The FemTech Foundation—and Fault Lines

In 2015, fewer than 300 ventures focused on women’s health existed. That number has tripled to 942, according to the Galen Growth HealthTech Alpha™ platform. These ventures now span the female health continuum—gynecology, menopause, oncology, cardiovascular disease, mental health and beyond.

Yet the investment tide has not fully turned in FemTech’s favor. While partnerships have risen 15.3-fold during the past decade, capital deployment has grown only 1.4 times. Compare that to the 2.6x expansion of digital health investments. In 2024, FemTech secured $2.2 billion in funding, a sliver of the $26 billion digital-health pie.

This disparity isn’t due to a lack of innovation—quite the opposite. The problem is systemic: funding gaps, policy voids, and clinical blind spots that overlook the $360 billion “ghost market” of women’s health. That phrase— “ghost market”—is the report’s haunting term for the opportunities left untouched by current investors and providers alike.

From Fertility to Full Spectrum

One of the report’s most critical takeaways is how much the FemTech category is maturing. Fertility tracking and pregnancy apps put the field on the map. But FemTech today is far more.  It recognizes the vast need for medicine to engage with women’s unique health needs, long unaddressed.

The Galen Growth data shows that while gynecology and oncology account for more than half of all FemTech ventures, menopause, chronic pain, autoimmune conditions, cardiovascular disease and mental health are surging into the investment and innovation spotlight. These are not “niche” categories—they represent common, often underdiagnosed or misdiagnosed conditions that disproportionately affect women and impair their quality of life.

This expansion reflects a growing recognition that women’s health is not a subset—it’s a central pillar of public health. As de Salaberry writes in a soon-to-appear Health Tech World byline: “To be transformative, FemTech must address the entirety of the women’s health continuum, including those therapeutic areas that are not traditionally branded as female-specific but affect women in distinct ways.”

Twice the Clinical Evidence—But Still Under Scrutiny

Perhaps the report’s most sobering—and telling—data point is that FemTech ventures generate nearly twice the volume of clinical trials, peer-reviewed research, and regulatory filings as their digital health peers. Twice. That’s not due to past scientific rigor; these companies are held to a higher standard. Founders and advocates must go the extra mile to validate the clinical value of their solutions.

Despite this, systemic barriers remain. The report shows 71 percent of early-stage FemTech ventures struggle to raise a Series A round. Funding the “middle”—those post-seed but pre-scaleup companies—is an urgent priority. Without it, too many promising solutions will stall before reaching the women who need them.

Let’s be clear: this isn’t just about meeting investor milestones. It’s about delivering equity in care. Cardiovascular disease is the leading cause of death among women, yet it remains underrepresented in FemTech portfolios. Alzheimer’s and autoimmune conditions disproportionately affect women, yet receive comparatively little innovation focus.

Those are not oversight gaps. They are deep, systemic failures – disparities in our health innovation system.

From Direct-to-Consumer to Deep Health Integration

Another significant signal of maturity is the shift away from pure direct-to-consumer (DTC) models. In 2024, 42 percent of FemTech partnerships involved health systems, up from just 10 percent in 2020. That’s a tectonic shift from point solutions to systemic integration.

As de Salaberry puts it, “DTC strategies alone cannot reach underserved populations or secure the reimbursement pathways necessary for scale.” Systemic integration—through payers, providers, and public institutions—is essential for sustainability and access. FemTech must live where care happens, not just on consumers’ cell phones.

Regionally, the picture is just as telling, with Europe leading in clinical rigor, with 50 percent of FemTech ventures demonstrating proven clinical strength. North America leads in funding ($1.3B), while Asia-Pacific remains a hub of AI-driven diagnostics, even amid a dip in capital investment. These trends point to what’s next: a future driven by localization, clinical excellence and technology convergence.

Forces Shaping the Future of FemTech

The report outlines five key factors shaping the FemTech evolution during the next five years. They’re worth noting for anyone investing, innovating or advocating for equitable care with an eye toward return on investment:

• Redefining the Scope: FemTech must look beyond reproductive health to address chronic diseases, aging, and behavioral health.
• Breaking the DTC Mold: Success will be defined by integrated partnerships with employers, insurers, and health systems.
• Balancing Rigor and Agility: Regulatory requirements must support innovation without stifling it.
• Funding the Growth Gap: Series A and B support is critical to help early innovators scale.
• Smart Consolidation: M&A isn’t just about exits—it’s about building category leaders with breadth and credibility.

