Femtech $1 Trillion Blind Spot

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-20/10/2025
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What may forward-thinking investors do about it?

By Marcos R Leal, KOMPASSIUM Managing Partner; Clarice Pinto , Pausetiv Founder.

The Wake-Up Call

Imagine this:

A 45-year-old executive walks into her doctor’s office experiencing brain fog, anxiety, irregular sleep patterns, and difficulty concentrating. After a battery of tests, she receives a diagnosis: ADHD.

She’s prescribed medication, may join support or online groups, and restructures her work life around this new reality. Three years and thousands of dollars later, she discovers the truth: she was experiencing perimenopause. The medication didn’t work because she was treating the wrong condition. Her symptoms were hormonal, not neurological [1].

She’s not alone. This scenario plays out thousands of times daily across healthcare systems worldwide, representing not just a medical challenge but a massive market inefficiency—and an investment opportunity that many are systematically overlooking.

The Numbers

Let’s start with a simple market observation: women constitute approximately 50% of the global population and spend twice as much on healthcare as men [2]. Yet femtech—technology-enabled products and services addressing women’s health—receives just 2% of overall health tech investment [2].

We are not getting into the inequality discussion (while it exists).

“It’s the economics, stupid”

– to rephrase the quote coined by James Carville in 1992 in the context of US elections.

When you have a market segment that represents half your potential customers, demonstrates higher spending propensity, and receives dramatically less innovation capital than comparable segments, you’re looking at what we call a “structural market inefficiency.” In simpler terms: an opportunity.

The femtech market is projected to surpass $103 billion by 2030 [2]. In 2024, global femtech investment reached $2.2 billion—but this accounted for only 8.5% of total digital health funding [3]. Meanwhile, women-led startups generated $730,000 in revenue over five years compared to $662,000 for male-led startups [4], yet female-only founding teams received a mere 2.3% of global VC funding in 2024 [5]—a figure that has remained stubbornly stagnant, with the 30-year average standing at just 2.4% [6].

Research from Yale School of Management reveals that women receive 14% less funding than their male counterparts, a gap that widens to an additional 8% if the investor has previously backed a failed woman-led startup [7]. This “one-way updating” suggests a cognitive bias where failures of women-led startups are generalized, while successes are not.

In a recent discussion with a female femtech founder from the Middle-East, she said, “relying on strategic partnership with corporations made a big difference for us, given the lack of VC interest”.

The entrepreneurial landscape exhibits significant disparity between male and female founders. In 2025, women represented just 13.7% of founders in million-dollar startups, a decline from 15% in 2022 [8]. This trend is further substantiated by data showing women account for only 13.2% of all startup founders [9], with some studies indicating that only 20% of startups have one or more women on their founding team [10].

These numbers reveal a pattern that savvy investors recognize immediately: underserved markets with demonstrated demand and proven performance create asymmetric return opportunities.

The Longevity Opportunity

Now, let’s talk about why this “desert” exists and why it’s so significant.

Here’s a statistic that should make every healthcare investor pause: 99% of preclinical aging studies ignore menopause [11]. Women live approximately one-third of their lives post-menopause, yet the medical research establishing our understanding of aging, chronic disease, and health optimization has systematically excluded this population [11].

The consequences of this research gap manifest in what we might call “diagnostic inefficiency”—a polite term for a healthcare system that frequently misdiagnoses conditions affecting hundreds of millions of women globally.

Consider perimenopause—the transitional phase before menopause that can last 4-10 years and typically begins in a woman’s 40s. The symptoms read like a medical mystery novel:

Vasomotor symptoms (Hot flashes and Night sweats)
Cognitive changes (brain fog, memory issues, difficulty concentrating)
Mood disturbances (anxiety, depression, irritability)
Sleep disruption
Physical symptoms (joint pain, headaches, heart palpitations)
Metabolic changes

Because these symptoms overlap with numerous other conditions, perimenopause is frequently misdiagnosed as [1]:

ADHD (attention and concentration issues)
Fibromyalgia (widespread pain and fatigue)
Anxiety and depression (mood changes)
Autoimmune disorders (joint pain, fatigue)
Gastrointestinal disorders (digestive issues)
In extreme cases, even brain tumors [12]

Each misdiagnosis triggers a cascade of unnecessary treatments, medications, and healthcare utilization—generating costs while failing to address the underlying issue. One study documented a woman whose brain tumor was initially misdiagnosed as perimenopause [12], illustrating how diagnostic uncertainty flows in both directions.

