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Hormonal health is a massive opportunity: Where are the unicorns?
Gaslighting is a form of psychological abuse, but Elizabeth Ruzzo says she experienced it firsthand after telling a doctor that she suffered from suicidal ideation after taking birth control pills.
Hormonal health sits at the center of conversations around personalized medicine and women’s health: By 2025, women’s health could be a $50 billion industry, and by 2026, digital health more broadly is estimated to hit $221 billion.
Ruzzo’s doctor told her there was no connection between birth control and self-harm, but she decided to stop taking the pill to see if her mental health improved. When it did, Ruzzo grasped the disconnect between women’s unique hormonal makeup and blanket-statement practices from medicine today.
Her realization led her to found Adyn Health, a startup that proactively helps women make health decisions that complement their hormonal state and background. The company started with, of course, helping people pick more personalized birth control.
Ruzzo is part of a group of growing entrepreneurs who are betting that hormonal health is the key wedge into the digital health boom. Hormones are fluctuating, ever-evolving and diverse — but these founders say they’re also key to solving many health conditions that disproportionately impact women, from diabetes to infertility to mental health challenges.
Many believe it’s that complexity that underscores the opportunity. Hormonal health sits at the center of conversations around personalized medicine and women’s health: By 2025, women’s health could be a $50 billion industry, and by 2026, digital health more broadly is estimated to hit $221 billion.
Still, as funding for women’s health startups drops and stigma continues to impact where venture dollars go, it’s unclear whether the sector will remain in its infancy or hit a true inflection point.
The future is proactive
Ruzzo views Adyn as a precision medicine startup. Its main product is an at-home test that tracks hormone levels, assesses genetic risk for specific side effects, and then gives recommendations for which birth control methods best suits the customer with the fewest side effects.
By Ruzzo’s estimates, 98% of sexually active women use birth control for 30 years of their life. That sort of lifetime value proposition made the company look like a sweet deal to founders, and Adyn raised a $2.5 million seed in April 2021 in a round co-led by Lux Capital and M13.
The moonshot, though, is using that as a way to become a trusted partner in a woman’s life, helping understand baseline hormone levels throughout those 30 years.
“My hope is that we can use precision medicine approaches, including looking at genetic markers to identify reliable diagnostic criteria, that can remove that uncertainty and pain and diagnostic odyssey that people have to go through,” Ruzzo said.
If Adyn becomes a trusted partner with teenage women, it could reach a point where it can detect changes in hormone levels over time.
“The hormone reference ranges that are used [in labs] are too broad to be personalized, let alone prescriptive,” she said. “And so what we’re hoping to do is correct for things that we know affect hormone levels like age, weight, ethnicity and compare you to your own expectations.”
If the first wave of digital health was a company like Ro, which answers consumers when they have a condition such as erectile dysfunction or hair loss, the second wave will look more like Adyn, which helps consumers navigate their health before getting diagnosed with a condition or experiencing issues.
The industry standard is still to wait for consumers to realize they have a condition, and then go to the doctor to manage their symptoms or look for a cure. A new startup that recently graduated from Y Combinator is finding its way into hormonal health through that angle.
One-tenth of all women are impacted by a hormonal condition
Veera Health is a startup that wants to help women in India manage polycystic ovary syndrome, or PCOS. The hormonal condition can cause irregular periods, infertility or gestational diabetes in women, as well as acne, weight gain and excessive hair growth. Plus, PCOS is far from rare, impacting one in 10 women.
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Future Family raises $9M to make fertility treatments more accessible and expand its clinic network
Future Family, a company we’ve written about a few times over the years, makes fertility treatments more accessible. They pre-negotiate terms with fertility clinics to ensure there are no surprise fees, convert the often substantial upfront costs into a monthly payment plan and give each user a dedicated Fertility Coach to help them navigate their journey.
This morning the company is announcing that it has raised a $9 million round of funding as it expands the network of clinics it works with.
The company last raised $10 million in a Series A back in 2018, and they’re positioning this round as an extension of that — a “Series A-1”, as they’re calling it — rather than a whole new round.
As I’ve written before, Future Family was inspired by founder Claire Tomkins’ own experiences:
Future Family was born out of Claire Tomkins’ own experiences with the complexities and costs of fertility treatments. After spending hundreds of thousands of dollars on treatments involved with having her first child (with much of the cost coming as a surprise only revealed once the process had begun), Claire set out to build a better way. Future Family partners with clinics to work out all the pricing ahead of time and pays the bill upfront, ensuring there are no billing surprises down the road.