Infrastructure, Not Hype

The key here is infrastructure. FemTech is not a trend—it’s the scaffolding of women’s health innovation. Investors need to hear that message and invest to make this population health category viable.

With nearly half the global workforce made up of women, the ROI on women’s health is not just moral—it’s macroeconomic. The health ecosystem can no longer afford to treat women’s health as an edge case. It is, in fact, the core of population health.

FemTech’s next chapter will be shaped by evidence, equity and integration. It must also be underpinned by trust from payers, providers, and patients. That trust is earned through data, outcomes and the bold assertion that women’s health is health, full stop. This Galen Growth Report goes a long way to demonstrating the positive outcomes when innovation and investment converge.

As Julien de Salaberry wisely states: “The next generation of Femtech isn’t about visibility—it’s about value, integration, and health systems impact.” That’s not just a forecast—it’s a framework for what’s next.

[Editor’s Note: For a deeper dive into the Galen Growth FemTech 2025 report, visit galengrowth.com. The full report and press release, are available now.]

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When Selam Solomon Caldwell and her husband learned she was pregnant last year, the stakes for finding the right OB-GYN felt high. Caldwell, a Black woman, had heard stories from family and friends of maternity care providers who ignored their requests or pressured them into cesarean sections without clear medical justification.

As a relative newcomer to Los Angeles, the recruiter, now 31, knew few Black people who could recommend doctors who had treated them with respect. She combed review sites, including Google reviews and Healthgrades, but couldn’t find how nearby physicians and hospitals might treat a Black woman like her.

“It’s hard to tell if it’s a fellow Black person who’s giving the review,” Caldwell said.

Consumer ratings sites rarely identify patient experiences by race or ethnicity and hospitals are under no obligation to reveal the racial and ethnic breakdowns of their patient satisfaction scores. Yet that information could be instrumental in holding maternity care providers and hospitals accountable for treating patients inequitably and could empower expectant mothers like Caldwell in finding quality obstetric care.

“You can’t change what you don’t see,” said Kimberly Seals Allers, founder of Irth, an app allowing Black and brown women to find and leave reviews of maternity care providers. She’s one of a few entrepreneurs developing new tools for collecting feedback from mothers of color.

A steady drip of new research over the past several years has spotlighted racial discrimination by maternity care providers and the role it may play in one of the country’s most vexing health disparities: Black women experience the worst birthing outcomes, a gap not explained by income or education, according to a KFF analysis. In 2021, they were nearly three times as likely to die of pregnancy-related causes as white women.

Mothers of color, especially Black women, report that they do in fact experience discrimination. They are more likely than white women to say that their care providers ignored them, scolded them, or pressured them into treatments they didn’t want. The extent to which discrimination is reported varies widely by survey, but one recently published report by the Centers for Disease Control and Prevention found roughly 30% of Black, Hispanic, and multiracial women reported mistreatment during maternity care, compared with 20% of women overall.

It’s unclear how many hospitals track survey responses by race, and, even if they do, they rarely reveal that information. And the federal government requires generic reporting on how patients say they were treated, making it difficult to pin down and address incidents of bias in maternity care.

Funding and Regulations Lag

Currently, the results of the industry’s standard patient experience survey, known as the Hospital Consumer Assessment of Healthcare Providers and Systems, are made publicly available by the federal government to help patients compare hospitals. They incentivize hospitals to improve care and are included in the rankings of many hospital ratings sites, such as U.S. News & World Report’s Best Hospitals. But it doesn’t ask about maternity care or discrimination and has low response rates, particularly among people of color.

These flaws can also make the survey inadequate for improving birth equity. “We know it’s insufficient,” said Amanda P. Williams, an OB-GYN and clinical innovation adviser to the nonprofit California Maternal Quality Care Collaborative. Hospitals, she said, could fill in the gaps by collecting feedback from maternity care surveys and breaking the results out by race and other demographic information; they could also talk to patients through forums such as town halls or focus groups.

Joy Lewis, senior vice president for health equity strategies at the American Hospital Association, said many hospitals do this work, both generally and in obstetrics.

However, Williams believes it isn’t happening enough in maternity care.