From an investment perspective, this diagnostic gap represents multiple market opportunities: improved diagnostic tools, better education platforms, condition-specific treatment solutions, and integrated care models.

The Compounding Effect

The diagnostic void has downstream consequences that expand the investment opportunity. Women experiencing menopause face increased risk for several comorbidities, including osteoporosis, cardiovascular disease, and metabolic disorders [13]. When the initial transition is misdiagnosed and undertreated, these secondary conditions develop without preventive intervention.

Current healthcare systems operate reactively—treating advanced osteoporosis rather than preventing bone density loss during the perimenopausal transition. Treating cardiovascular disease rather than managing the hormonal changes that increase cardiovascular risk. This reactive approach is both more expensive and less effective than early, accurate intervention.

Additional Opportunities: preventive, proactive solutions that address the root cause rather than managing downstream consequences. This is precisely the type of care model that modern healthcare systems need but legacy providers struggle to deliver.

Why Do Those Opportunity Exists?

Before we discuss the solution space, it’s worth understanding why this opportunity exists—because the same structural factors that created the gap also make it attractive for new entrants.

Research Inertia

Medical research and pharmaceutical development have historically centered on male subjects, with female-specific conditions receiving dramatically less research funding. This created a knowledge gap that translates directly into diagnostic and treatment gaps. The system isn’t designed to be exclusive—it’s designed to be efficient, and efficiency in research meant studying homogeneous populations without the “complication” of hormonal cycles [11].

During NEXii Longevity Congress 2025, Porto, one of the panel members referred to a dilemma he faced earlier in his career: while inquiring about using female rats, he was told, “They are too complicated. It won’t be good for your research.”

This historical research approach created a vacuum in understanding conditions specific to women’s health, particularly those related to reproductive and hormonal systems beyond childbearing years.

Training Gaps

Medical education traditionally provided minimal training in menopause and perimenopause management. Many physicians receive only a few hours of menopause-specific education throughout their medical training. This knowledge gap persists across healthcare systems worldwide, leading to diagnostic uncertainty and conservative treatment approaches.

Stigma

Most importantly, all this often stems from the stigma surrounding menopause. Society tends to avoid the topic, leaving women to navigate this phase feeling unseen and alone. These cultural roots are among the key factors contributing to the gap in knowledge, research, and ultimately investment in this crucial area of women’s health.

Research > Needs > Innovation > Products > Better lives

The Baby Boomer generation is now navigating menopause and perimenopause. By 2030, approximately 1.2 billion women globally will be over age 50 [11]. This demographic wave is creating unprecedented demand for solutions addressing health needs in the second half of life.

For investors, this means business: demonstrated need, insufficient existing solutions, a growing market, and structural barriers that have prevented incumbents from effectively addressing the opportunity.

Call for Investors

Let’s move from problem to solution—specifically, where the investment opportunities lie within this structural inefficiency.

1. AI-Powered Diagnostic Solutions

The overlap between perimenopause symptoms and other conditions creates an ideal application for AI-powered differential diagnosis. Machine learning models can integrate multiple data points—symptom profiles, biomarker data, age, medical history, and real-time physiological monitoring—to improve diagnostic accuracy.

The opportunity: Companies developing AI diagnostic tools specifically trained on women’s health data, particularly for hormonal transitions and related conditions. These solutions can reduce time-to-diagnosis, prevent unnecessary treatments, and enable earlier intervention.

Several startups in this space have demonstrated early traction, but the market remains dramatically underserved relative to male-focused diagnostic applications. The diagnostic void isn’t a barrier—it’s the market need these solutions address.

2. Digital Health (Telehealth and Symptom tracking)

The chronic nature of perimenopause and menopause—combined with the need for continuous monitoring and personalized interventions—makes these conditions ideal for mobile-first, telehealth-enabled solutions. Women need tools that travel with them, adapt to their evolving symptoms, and provide actionable, science-based guidance and medical support in real time, no matter where they are.

The opportunity: Platforms that go beyond simple symptom tracking to integrate telehealth consultations, personalized care plans, educational content, and community support. By combining accessibility, reliability, and personalization, these solutions address a massive unmet need—while the subscription model naturally aligns with the ongoing nature of the journey, creating predictable recurring revenue and high lifetime value.

Importantly, these platforms generate valuable data that can improve both individual care and population-level understanding of women’s health conditions—creating compounding value over time.

