We've long been overdue for women's technology to emerge out of the dark ages. But it may just happen this time.

At last, scientists and engineers and marketers — many of whom are women — have contributed to the emergence of "femtech," an industry that encompasses the category of software, devices and services using technology to focus on women's physiological and reproductive health. These are historically chronically underserved markets, with lucrative consumer groups like postnatal and menopausal women lacking legitimate information and care as it relates to their bodies. (It's now estimated to reach more than $53 billion by the end of 2027.) Enter: the growing number of healthcare technology companies committed to creating smarter, safer, more practical products and services for women who have long been relegated to powder-pink spin-offs.

After a decade working in public health at various NGOs and the United Nations, women's health expert Tania Boler launched London-based femtech startup Elvie in 2013. Though she built a career around sexual education, serving as Team Leader for HIV prevention at UNESCO, it wasn't until she became a mother herself eight years ago that she says she suddenly realized just how systemically taboo even the most natural women's issues are across all cultures, in all corners of the world.

"I didn't have a plan to start a business or develop a tech product, but I saw a really important problem in women's health that needed a solution," says Boler, who holds master's degrees from both Stanford and Oxford. "The more I looked into it, the more I realized that what existed were these horrible medical devices. And the simple question was: Why couldn't we turn them into something women actually want to use?"

Boler quit her job soon after, beginning to raise money to bring her vision — a global network of women's health and lifestyle products — to life. Early on in her research process, Boler was introduced to consumer electronics business Jawbone co-founder Alexander Asseily, who came on board as Elvie's co-founder. Together, they built a team that now includes engineers from Dyson and a head of marketing from Apple, roughly 60% of whom are women.

"It was all about bringing together the best engineers who don't normally think about women's health and giving them a new problem to solve, to come up with a different type of solution," says Boler. "Because ultimately, with women's health, if you want it to break through, it's not just about the technology. You also need to change the way people think about women's health and move it from a medical issue to more of a lifestyle one."

The Elvie Trainer, a Kegel trainer with accompanying real-time biofeedback.

The Elvie Trainer, a Kegel trainer with accompanying real-time biofeedback.

In 2015, Elvie introduced its first device: the Elvie Trainer, a $199 Kegel trainer designed to help build muscle strength in their pelvic floor, the muscles of which play a crucial role in core stability, bladder control and what Elvie calls "intimate wellbeing."

In the U.S. alone, roughly a quarter of women are affected by pelvic floor disorders. And the frequency of pelvic floor disorders also increases with age, affecting more than 40 percent of women from 60 to 79 years of age, and about 50 percent of women 80 and older.

"The pelvic floor and the vagina are such an important part of what makes us feel strong," says Boler. "It has everything to do with sex and health and motherhood. And yet for most women, we don't really think about it, so therefore, a lot of women have really preventable health problems. If women could exercise their pelvic floor, they could have all the benefits of a stronger core from better, stronger backs to better sex to better health."

It's not that women are ignoring their pelvic floors altogether. The clenching-and-releasing exercises known as "Kegels" have become commonplace enough to warrant their own Jane Fonda workout video (2010's "Prime Time Fit & Strong," targeting aging baby boomers). But Boler found that many simply aren't exercising them, even if they know, empirically, they should be.

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In developing Elvie Trainer, Boler needed to reinvent the wheel. Early research isolated two key problems afflicting the pelvic floor market (or lack thereof): the first being that Kegel exercises are just really, really boring, and the second that women are really, really busy.

The final product aims to tick off both boxes. The device itself is a slender teardrop of 100% medical-grade, 100% waterproof silicone that can be easily inserted into and removed from the vagina with the help of an external appendage. Elvie Trainer connects to your smartphone via Bluetooth, where the Elvie app provides six different exercise programs tailored to your goals.

Like a Fitbit, Elvie gameifies exercise with optimized metrics. As you clench your pelvic floor muscles, a gem icon on the app lifts in response to the strength or length of the contraction. 