Image Credits: Claire Tomkins, Future FamilyClaire tells me that, as it did for just about everyone, 2020 brought a whole new set of challenges for the company. In the early days of the pandemic, as a million questions about COVID-19 emerged, many fertility clinics closed their doors. And even as the clinics began reopening, with little certainty about where things might be in nine months, many patients understandably held off.
“It was definitely a tough year,” she says, “but I think we’re emerging in a good place.”
2021 is already looking like a different story, Claire tells me. “People had to sit on the sidelines,” she says. “People who have wanted to go forward with treatment, and now have waited 12 or more months… it’s gotten very busy.” According to their numbers, Claire expects the second half of 2021 to hit “record levels of activity.”
To help with the sudden spike in demand, the company is adding more fertility clinics to its network, including CCRM — a fertility group with locations in Minneapolis, Houston, Denver, San Francisco and a number of other major metros.
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How to get people to open your emails
Julian Shapiro is the founder of BellCurve.com, a growth marketing agency that trains you to become a marketing professional. He also writes at Julian.com.
More posts by this contributor
We’ve aggregated the world’s best growth marketers into one community. Twice a month, we ask them to share their most effective growth tactics, and we compile them into this Growth Report.
This is how you’re going stay up-to-date on growth marketing tactics — with advice you can’t get elsewhere.
Our community consists of 600 startup founders paired with VP’s of growth from later-stage companies. We have 300 YC founders plus senior marketers from companies including Medium, Docker, Invision, Intuit, Pinterest, Discord, Webflow, Lambda School, Perfect Keto, Typeform, Modern Fertility, Segment, Udemy, Puma, Cameo, and Ritual .
You can participate in our community by joining Demand Curve’s marketing webinars, Slack group, or marketing training program. See past growth reports here and here.
Without further ado, onto the advice.
How can you send email campaigns that get opened by 100% of your mailing list?
Based on insights from Nick Selman, Fletcher Richman of Halp, and Wes Wagner.
- First, a few obvious pieces of advice for avoiding low open rates:
- Avoid spam filters by avoiding keywords commonly used in spam emails.
- Consider using email subjects (1) that are clearly descriptive and (2) look like they were written by a friend. Then A/B your top choices.
- Include the recipient’s name in your email body. This signals to spam filters that you do in fact know the recipient.
- Now, for the real advice: Let’s say 60% of your audience opens your mailing, how can you get the remaining 40% to open and read it too?
- First, wait 2 weeks to give everyone a chance to open the initial email.
- Next, export a list of those who haven’t opened. Mailchimp lets you do this.
- Important note: The reason many recipients don’t open your email is because it was sent to Spam, it was buried in Promotions, or it was insta-deleted because it looked like spam (but wasn’t). The goal here is to resuscitate these people. You have two options for doing so:
- (1) Duplicate the initial email then selectively re-send it to non-openers. This time, use a new subject (try a new hook) and downgrade the email to plain text: remove images and link tracking. De-enriching the email in this way can help bypass spam filters and the Promotions tab.
- (2) Alternatively, export your list of non-openers to a third-party email tool like Mailshake (or Mixmax).
- First, connect Mailshake to a new Gmail account on your company domain.
- Next, configure Mailshake to automatically dole out small batches of emails on a daily schedule. Let it churn through non-openers slowly so that Gmail doesn’t flag your account as a spammer.
- Emails sent through Mailshake are more likely to get opened than emails sent through Mailchimp. Why? Mailshake sends emails through your Gmail account, and Gmail-to-Gmail emails have a greater chance of bypassing Spam and Promotions folders, particularly if the sender doesn’t have a history of its emails being marked as spam.
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How to get your ads working, and whether PR is worth it
Julian Shapiro is the founder of BellCurve.com, a growth marketing agency that trains you to become a marketing professional. He also writes at Julian.com.
More posts by this contributor
We’ve aggregated the world’s best growth marketers into one community. Twice a month, we ask them to share their most effective growth tactics, and we compile them into this Growth Report.
This is how you’re going stay up-to-date on growth marketing tactics — with advice you can’t get elsewhere.
Our community consists of 600 startup founders paired with VP’s of growth from later-stage companies. We have 300 YC founders plus senior marketers from companies including Medium, Docker, Invision, Intuit, Pinterest, Discord, Webflow, Lambda School, Perfect Keto, Typeform, Modern Fertility, Segment, Udemy, Puma, Cameo, and Ritual.