3. Integrated Care

The fragmentation of women’s healthcare—bouncing between primary care, gynecology, endocrinology, cardiology, and mental health—creates both frustration and inefficiency. Women experiencing perimenopause typically see 4-6 different specialists before receiving an accurate diagnosis and coordinated treatment [13].

The opportunity: Integrated care models that provide coordinated, women-focused healthcare across the lifespan. Think of it as creating a “center of excellence” for women’s health that brings together multiple specialties under one roof (or platform) including lifestyle medicine, with providers explicitly trained in women’s health.

The business model works because integrated care reduces overall healthcare costs while improving outcomes—creating value for patients, payers, and providers simultaneously.

4. Biomarker Testing and Monitoring

The diagnostic challenge partly stems from the lack of simple, accessible testing for hormonal status. While blood tests exist, they’re often poorly timed (hormone levels fluctuate significantly), expensive, and require a physician’s order.

The opportunity: Direct-to-consumer or physician-enabled testing solutions that provide comprehensive hormonal profiles, trend tracking over time, and actionable insights.

Advanced biomarker panels that go beyond basic hormone levels to include markers for bone health, cardiovascular risk, and metabolic function create additional value and justify premium pricing.

5. Digital Therapeutics

As global regulatory bodies establish pathways for digital therapeutics—software-based interventions that treat medical conditions—women’s health conditions represent ideal applications. Many perimenopause and menopause symptoms respond well to behavioral interventions, cognitive behavioral therapy, and lifestyle modifications.

The opportunity: Evidence-based digital therapeutics for specific women’s health conditions. These solutions can be prescribed by physicians, covered by insurance, and integrated into existing care pathways—while being delivered at scale through mobile devices.

The regulatory pathway is now clear, reimbursement mechanisms are emerging, and the clinical need is substantial.

6. Non-hormonal solutions

While hormone replacement therapy (HRT) remains the gold standard for managing menopausal symptoms and preventing chronic conditions such as osteoporosis, many women cannot—or choose not to—use it due to medical contraindications or personal preferences. This leaves millions of women with limited access to effective, evidence-based alternatives for symptom relief and long-term health support.

The opportunity: To develop and scale non-hormonal, science-backed solutions that address menopause holistically—combining nutritional, lifestyle, behavioral, and pharmacological approaches tailored to each woman’s needs. By leveraging data, personalization, and continuous medical support, these solutions can fill a major treatment gap and unlock a rapidly expanding market for safer, more inclusive menopause care.

Innovation in Action: Pausetiv’s Integrated Approach

At the NEXii Longevity congress in Porto this past October, Clarice Pinto, founder of Pausetiv (https://www.pausetiv.com/) and co-author of this article, highlighted a critical insight: the lack of innovation in menopause care is not just a healthcare gap but a massive market opportunity. Her perspective centered on a compelling economic reality—women are the primary healthcare decision-makers in families, making purchasing decisions not just for themselves but for entire households [14].

Pausetiv exemplifies the type of integrated solution that addresses the diagnostic and care gaps we’ve outlined. Rather than treating menopause as a single medical issue requiring a narrow intervention, Pausetiv has built a comprehensive platform that recognizes the complexity of this life transition [15].

Pausetiv Case

Personalized Care Pathways: Recognizing that every woman’s menopause journey is different, Pausetiv starts with individualized assessment and creates tailored care plans. This personalization addresses one of the fundamental failures of traditional healthcare—the assumption that all women experience menopause the same way [15].

Integrated Expertise: The platform brings together medical specialists in gynecology and obstetrics with support for nutrition, mental health, and lifestyle. This integrated approach addresses the fragmentation problem, reducing the need for self-discipline in coordinating among multiple unconnected specialists [15].

Science-Backed:The Pausetiv Scientific Committee has developed a proprietary clinical protocol that guides all healthcare professionals collaborating with the platform, ensuring a rigorous, standardized, and evidence-based clinical approach. In addition, Pausetiv offers scientifically validated educational resources designed to empower women to make informed decisions about their health. This educational component helps bridge the knowledge gap that often leads to misdiagnosis and inadequate care as well as put patients at a more proactive informed position in their health journey.[15].

Empathetic, Optimistic Approach: Pausetiv frames menopause not as a medical problem to be managed but as a life transition to be navigated with support and positivity. This positioning matters—it shifts menopause from the margins of healthcare to a regular part of the lifespan deserving quality care [15]. The use of a digital platform can also mitigate cultural biases that are driving women away from regular doctor visits.

