A small team of Kiwi scientists and engineers have been working on technology that could help alleviate a health condition afflicting as many as one in three women worldwide.
Based at the Auckland University bio-engineering building, JunoFem co-founder and chief science officer Dr Jenny Kruger has over the last five years managed the development of a medical device called the FemFit, which is designed to help women suffering from urinary incontinence.
The global femtech market generated US$820 million in 2019 and is expected to rise to US$3b by 2030.
Embedded with eight sensors, the FemFit measures internal pressure along the wall of the vagina and sends real-time feedback to a mobile app.
The mobile app then helps women understand whether they're flexing the right muscles when doing Kegel or other associated exercises. It essentially takes the guesswork out of the process of strengthening the pelvic floor and gives the user the certainty that the right muscles are being strengthened.
This development could provide a powerful tool in the fight against a condition that remains notoriously taboo, despite research showing that millions of women around the world silently struggle with urine leakage.
"We know that one in three women will suffer from incontinence of some form or another in their lifetime – and that's global," says Kruger.
"It often manifests in pregnancy, post-natal, but it could happen anytime women are more vulnerable. It could happen during menopause, if you happen to gain weight, if you develop a chronic cough or even if you participate in high-impact sport."
The condition doesn't discriminate, with Kruger pointing out that the ratio of people affected is consistent across countries, body types, ethnicities and age groups.
Kruger's initial interest in this space was driven by a curiosity to better understand why so many women were struggling with this issue, but she quickly ran into a significant challenge.
"We realised really early in the piece that there were no instruments that could really give us good information on what was happening along the length of the vagina to understand the changes in pressure [that led to the problem]," she says.
Doing pelvic strengthening exercises correctly could resolve incontinence in more than 80 per cent of cases, but without the right information it's incredibly difficult for women to know whether they're working their abdominal or pelvic muscles.
To get the information required, she would have to build a device from scratch. And to do this, she called in her co-founder, associate professor David Budgett, who had experience engineering devices capable of measuring tiny changes in bodily pressure.
Budgett and the team set about designing a device that was slim, flexible and did not impede the movement or comfort of the wearer.
This device would ultimately become the FemFit, which was last year recognised by Callaghan Innovation as the judges' winner at Callaghan Innovation's HealthTech Week event, which shines the spotlight on emerging health tech companies.
In recent months, the company reached a major milestone in acquiring medical device quality certification that confirms the processes that go into the development of each product meet the stringent regulations of developing a medical device.
What's remarkable about this is that the business has got this far without burning through any investor money so far. It's all been built with backing from Callaghan Innovation and the university.
The next stage of the journey, which involves taking the product to the market, will however necessitate investor funds.
"We're looking to raise $500,000 now, which is really about addressing the clinical uptake of the device that will prepare us to take it to consumers," explains Budgett.
The device could initially be used by physiotherapy professionals to help patients, but Budgett believes there's potential for a direct-to-consumer market that could see the device mailed to women who need it.
He and the team at JunoFem aren't alone in this belief.
Dr Margaret Sherburn, co-ordinator of women's health programmes at the University of Melbourne, sees the device as a useful tool to improve outcomes for women struggling with incontinence.
"When you consider the high prevalence of the many pelvic floor disorders in society, this product could be used extremely widely," says Sherburn.
"There is really no reason why it couldn't be used by all adult women for maintenance of their pelvic health as well as for women who have pelvic floor disorders."
Sherburn is well-versed in the range of products currently available, and sees some major points of difference when compared with FemFit. She says that the quality of data gleaned with FemFit is superior because it's able to separate pelvic and abdominal pressure, enabling women to correct their exercises.
The slim design, she adds, is another important differentiator in an industry replete with bulky devices that "distort the vagina" and often feel uncomfortable for the user.
From a commercial perspective, she sees potential for the development of both a medical and personal use market.
"If it were available for purchase online, with clear instructions for use, it could be safely used by any woman for the purpose of improving their pelvic floor muscles and thus their pelvic floor disorder symptoms," she says.
The femtech barrier
The likelihood of the product realising its potential does, however, remain contingent on funding – and that can prove a significant hurdle when it comes to femtech.
An analyst note published by equity market researcher Pitchbook, part of Morningstar, on 26 August this year identified the femtech sector as a "significantly underdeveloped" part of the healthcare market, despite its massive growth potential.
Analysts Kaia Colban and Ander Akers pointed out that while women already account for over US$500 billion ($751.9b) in healthcare expenses annually, only 4 per cent of healthcare and research and development funding is targeted toward women's health.
The research shows that working-age women spend 29 per cent more per capita and are 75 per cent more likely than men to use digital tools for healthcare.
These factors combined should be appealing to investors, but the research shows that pitching to male investors remains a barrier to business owners operating in the femtech space.
Colban and Akers point out that over 90 per cent of venture capital decision makers are male and that many do not seek to understand women's issues – thereby limiting their ability to gauge the market opportunity.
This is something the team at JunoFem has already experienced firsthand, with Kruger pointing out the difficulty in convincing a room full of male investors how debilitating the issue of incontinence can be to women.
"If you say to a group of men that this is a real problem, you could get a response like: 'Ah, why don't you just use a pad. What's the big deal?'" says Kruger.
"The big deal is that this problem can change your life completely. Imagine not being able to go to the park without having a toilet nearby. Imagine not being able to play tennis in your fifties because you worry about what might happen every time you go for the ball. Or imagine not being able to go on that trip to India with your friends because you need to always be near a toilet. This problem can really compromise your life."
The challenge now is convincing investors these things matter enough to make the financial risk worthwhile.