You can participate in our community by joining Demand Curve’s marketing webinars, Slack group, or marketing training program. See past growth reports here.
Without further ado, onto the advice.
How to get customer testimonials from hard-to-reach executives
Based on insights from Guillaume Cabane.
A customer testimonial from a well-known executive may be the social proof that improves conversion rates on your landing pages or in sales collateral. But executives of reputable companies are generally busy and difficult to reach.
Here’s how to get the testimonial:
- Contract with a freelance journalist who’s written for a reputable publication like the New York Times.
- Reach out to your executive customers with something like “Hey, we have a journalist who has previously written for NYT who’s interested in speaking to a few of our customers for a piece. Do you have 15 minutes for a quick call?”
- For $200 in freelancer time, you get a testimonial you can use (in the words you want) from a reputable executive. Be sure to figure out some way to make it worth the executive’s time.
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How to work with top influencers and avoid ad blockers
Julian Shapiro is the founder of BellCurve.com, a growth marketing agency that trains you to become a marketing professional. He also writes at Julian.com.
More posts by this contributor
We’ve aggregated the world’s best growth marketers into one community. Twice a month, we ask them to share their most effective growth tactics, and we compile them into this Growth Report.
This is how you’re going stay up-to-date on growth marketing tactics — with advice you can’t get elsewhere.
Our community consists of 600 startup founders paired with VP’s of growth from later-stage companies. We have 300 YC founders plus senior marketers from companies including Medium, Docker, Invision, Intuit, Pinterest, Discord, Webflow, Lambda School, Perfect Keto, Typeform, Modern Fertility, Segment, Udemy, Puma, Cameo, and Ritual.
You can participate in our community by joining Demand Curve’s marketing webinars, Slack group, or marketing training program.
Without further ado, onto the advice.
Editor’s note: This is the first of a new series of articles on startup growth tactics in 2019 for Extra Crunch. This first article has been unlocked for all TechCrunch readers.
Don’t abandon email unsubscribers. They’re still useful.
Based on insights from Matt Sornson of Clearbit.
You’ve launched a new feature and want to tell your audience about it. You can send an email to your newsletter subscribers, but how do you reach the 20%+ who unsubscribed? Most people mistakenly consider this audience to be a lost cause.
- Create a custom audience of all newsletter unsubscribers on Facebook.
- Run ads announcing the new feature to that audience.
- Now you’ve reactivated people who at one point had an interest in your product — instead of forever ignoring them.
Tips for effectively working with influencers
Based on insights from Barron Caster of Rev.
- Create a referral system for influencers: Influencers who sign up others get a % of their sales or signups. This makes a mini-pyramid structure and turns your influencers into a salesforce. Why is this important? Some influencers don’t actually sell products, but just sign up tons of other influencers. Find these people.
- Get everything you can out of an engagement (e.g. permission to use them as a testimonial for emails, social proof, etc.).
- Working with influencers is a relationship-building game:
- Actually go to conferences to meet influencers.
- Treat influencers like royalty. Surprise them with gifts like flowers/donuts. $100 to send a gift can pay hefty dividends if they like your brand more and share that with their followers.
- Give influencers a tangible benefit to share with their followers. They care about their followers and want to beneficially incentivize them to click on their link and buy with them.
More tips for working with influencers
Based on insights from Cezar Grigore of Tremo Books.
- Geo rollouts: Your ROI increases when a bunch of influencers in the same category / region share your product within an interval of 2-4 weeks. It gives the impression that everyone is talking about your product.
- Initially focus on influencers with 10-150k audiences. They’re smaller and more willing to accept bartered deals. There are enough influencers in this range willing to work in exchange for a free product. Most may not be producing results, but some work well, bringing in 50-200 customers within 24 hours. As you build up your following and reputation for your brand, it becomes much easier to work with more influential people.
- It’s harder to cut deals with bigger influencers (100k-2M). Only about 5-10% of bigger influencers are willing to work on an affiliate basis (e.g. $10/customer).
Overcoming ad blockers that screw up your conversion data
- Ad blockers can block FB’s tracking libraries and underreport ad conversions (even by 50%). The trick? Consider using the static IMG FB pixel — not the JavaScript one — which ad blockers don’t appear to block. — C.