Why This Model Works

1. It fills a critical care gap Traditional healthcare systems are not designed to support women through the long and variable journey of menopause. Most care is fragmented, and unprepared. Pausetiv redefines menopause care by offering reliable, integrated, and personalized support, addressing both the medical and lifestyle dimensions of women’s health.

2. It combines personalization with scalability By starting from a structured digital assessment and guided by a proprietary clinical protocol, Pausetiv delivers individualized care pathways that can be scaled efficiently through technology. This model ensures that every woman receives relevant, high-quality care—without overburdening clinicians or increasing costs.

3. It blends human empathy with digital efficiency Telehealth consultations, symptom tracking, and education are supported by real medical professionals trained in menopause care. The result is a hybrid model that maintains human connection and trust, while enabling fast, accessible, and reliable support—anytime, anywhere.

4. It builds long-term engagement and outcomes Menopause is not a one-time event but a multi-year transition. Pausetiv’s platform enables continuous monitoring and follow-up, fostering adherence, early detection of complications, and preventive care. This sustained relationship increases both patient outcomes and lifetime value.

5. It recognizes menopause as both a health and cultural issue Menopause is much more than a medical condition—it’s a cultural and social experience shaped by stigma and outdated narratives. Pausetiv aims to shift the perception of menopause from a moment of decline to a powerful phase of renewal and transformation. By promoting an open, positive, and informed conversation, the platform not only improves women’s health outcomes but also redefines how society views this stage of life.

From Insight to Action

For investors considering this space, we recommend a framework grounded in market realities rather than aspirational thinking. At KOMPASSIUM, our experience transforming healthcare businesses globally has taught us that successful execution requires understanding both the opportunity and the operational realities.

1. Prioritize Solutions with Clear Commercial Pathways

The most elegant medical solution fails if it can’t navigate reimbursement, regulatory approval, and provider adoption. Favor companies that have identified clear routes to revenue—whether through direct-to-consumer models, employer-sponsored benefits, insurance reimbursement, or provider partnerships.

The femtech graveyard is littered with companies that built products women wanted but couldn’t construct viable business models around them.

2. Look for Founder-Market Fit

In women’s health, lived experience matters. Founders who have personally navigated the diagnostic odyssey, who understand the patient experience viscerally, and who can articulate both the medical need and the market opportunity tend to build better products and more resilient companies.

Are those mandatory criteria? No. But it can be a significant advantage.

This isn’t about identity—it’s about domain expertise. The same principle applies across healthcare: founders with a deep understanding of the problem space they’re addressing demonstrate better product-market fit and execution capability.

3. Assess Data Strategy

Companies in this space that will generate outsized returns aren’t just solving today’s diagnostic challenge—they’re building proprietary datasets that become increasingly valuable over time. How is the company (legally and ethically) collecting data? What insights can they derive? How does their data advantage compound?

The winning companies will be those that understand the data-behavior dilemma and manage it as a strategic advantage.

4. Evaluate Scalability Pathways

Solutions that work in one market or demographic should have clear pathways to adjacent markets. A perimenopause diagnostic tool should be extensible to postmenopause management. A symptom-tracking app should be built on the path to be soon integrated with other health data (one of the current Healthcare system challenges). A provider network in one geography should be replicable elsewhere.

Particularly in women’s health, where conditions often have global relevance but regional differences in healthcare systems, a scalability strategy separates venture-scale opportunities from lifestyle businesses.

5. Understand Regulatory Strategy

Healthcare is a regulated industry for good reason. Companies that view regulatory requirements as obstacles struggle; companies that view them as competitive moats and quality signals thrive. Early consideration of regulatory agencies’ clearance, data privacy compliance, and clinical evidence generation distinguishes sophisticated healthcare companies from consumer tech companies dabbling in health. For startup founders, that should not freeze you. But that should be thought well in advance.

6. Look Beyond Past Performance

Femtech is a nascent market—one that still lacks a long track record of exits or benchmarks to guide traditional valuations. However, the underlying demand and pain points are undeniable: across menopause, fertility, sexual health, and chronic conditions, women continue to face significant unmet needs that technology can meaningfully address.

Investors who rely solely on historical performance risk missing the inflection point of a category that is only now beginning to mature. The next generation of winners will emerge not by mirroring past healthcare models, but by building entirely new ones—anchored in evidence, personalization, and accessibility.