She said there are some pockets where people are doing these activities but that they are not yet widespread. At a national conference of 200 hospital executives this year, Williams said, only a few raised their hands when asked if they break out their maternity outcomes data. “If your overall C-section rate is fine, you might think everything’s hunky-dory,” she said. “But if you see that your Black people are having 50% higher C-section rates than your white and Asian patients, there’s very important work to be done.”

Then there are barriers to participation. Studies have found many in the Black community distrust the health care system.

Fearing retaliation and being seen as an “angry Black woman,” Ta-She-Ra Manning, a maternal health program coordinator in Fresno, California, said she didn’t provide any critical feedback when her OB-GYN dismissed her concerns about unusual symptoms during her 2021 pregnancy.

Meanwhile, new funding to measure disparities has been slow in coming. President Biden’s 2023 budget proposed $7.4 million to develop a supplemental survey aimed at reducing maternal health disparities, among other steps. But Congress did not fund the item. Instead, an agency in the Department of Health and Human Services is developing it with its own funding and estimates the work will take less than five years, according to a statement from Caren Ginsberg, who directs the agency’s surveys.

Still, the public likely won’t see changes anytime soon. After a survey’s measures are created, it can take several years for the results to be publicly reported or tied to payment, said Carol Sakala, senior director for maternal health at the National Partnership for Women & Families, an advocacy organization.

“This molasses level of movement contrasts acutely with all the things hitting the news about people not getting the right care and attention and respect,” Sakala said.

Amid growing interest in health equity, traditional ratings sites are grappling with how much to share with the public. For its birthing hospital ratings, U.S. News & World Report recently started assessing whether hospitals tracked racial disparities in maternity outcomes measures, but it withholds actual results. Healthgrades is taking time to think through how to collect and display sensitive information publicly, said spokesperson Sarah Javors in a statement.

Black Innovators Fight for Better Data

Some Black women are trying to fill the void by creating new feedback mechanisms that could be more trusted by the community. Allers said she created Irth after a traumatic birth experience as a Black mother at a highly rated hospital left her feeling failed by mainstream ratings. On the app, verified users answer questions, from whether they felt respected by their doctor to if they experienced certain types of mistreatment such as dismissal of pain. Irth currently has 10,000 reviews of hospitals, OB-GYNs, and pediatricians nationally, according to Allers.

“Our data is for the community,” said Allers. “They know their feedback has value to another mom or family.”

Irth also offers analysis of the reviews to hospitals and leads campaigns to collect more reviews for them. But Allers said many hospitals have expressed little interest.

Karen Scott, an OB-GYN who created PREM-OB, a scientifically validated survey that measures racism in Black birthing experiences, said she has met hospital leaders who don’t think their providers could mistreat patients or who worry that documenting responses could carry legal risk.

The American Hospital Association’s Lewis declined to comment specifically on Irth and PREM-OB but acknowledged the Black community’s long-standing mistrust of health care providers. She said hospitals want to hear more from patients in historically marginalized groups.

Early signs of progress are emerging in parts of the country.

California hospitals will likely report disparities in birth outcomes and patient satisfaction measures. Hospitals are expected to start posting data broken out by race and other demographics on their websites in 2026, though the state hasn’t finalized the measures that will be required, said Andrew DiLuccia, a spokesperson for the state’s health data agency. At least two states, Washington and New Jersey, have disclosed rates of C-sections among low-risk patients by race for individual hospitals.

Scott founded Birthing Cultural Rigor to increase uptake of her survey. The firm has partnered with birth equity groups to recruit respondents in select counties in Georgia, Michigan, Ohio, and Tennessee. Scott said results will be used to train local health professionals on how to reduce racism in maternity care.

Separately, Irth will collect and analyze reviews for three hospitals or health systems in California, said Allers. One of them, MemorialCare Miller Children’s and Women’s Hospital Long Beach, will work with Irth to better understand the impact of birth equity efforts such as implicit bias training.

“We’ll get to see if what we’re doing is actually working,” said Sharilyn Kelly, executive director of the hospital’s perinatal services.

Caldwell, the recruiter, eventually found a doctor she trusted and went on to have a smooth pregnancy and delivery. Her son is now 8 months old. But with so little information available on how she might be treated, she said, she felt anxious until she met her doctor, when “a lot of that stress and anxiety melted away.”

