Hormonal Health: The Billion-Dollar Opportunity

The Impact of Hormonal Health and Emerging Digital Solutions

Gaslighting, a manipulative form of psychological abuse, was reportedly experienced by Elizabeth Ruzzo following a disclosure to a physician regarding suicidal ideation linked to birth control pill usage.

Despite Ruzzo’s report, her doctor dismissed any correlation between hormonal contraception and her mental health struggles. She subsequently chose to discontinue the pill to assess potential improvements in her psychological well-being.

A noticeable enhancement in her mental state confirmed Ruzzo’s suspicion of a disconnect between the distinct hormonal profiles of women and the generalized approaches often employed within contemporary medical practice.

The Genesis of Adyn Health

This insight prompted Ruzzo to establish Adyn Health, a company dedicated to empowering women to make informed healthcare choices aligned with their individual hormonal cycles and personal histories.

Initially, the company focused on facilitating the selection of more tailored birth control options.

A Growing Trend in Digital Health

Ruzzo is among a rising number of entrepreneurs who posit that understanding hormonal health is crucial for unlocking advancements in the digital health sector.

Hormones are inherently dynamic, constantly changing, and highly individualized. These founders contend that they hold the key to addressing numerous health issues that disproportionately affect women, including diabetes, infertility, and mental health challenges.

The Market Potential

The inherent complexity of hormonal health is seen as a significant opportunity for innovation.

It represents a central tenet of both personalized medicine and women’s health initiatives. Projections indicate that the women’s health market could reach $50 billion by 2025.

Furthermore, the broader digital health market is anticipated to achieve a value of $221 billion by 2026.

Challenges and Future Outlook

Despite this potential, the sector faces headwinds.

Decreasing funding for women’s health startups, coupled with persistent stigma influencing venture capital allocation, raises questions about the long-term trajectory of this field.

It remains uncertain whether this area will remain in a nascent stage or experience substantial growth and reach a pivotal moment of expansion.

The future will depend on continued investment and a shift in perceptions regarding the importance of addressing women’s unique health needs.

A Proactive Approach to Women's Health

Adyn is positioned by Ruzzo as a company focused on precision medicine. Their primary offering is a home-based testing service designed to monitor hormone levels and evaluate genetic predispositions to potential side effects.

Based on these insights, personalized recommendations are provided to help customers identify the most suitable birth control options, minimizing adverse reactions.

Ruzzo estimates that approximately 98% of women who are sexually active utilize birth control for roughly three decades. This substantial long-term value attracted investors, leading to a $2.5 million seed funding round in April 2021, co-led by Lux Capital and M13.

Beyond Birth Control: A Long-Term Vision

The company’s ambitious goal extends beyond simply selecting the right contraceptive method. Adyn aims to establish itself as a reliable health partner throughout a woman’s life, facilitating a deeper understanding of her hormonal fluctuations over time.

“We envision leveraging precision medicine, including genetic analysis, to establish dependable diagnostic benchmarks,” Ruzzo explained. “This will alleviate the uncertainty and prolonged diagnostic processes many individuals currently face.”

Establishing a relationship with young women during their teenage years could enable Adyn to track hormonal shifts as they occur.

“Current laboratory hormone reference ranges are insufficiently specific for personalized or prescriptive guidance,” she stated. “Our objective is to account for factors influencing hormone levels – such as age, weight, and ethnicity – and compare an individual’s results against her own baseline.”

A Shift in Digital Health

While companies like Ro address health concerns after a diagnosis, such as erectile dysfunction or hair loss, Adyn represents a new wave of digital health.

Adyn focuses on proactive health management, assisting consumers before the onset of conditions or symptoms.

Traditionally, healthcare has been reactive, waiting for individuals to recognize a problem before seeking medical attention for symptom management or treatment.

A recently launched startup, emerging from Y Combinator, is also entering the hormonal health space, adopting a similar proactive strategy.

A Significant Percentage of Women Experience Hormonal Imbalances

Veera Health is a newly established company dedicated to assisting women in India with the management of polycystic ovary syndrome, commonly known as PCOS. This hormonal disorder can lead to menstrual irregularities, potential infertility, and gestational diabetes in women. Furthermore, it often manifests with symptoms like acne, weight fluctuations, and excessive hair growth.

Founded by sisters Shashwata and Shobhita Narain, Veera Health intends to address the current state of women’s healthcare in India, which is often fragmented and burdened by stigma. The company operates as an online clinic, concentrating on guiding women through symptom management. This includes connecting them with dedicated care managers and providing access to a curated selection of mental health resources.

The Challenges of Current PCOS Treatment

Many women encounter difficulties due to the disjointed nature of PCOS treatment options. Individuals experiencing symptoms may find themselves consulting multiple specialists – dermatologists and gynecologists, for example – and navigating conflicting advice. Veera Health aims to consolidate these experiences into a streamlined, digital platform.