The Broader Context: Connecting Dots Across Healthcare

This investment opportunity doesn’t exist in isolation. Three broader trends amplify the case for investment in women’s health solutions:

First, the consumerization of healthcare is accelerating. Patients—particularly women, who make approximately 80% of healthcare decisions for their families—increasingly expect healthcare that looks more like consumer technology: accessible, personalized, user-friendly, and available on their terms. This shift favors new entrants over legacy providers.

Second, the shift from reactive to proactive healthcare aligns perfectly with women’s health needs. The most significant value in women’s health isn’t treating advanced disease—it’s preventing its development through early, accurate diagnosis and intervention. This prevention-focused approach represents the future of value-based care.

Third, the longevity economy is emerging as a significant market force. As populations age and healthspan extension becomes realistic, the second half of life—particularly for women, who live longer than men—represents massive economic opportunity. Solutions addressing menopause and beyond aren’t just women’s health solutions; they’re longevity solutions for half the population.

What Else? Not convinced?

The data is clear: women’s health represents a massive, underserved market with demonstrated demand, proven business models, and multiple solution pathways. The question isn’t whether this represents an opportunity—it’s whether investors will recognize it before the market corrects this inefficiency.

Here’s what we know:

The market is large and growing ($103B+ by 2030) [2]
The funding gap is substantial (2% of health tech investment) [2]
The performance data is compelling (women-led startups show strong returns) [4]
The demographic trends are favorable (1.2B women over 50 by 2030) [11]
The enabling technologies are mature (AI, mobile, digital therapeutics)
The business models are proven (subscription, B2B2C, insurance reimbursement)

What’s missing isn’t opportunity—it’s recognition that this represents one of the highest-potential areas in healthcare investment for the next decade.

At KOMPASSIUM, we work with investors and companies to identify structural market opportunities and execute strategies that transform them into sustainable competitive advantages. We understand, navigate through, or reshape ecosystems. The women’s health investment gap is precisely the type of market inefficiency that creates asymmetric returns—but only for those who recognize it before it becomes consensus.

The McKinsey Health Institute and World Economic Forum estimate that closing the women’s health gap could add $1 trillion to the global economy annually by 2040 [16]. That value will flow to those building solutions, those funding innovation, and those recognizing market structure before others.

Who will fill this gap (ops… seize this opportunity)?

About the Authors and Organizations

Clarice Pinto is the founder of Pausetiv, a pioneering integrated menopause care platform. A thought leader in women’s health innovation, Clarice presented at the NEXii Longevity Congress in Porto (October 2025), where she highlighted the significant market opportunity in addressing menopause care—emphasizing that women, as primary healthcare decision-makers in families, represent an underserved market segment with substantial purchasing power. Her vision for Pausetiv centers on personalized, science-backed, and empathetic care that treats menopause as a natural life transition deserving comprehensive support.

Marcos Leal is Managing Partner at KOMPASSIUM, a global consulting network headquartered in Frankfurt, Germany. With decades of experience transforming healthcare and technology businesses across multiple continents, Marcos specializes in helping companies navigate complex market transitions and scale sustainable growth. His work spans business longevity strategies, healthcare innovation, and cross-border investment opportunities. Marcos combines deep operational expertise with strategic vision, embodying KOMPASSIUM’s philosophy of being “doers, not sayers.”

KOMPASSIUM is a truly global network of experienced leaders, innovators, and hands-on executives who combine deep expertise with smart business practices and advanced technology to solve complex problems. Based in Frankfurt am Main, Germany, KOMPASSIUM brings together 35+ senior executives and entrepreneurs offering over 700 years of combined experience across diverse industries and markets. The firm’s unique Advisory Programs provide a hybrid consulting model that emphasizes practical implementation, peer learning, and sustained business transformation. KOMPASSIUM specializes in healthcare, energy transition, agribusiness technologies, and business longevity strategies. Learn more at www.kompassium.com

Pausetiv is an integrated menopause care platform founded by Clarice Pinto that provides personalized, comprehensive support for women navigating perimenopause and menopause. Combining medical expertise in gynecology and obstetrics with nutritional, mental health, and lifestyle support, Pausetiv addresses the fragmentation that characterizes traditional women’s healthcare. The platform offers science-backed education, individualized care pathways, and an empathetic approach that reframes menopause from a medical problem to a natural life transition. Pausetiv exemplifies the type of innovative, integrated solution needed to close the diagnostic and care gaps in women’s health. Learn more at www.pausetiv.com