"Nobody ever sees the benefits, so it's quite difficult to motivate people to exercise if they're not seeing an improvement," says Boler. "So it's about setting goals for women that are personalized to what they can achieve to make the workouts more fun."

Elvie Founder and CEO Tania Boler.

Elvie Founder and CEO Tania Boler.

In September 2018, Elvie began its slow expansion with the launch of its Elvie Pump. At $279 for a single unit or $499 for a set of two, Elvie Pump is silent and wireless, designed to fit into a nursing bra.

"All products designed for women's health are horribly-designed, out-of-date medical devices," says Boler. "The product that was screaming out for a redesign — and that in some ways epitomized everything that was bad about women's health technology — was the breast pump. They're painful, they're noisy. You have to be plugged into a wall to use them. And women often said that they felt really degraded during quite a vulnerable period of their lives."

The breast pump is an essential product for new mothers — more than 80% use them — yet it's a category that Boler realized hadn't been paid much attention since the first mechanical breast pump was invented in the early 1920s. Elvie Pump's core team of 10 started by outlining six mantras that defined what a breast pump should be: silent, hands-free, discreet, smart, easy to use and, to quote, "not for cows."

At five inches tall and four wide, Elvie is small and lightweight, and with five parts, reportedly takes seconds to assemble. Like Elvie Trainer, it connects to a free app that monitors milk volume in real time and tracks pumping history for each breast.

"Our products are so emotional — they're on very intimate parts of our bodies," says Boler. "I think, to be honest, because the tech products women have used in the past were designed by men, they weren't created with that emotion at the center. They were products that created negative experiences, which also reinforced that breast-pumping can seem quite shameful."

The silent, wire-free Elvie Pump, which retails at $279 for a single unit or $499 for a set of two.

The silent, wire-free Elvie Pump, which retails at $279 for a single unit or $499 for a set of two.

Boler realized early on that if Elvie was going to redesign the solution, it needed to first redesign consumer perceptions. Wholesale partners have played an important role since day one, with Elvie launching in a strategic assortment of boutique gyms and spas, as well as exclusive e-commerce platforms like Goop.

"Our go-to-market strategy was all about making sure Elvie was being seen in the right places to shift people's thinking around Kegel exercise out of the medical into the lifestyle," she says. "The direct-to-consumer model works well to show proof of concept. But there's a certain stage where, if you really want to scale, retail still plays an important role."

With such steep price points, this positioning raises a question of inaccessibility — one that famously stretches across all of femtech. The mainstream health and wellness industry is, to quote the New York Times, "a largely white, privileged enterprise catering to largely white, privileged and able-bodied women." Do the taboos that Elvie is striving to break afflict women in this circle? Certainly. But there is no group of women more harshly affected by the stigmas surrounding women's health than those outside of it.

When reached for a statement on this topic, the brand provided the following:

Quality and cutting-edge technology is at the core of Elvie's products, and will remain to be a focus as we scale. While the integrity of our products is a priority for us, it is also the brand's founding mission is to empower women globally. As Elvie grows and expands, we are dedicating greater attention to price point and affordability within our product portfolio. We are committed to developing solutions that not only bring women's technology out of the dark ages, but also increase women's accessibility to these innovations.

Financially, at least, Elvie has shown it may have the legs to do so. Last April, the business announced a $42 million Series B round, the biggest femtech investment yet. Reports detailed the round would support the release of four additional women's health products, though Boler is tight-lipped on what will come next beyond that upcoming products will support women "at all stages of life."

Elvie is also internationalizing: With a team of 120 people, the company now operates offices in Shanghai and New York City in addition to its London headquarters — as it were for what aims to be the first-ever global women's health tech brand.

"When you open our boxes, it feels like you're opening a jewelry box," says Boler. "Our vagina is part of our bodies that we should also feel proud of and treat with respect, and not something that we shy away from."

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