Digital strategy & audience engagement editor Chaseedaw Giles contributed to this report.

[Editor’s note: California Healthline is an editorially independent service of the California Health Care Foundation, which has contributed funding to PREM-OB and the birth equity nonprofit Narrative Nation, which developed Irth.]

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

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The clinics, spread over two floors and 180 sqm, will house a resident OB-GYN and pediatrician with access to the latest medical technology. Expectant mothers will also benefit from on-site birthing facilities in a country with high maternal mortality.  The pilot clinics will be built in Albay, a rural region of Luzon, the Philippines’ largest island. The Philippines is home to approx. 140 million people, many of whom still live below the poverty line.

“Statistics tell the relentless story of needless suffering and death,” reflects Clinics IV Life Founder. Robert Turner.  “For decades we’ve thrown billions of dollars in aid each year at the problem. It remains and, in many instances, worsens year to year. Historical charitable models are flawed.”  Turner adds: “Clinics IV Life was launched by seasoned health professionals who seek to address these shortcomings in novel ways. Our hybrid clinic model removes the need for continued donor funding and integrates into local healthcare systems, removing the dependencies created by historical charitable efforts.”

Each clinic aims to treat 1000 indigent patients annually, making inroads on the high maternal and infant mortality levels plaguing developing nations. The first of the three clinics earmarked for Luzon will open in 2024, followed by openings in late 2024 and 2025. Access to care remains one of the critical reasons mothers die in childbirth.  The leading causes of maternal mortality in the Philippines – like in many emerging nations – include challenges that can be prevented with medical oversight, such as bleeding, infection, unsafe abortion, hypertensive disorders and obstructed labor.

A NEW ECONOMIC MODEL FOR SUSTAINABILITY

Their clinic model relies on a unique shared practice agreement that ensures its clinics are self-sustaining, removing the need for the continued use of donor funds beyond construction and equipping a site. The Not-for-Profit plans to extend its reach into India, Africa and other Asian countries during the next three years.

Unlike traditional charitable models, Clinics for Life will not seek funding from the general public. 

“We form close corporate partnerships with companies that serve the maternal and newborn health markets and share our vision. Our clinic model offers the best ROI in terms of corporate giving. We pair each clinic with a corporate partner and for a single donation a company can generate more than 30 years of health impact in a community. It’s a gift that keeps on giving; both for the patients and the donors,” says Kemi Olugemo, chair of Clinics IV Life’s Fundraising Board, on their approach to funding.

ABOUT MATERNAL AND INFANT MORTALITY 

Every minute, around the globe, four newborns die; every two minutes, an expectant woman dies, often in childbirth. It is estimated that 85% of these deaths, primarily occurring in developing countries, are avoidable with access to proper medical care. In India alone last year, 2.7 million babies were stillborn, and nearly 600 thousand died in their first month.

Historically, women suffer more from health inequalities and require more complex medical interventions than their male counterparts on a more frequent basis. Access to procedures taken for granted in developed nations, like ultrasounds and fetal monitoring, are luxuries in developing countries, only affordable to those with money. 

ABOUT CLINICS IV LIFE 

Clinics IV Life was created specifically to address these health inequities that are commonplace in emerging nations. Their hybrid clinic model overcomes continued reliance on donor funding by creating self-sustaining businesses, obviating the need for financial donor support to ensure the ongoing success of each clinic. Donor funds are only utilized for the construction and equipping of a clinic.

Clinics IV Life views every element of the patient-provider ecosystem as being of equal value, and places great emphasis on ensuring its doctors, nurses and staff can serve their patients in a safe, secure and welcoming environment while having access to the latest medical technology and training and a global network of knowledge provided by colleagues who selflessly volunteer their time and skills.

The Clinics IV Life board of directors includes physicians, pharmacists, psychologists, public health professionals and business leaders who have brought their knowledge, connections and resources to this needed cause.  

