take their period pain seriously.” What’s often diagnosed as period cramps can actually be a myriad of severe conditions, including endometriosis, fibroids, polycystic ovary syndrome, and others, that can lead to irreversible health damage when left unaddressed.  

Even if a woman advocates for further examination and more serious consideration, the tools that can help improve the accuracy of diagnosis are underfunded and under-prioritized. A lack of open dialogue leads to a lack of catalyst for the government and other entities to change. Dr. Elovitz made the point that oftentimes men are in the driver’s seat of these institutions, and that doesn’t mean that men are intentionally omitting women-focused efforts. More often than not, many men—and some women—genuinely do not understand the severity of women’s conditions or the degree to which female- and sex-specific conditions burden women. It may seem unfair to have to fight so ardently for something that should be a given, but if we want to start seeing change, it falls to us women, and all those who care for women, to start speaking up and educating others. We can’t, and should not, be alone in this fight. The louder that these issues are presented, the more likely it is that they will be heard at the driver’s seat level. 

An evident example of this in practice was proposed to me by Dr. Garner. In March 2024, President Biden called on Congress to make a $12 billion investment in women’s health. $100 million has gone to the Advanced Research Projects Agency for Health (ARPA-H) Sprint for Women’s Health, with the rest hopefully making its way towards funding research initiatives, but official allocations are currently unclear. The questions I had for Dr. Garner were: Why now? Why the sudden push from the government in support of the cause? She herself has been a strong advocate for women’s health since her early days at Harvard and cannot contain her excitement over how much attention women’s health has gained since. “There have been several of us that have been advocating for years, and there were others that I didn’t even know about…that led to the McKinsey report and the Women’s Health Access Matters [WHAM] report…then there was a huge meeting where WHAM brought together a large number of people in women's health, both academia and industry…3Not30 goals were championed and then put on course to the White House.” Advocates reaching out to each other built the basis for the groundbreaking reports highlighting the gaps in women's health research. These reports served as an educational tool for the public, encouraging even more people to start advocating. When these people came together at the WHAM conference, they were able to uphold these goals and bring them to the attention of the right people. Fast forward to March 2024, and the government is now developing active legislation to invest in women’s health research. It all starts and ends with women talking. 

Where Are We Now? 

Women’s health is underrepresented in venture capital, receiving only 2% of total funding in 2023. This statistic is supported by two more: 1) in 2020, nearly 90% of investment decisions were made by men, and 2) all-male teams were four times more likely to receive funding than companies with at least one female leader. However, there is hope for change as attention to women’s health is increasing in both the government and the financial sector. The banner term for venture capital entrepreneurship within women’s health is “FemTech.” Ida Tin, founder of the menstrual tracking app Clue, coined the term in 2016 when she found herself needing terminology with male investors that was more digestible for them than “period” and “vagina.” It encompasses technology products, services, and companies focusing on uniquely women's concerns, and has become a trending focus for women’s health in the current startup ecosystem. 

We can all agree that this is a positive type of attention. As Dr. Garner said, “More investment, more money, more ability to understand the science of women's health.” That’s the same line of thinking that many of these FemTech companies are advertising; we do this for women with the ultimate goal of helping women through our product. However, the United States is a capitalistic, profit-driven system where, more often than not, the bottom line is prioritized over much else. When investors put their money into companies, they do so with the expectation of a greater return and within a certain time frame. This puts pressure on companies to exceed expectations and to do so as fast as possible. Dr. Elovitz is aware of these conditions.“I hope they’re doing it right, that’s the first thing that comes to mind,” she said. What does that mean? She elaborates that, for both sides, it means actually having people in the room who are experts in the field, having the research that backs up the product, and remembering that the return on investment in focus is the improvement of women’s health above all else. 

Few companies can find success without being able to provide a level of evidence to support their claims and, more importantly, without having established legitimacy. How does a company show legitimacy? Oftentimes, through the experts they have on their teams and on their boards: industry-specific legends, academic superstars, employees from name-brand universities, etc. For women’s health, the legitimacy one looks for falls in the area of medical and scientific expertise. An esteemed medical professional employed by a start-up gives investors the confidence they need to proceed with their monetary commitments. Unfortunately, this offers a much lower guarantee than people may like to believe. Dr. Elovitz echoed this sentiment as an esteemed medical professional herself, saying, “Respectfully, just having a physician on the board—who isn’t an OB-GYN or related specialty within reproductive or women’s health science—I mean they may or may not know. The representation is nice, but that doesn't mean that they have the skill set to ask rigorous questions on what the company is focused on.” 

As FemTech rightfully gains traction within the venture capital space, it falls on investors to do the due diligence to ensure that the resources are going to deserving spaces. A vote of confidence from a big investment firm translates to a more positive reception within the market from the media and other investors. Wielding this power properly can be the catalyst for getting many therapies and products off the ground that are actually going to help people. At the end of the day, if you’re putting your money and reputation on the line, wouldn’t you want to be sure for yourself that the vision you’re backing is legitimate? It all comes back to both the startup founders and the investors being aligned on the singular point that the return on investment in focus is to genuinely offer a positive contribution towards improving women’s health.  

Where Are We Going? 

I will admit, I myself have a slightly cynical approach towards the priorities of investors and even certain founders, both of whom may see FemTech as a trending opportunity to profit rather than working to genuinely further the health of women. I shared my slightly pessimistic take with Dr. Elovitz, asking her where she saw herself in terms of hope for the future of the field with the current newfound attention. “I’m optimistic about women’s health because women are speaking up more and demanding more for their health…All of a sudden there is a voice growing, and there’s women getting frustrated and advocating,” she observed. Dr. Elovitz continued, “They’re taking ownership, and that is more of what I’m optimistic about.” 

If there is one thing we’ve come across again and again in history, it’s to never underestimate a frustrated woman. In the present day, women are sick and tired of watching their friends and family die around them, tired of having to suffer physical pain just to be dismissed by physicians with a generalized diagnosis, and tired of the narrative around their very biological nature being stigmatized throughout modern society. It’s also not enough that women are frustrated; we all need to be frustrated. When a woman spends an average of nine years in poor health, this affects her ability to be present and/or productive at home, in the workforce, and in the community, leading to a negative domino effect throughout our society. 

Dr. Garner said best, "Now that we’ve had that surge of anger, it’s time to turn our attention to what we can be doing.” Advocating for ourselves and others about topics we may feel inherently uncomfortable about, supporting organized initiatives on a government and local level, and, as I’ve learned from Dr. Garner and Dr. Elovitz, just talking about it can oftentimes be the very contribution that we need to see meaningful change on a large scale.