The following guest post was written by Carolyn Rush, Strategy Director at Koto and a postpartum doula. She explores the growing gap between femtech’s market momentum and its brand maturity, outlining why trust, positioning, and strategy are now make-or-break for health startups.
In 2016, the term “femtech” was mostly synonymous with tracking your cycle. Fast forward almost a decade and it’s now set to become a $100B market in the next five years, covering everything from menopause and mental health to hormone testing and longevity.
But, for all the momentum, the sector’s positioning hasn’t quite kept pace. That’s because there’s a paradox at the heart of femtech. On one hand, the opportunity is huge. Over 80% of women experience a reproductive health issue in their lifetime and obstetrical complications affect more than 33% of women worldwide. Yet femtech companies attract just 2% of total venture capital, and less than 5% of health tech startups focus on women’s health. Even within clinical research, obstetrics accounts for less than 2% of trials in the US, which is a stunning disparity given the scale of unmet need.
Before becoming a strategist at Koto, I was the Head of Brand at Robyn, the first marketplace for integrative maternal wellness providers supporting people through fertility, pregnancy, and postpartum. As one of the early employees, I helped build the MVP product, shape go-to-market strategy, and navigate the fundraising process. Alongside that work, I trained and continue to practise as a birth and postpartum doula, which has deeply informed my view on how support systems for women’s health are designed, both digitally and in real life.
As someone who has worked both inside femtech startups and alongside them in agency settings, I’ve seen the ripple effects of this imbalance firsthand. The result is a sector that’s often underfunded, under-researched, and underestimated – and whose brands are fighting not just for consumer awareness, but for legitimacy.
Part of the challenge is rooted in how women’s health has historically been positioned more as wellness than infrastructure. That framing has helped open up conversations, but it’s also invited confusion, exclusion, and – in some cases – outright harm. Just look at the data privacy concerns surrounding period tracking apps, or how Natural Cycles was sued in 2018 after marketing itself as a form of contraception. These moments haven’t just damaged individual companies, they’ve chipped away at public trust in the sector overall.
There’s no doubt that the stakes are high, because femtech brands aren’t just building products. They’re navigating a space with systemic barriers baked in – from insurance reimbursement to regulatory scrutiny to cultural stigma – so the odds are often stacked against them. Founders in this space need to understand medical research, policy, user psychology, and brand trust all at once, while many are still pre-seed or Series A.
That’s why positioning is more than just a communications exercise in femtech and health. It’s a strategic imperative.
What does a successful femtech brand look like in 2025, then? It’s one that recognises the shift from single-use apps to integrated platforms, from track-your-period tools to multi-touch ecosystems that support users through multiple life stages.
Midi, for instance, is bridging virtual care and hormone therapy for midlife women, while Juno Bio is building better microbiome testing for overlooked conditions. Even Oura – often perceived as a lifestyle tool – is actively pursuing payer partnerships and deeper clinical relevance.
There’s also a noticeable tone shift happening. If 2015–2020 was the “Girlboss era” of femtech – all aspirational storytelling and community-first vibes – we’re now entering a more clinical, data-led phase. AI, at-home diagnostics, and hormone tracking tools are pushing the category closer to biotech, where credibility is currency. Consumers are rightly demanding more evidence and fewer empty claims. (See warnings about unregulated menopause supplements, or Kanya Mano’s Substack on the costly consequences of skipping early consumer testing.)
What’s very clear is that science alone isn’t enough. Adoption still hinges on resonance and on whether a product feels safe, inclusive, and genuinely designed for its users. For that, brand strategy plays a critical role, not just in selling features but in selling commitment. Of course it also helps with marketing efficacy, but first and foremost it helps shape experiences that people trust.
Brand strategy sits at the intersection of audience and culture. When done well, it can go much deeper than a surface level exercise, informing product decisions, go-to-market plans, partnerships and even internal culture. At its core, a strong brand strategy helps you define who you are, what you do, who you’re for, and why you matter. It carves out a clear position in the world and builds a foundation for every layer that follows, like messaging, storytelling, design, community, and growth.
In the femtech category, where emotional resonance and scientific credibility must coexist, brand strategy helps founders balance the two. It helps them build not just a visual identity, but a platform for consistent communication, behaviour, and decision-making. It gives shape to the big vision behind the business and the thing that sets them apart from a wave of increasingly clinical-sounding competitors.
I see the same core question emerging. In a field defined by underfunding, data mistrust, and cultural stigma, how do you build a brand that reassures as much as it resonates?
We have a huge opportunity to move past pinkwashing and surface-level solutions and build femtech brands that are ambitious, rigorous, and radically user-first. To do that, we need to design not just with women in mind, but with them at the table.
Most importantly, we need to acknowledge that femtech isn’t a niche anymore. It’s the future of healthcare.