- Here’s another ad block workaround: You can extract UTM tags from the URL then save them into LocalStorage using JavaScript. Next, send that stored data plus the user’s on-site conversion behavior to a custom backend that, inherently, will circumvent ad blockers. Just be diligent about ensuring your marketing links all have UTM tags. —Neal O’Grady of Demand Curve
- Remember that the use of ad blockers varies heavily by audience and device type. Depending on who your audience is, ad blockers can either be a huge problem or a non-problem. —Neal O’Grady of Demand Curve
- So, for example, few people on mobile have ad blockers. Not much of a problem there.
- However, on desktop, up to ~75% of millennial gamers and techies may have it installed.
- In contrast, on desktop, maybe only 25% of middle-aged Americans outside of tech hub cities may have it installed.
- These are hand-wavy numbers. Google for specifics.
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It’s a new era for fertility tech
Women’s health has long been devoid of technological innovation, but when it comes to fertility options, that’s starting to change. Startups in the space are securing hundreds of millions in venture capital investment, a significant increase to the dearth of funding collected in previous years.
Fertility entrepreneurs are focused on a growing market: couples are choosing to reproduce later in life, an increasing number of female breadwinners are able to make their own decisions about when and how to reproduce, and overall, around 10% of women in the US today have trouble conceiving, according to the Centers for Disease Control and Prevention.
Startups, as a result, are working to improve various pain points in a women’s fertility journey, whether that be with new-age brick-and-mortar clinics, information platforms, mobile applications, wearables, direct-to-consumer medical tests or otherwise.
Although the investment numbers are still relatively small (compared to, say, scooters), the trend is up — here’s the latest from founders and investors in the space.
VCs want to help you get pregnant
Clue, a period and ovulation-tracking app, co-founder and CEO Ida Tin talks at TechCrunch Disrupt Berlin 2017 (Photo by Noam Galai/Getty Images for TechCrunch)
This fall, TechCrunch received a tip that SoftBank, a prolific venture capital firm known for its nearly $100 billion Vision Fund, was investing in Glow, a period-tracking app meant to help women get pregnant. Max Levchin, Glow’s co-founder and a well-known member of the PayPal mafia, succinctly responded to a TechCrunch inquiry regarding the deal via e-mail: “Fairly sure you got this particular story wrong,” he wrote. Glow co-founder and chief executive officer Mike Huang did not respond to multiple requests for comment at the time.
Needless to say, some semblance of a SoftBank fertility deal got this reporter interested in a space that seldom populates tech blogs.
Femtech, a term coined by Ida Tin, the founder of another period and ovulation-tracking app Clue, is defined as any software, diagnostics, products and services that leverage technology to improve women’s health. Femtech, and more specifically the businesses in the fertility and contraception lanes, hasn’t made headlines as often as AI or blockchain technology has, for example. Probably because companies in the sector haven’t closed as many notable venture deals. That’s changing.
The global fertility services market is expected to exceed $21 billion by 2020, according to Technavio. Meanwhile, private investment in the femtech space surpassed $400 million in 2018 after reaching a high of $354 million the previous year, per data collected from PitchBook and Crunchbase. This year already several companies have inked venture deals, including men’s fertility business Dadi and Extend Fertility, which helps women freeze their eggs.
“In the last three to six months, it feels like investor interest has gone through the roof,” Jake Anderson-Bialis, co-founder of FertilityIQ and a former investor at Sequoia Capital, told TechCrunch. “It’s three to four emails a day; people are coming out of the woodwork. It feels like somebody shook the snow globe here and it just hasn’t stopped for months now.”
Dadi, Extend Fertility and FertilityIQ are among a growing list of startups in the fertility space to crop up in recent years. FertilityIQ, for its part, provides a digital platform for fertility patients to research and review doctors and clinics. The company also collects data and issues reports, like this one, which ranked businesses by fertility benefits. Anderson-Bialis launched the platform with his wife, co-founder Deborah Anderson-Bialis, in 2016 after the pair overcame their own set of infertility issues.
Anderson-Bialis said he has recently fielded requests from seed, Series A and growth-stage investors interested in exploring the growing fertility market. His company, however, has yet to raise any outside capital. Why? He doesn’t see FertilityIQ as a venture-scale business, but rather a passion project, and he’s skeptical of the true market opportunity for other businesses in the space.
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Modern Fertility is offering a comprehensive fertility test for women who hope to be moms someday
There are a number of ways to find out more about your fertility these days — including from several at-home fertility test startups that have started to pop up in the last few years. Modern Fertility hopes to soon operate in much the same way, but with a more affordable option for testing 10 key hormones affecting women’s fertility. Read More
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