Veera Health's Competitive Landscape

Within the realm of digital health startups focusing on a single condition, Veera Health faces limited competition, with companies like Tia and Perla Health being notable examples. The widespread impact of PCOS, coupled with its connection to reproductive health issues, aligns with the growing investor interest in fertility-focused startups. Recently, Veera Health secured a $3 million seed funding round from a diverse group of investors.

However, PCOS presents a diagnostic challenge, as there isn’t a single, conclusive test. Diagnosis typically relies on the Rotterdam criteria, requiring patients to meet two out of three conditions: anovulation, hyperandrogenism, or the presence of polycystic ovaries detected via ultrasound.

Managing Symptoms, Not Curing the Condition

Currently, there is no definitive cure for PCOS symptoms. Consequently, Veera Health, like any startup targeting PCOS, operates within a nuanced space. While it cannot consistently provide a diagnosis or complete resolution, it can effectively manage symptoms to improve quality of life for women.

Simran Suri, an analyst at Equal Ventures, emphasizes that this very gap highlights the necessity for accessible, specialized care and innovative testing methods. Suri has conducted extensive research into PCOS innovation, seeking opportunities for venture-backed companies in the field of hormonal health.

Addressing an Underserved Patient Population

Suri believes that PCOS startups cater to a currently underserved segment of the women’s health market: those who are not actively seeking to become pregnant. She notes that a substantial number of women experience PCOS without desiring children, or are too young to consider parenthood, and often fall through the cracks of traditional healthcare pathways.

“A significant portion of women are affected by PCOS who may never want children, aren’t currently trying, or are simply too young to be considering it,” Suri explained. “These individuals represent a patient group that is frequently overlooked, and focusing on PCOS allows us to reach them.”

The Evolution of Women’s Health Startups

Suri anticipates a shift in the women’s health landscape, with the initial focus on fertility companies giving way to increased attention on conditions like PCOS, as well as menopause and sexual wellness. “This is an ongoing process,” she stated. “Particularly for a community that has historically been underserved by existing healthcare systems, the current market structure is a direct result of that historical neglect.”

Recent activity in the hormonal health sector, such as an acquisition by Ro, suggests that this second wave of women’s health startups may emerge more rapidly than anticipated.

Ro Acquires Modern Fertility for $225 Million

Last month saw the acquisition of Modern Fertility by Ro, a leading digital healthcare and telemedicine company, in a deal exceeding $225 million. This majority-equity transaction, involving the 25-member Modern Fertility team, highlights potential exit strategies within the hormonal health sector, despite existing challenges.

Established in 2017 by Afton Vechery and Carly Leahy, Modern Fertility was created to identify potential fertility concerns in women at an early stage. Vechery articulated that aligning with Ro provides Modern Fertility with established distribution channels through telemedicine and pharmacy services, avoiding the need for independent infrastructure development.

“We considered the benefits of immediate integration with their existing infrastructure and the accelerated impact this would have on our customers and women’s health overall,” she stated. She further emphasized the shared commitment between Ro and Modern Fertility to create a patient-focused healthcare system, driven by the urgency surrounding women’s health.

This acquisition represents a relatively uncommon exit, and the landscape of companies valued at over $1 billion specifically dedicated to women’s hormonal health remains sparse.

Founded concurrently with Modern Fertility, Ro currently holds a valuation of $5 billion, while Modern Fertility was acquired for a smaller sum. Both companies initially focused on direct-to-consumer care for sensitive and often stigmatized health issues, including erectile dysfunction and infertility. Ro concentrated on reactive treatment – providing solutions for existing conditions – whereas Modern Fertility prioritized proactive identification of potential issues before conception attempts. This difference in outcomes doesn’t diminish Modern Fertility’s potential for growth, potentially reaching a $1 billion valuation under Ro’s ownership, but illustrates the importance of achieving scale.

Despite complexities, stigma, and historical underfunding, the hormonal health startup market may be experiencing a shift. Recent investments, forecasts, and the Modern Fertility acquisition demonstrate a growing awareness within the tech industry regarding the competitive advantage offered by hormonal health in the evolving consumer healthcare landscape.

Currently, startups entering this market typically specialize in a single condition, such as Polycystic Ovary Syndrome (PCOS) or fertility, and then determine whether to emphasize proactive care or post-diagnosis management. While neither strategy guarantees success, both represent ambitious endeavors and signal a future for women’s health characterized by increased choice and patient control. Considering the fundamental role hormones play in overall health, this represents a significant, though overdue, advancement.

Key Takeaways

• Ro's acquisition of Modern Fertility signifies growing investment in hormonal health.
• The deal highlights the value of established telemedicine and pharmacy infrastructure.
• A focus on proactive versus reactive care impacts company valuation and growth potential.
• The market is shifting towards specialized startups addressing specific hormonal conditions.

The acquisition underscores the increasing recognition of hormonal health as a crucial area within the broader consumer healthcare sector.