Find out more by visiting: https://clinics4life.com/

Clinic IV Life Board members and industry advisors include: 

• Robert Turner – Founding Board Member
• Kemi Olugemo MD FAAN – Chair, Fundraising and Board of Directors
• Shazia Ahmad
• Gil Bashe – Board of Directors
• Grace Delerme
• Hesham Hassaballa MD
• Sharon Handelman-Gotlib
• Karie Hudson MS
• Viveca Livezey MD FAAN
• Jeff Livingston MD, Board of Directors
• Kellie Lease Stecher MD
• Dr. Soojin Jun
• Tom Krohn
• Teresita Pulgarin 
• Bianca Rose Phillips LLB. BComm. GradDipLP. LLM 

Media Contacts:

Kemi Olugemo, MD, FAAN
Board Chair, Fundraising
Tel: +1 (781) 226 0429
Email: kemi.olugemo@clinics4life.com

Gil Bashe
Board Chair, Executive
Cell: +1 (732) 371-0922
Email: gil.bashe@finnpartners.com

The post Clinics IV Life Launches a New Clinic Model to Change the Face of Charitable Maternal Care, Delivery to Impoverished Communities appeared first on Medika Life.

As a long-time supporter of Democrats, I’ve been forced into an awful realization during the past few years. None of what transpires under their governance is for the interests of the people they govern. While I am not suggesting the opposite is true of the Republicans, there is one critical difference. When called on to act, however reprehensible the calls may appear to us, steadfast Republican supporters respond.

The Nashville school shooting simply attests to this fact. How? Simply by the fact that the voice of power for unchecked gun ownership is driven primarily by Republicans. They are passionate and they are committed. The issue of abortion is another excellent example of how a dedicated and carefully construed Republican plan to eliminate women’s access to this life-saving option was like a steamroller flattening the people it most affects. How the Senate Majority Leader Mitch McConnell and then President Trump worked diligently to stack a Supreme Court with like-minded jurors?

While I type this, Republicans are in the last quarter of a fiendishly well-orchestrated campaign that, in its final steps, will, through a judge in Texas, overrule the FDA approval of a drug that doctors have relied on for decades to induce abortion safely. Where are the Democrats, you ask? Uncomfortably quiet. As they were when Roe v. Wade was overturned.

You see, Democrats absolutely do care, the truth is they may even voice outrage, but at the end of the day, they lack the “true grit” to do what is necessary to ensure the safety of their wives and their children. They don’t dare to stand up for themselves, and for this simple reason, Republicans will continue to ride roughshod over you like sheep. Unlike Charlton Heston’s mantra from the May 20, 2000, National Rifle Association national meeting, they don’t exhibit sufficient fire in the belly to cry out the sensible alternative to: “You can have my gun when you pry it from my cold, dead hands.” 

Before you accuse me of being harsh, let’s examine the issue of gun control and ownership of high-powered, semi-automatic weapons like the AR15, the homicidal maniac’s weapon of choice. After every school shooting, the public sings the same refrain. “This has to stop,” and “let this be the last, ” knowing it will never be. After all, didn’t we think Sandy Hook would be the last? How many lasts have happened since that horrific shooting – a war against children?

A reality check for those who still believe in your elected politicians to look after your best interests. How did the pandemic go, how’s that women’s right to choose plan looking, and is there a bipartisan bill to outlaw AR15s moving through both Houses of Congress? Thought not. Biden and co. will issue platitudes of ire on social media and make passionate statements; a week will pass. Then, like with all the previous atrocities committed in schools, it will be forgotten by all but the bereaved parents, traumatized classmates and teachers – forever emotionally scared.

Your Child Could be Next!!!

If you are privileged enough, do not think you can homeschool your child to adulthood in complete safety either. Shooting in malls, movie theaters, dance clubs and churches mean that nowhere on U.S. soil is your child beyond the reach of these armed maniacs, often themselves only recently children.

You know the risks to your children, and yet you still choose to do nothing. Where is the communal outrage of people assembling and marching in the streets? Since the Vietnam War, America has forsaken its power and the mechanisms of civil disobedience. Even the French shame you and the Republicans; they laugh, load their guns, and head off to the range. They photograph themselves and their families holding AR15s and standing in front of the family Christmas Tree on election campaign greeting cards.

Stopping This Madness is Possible!

It would be best if you acted as a united front to protect your children across the US, and strikes are the most effective means of achieving this. They require no confrontation, and send a message those in power cannot ignore. Act now, or suffer the consequences at the next election, and if you have children of your own, I pity them if you continue to sit idle. If for these two issues alone – choice and gun safety – rally and elect representatives who unite to keep people safe.

Boycott schools, keep your children home, shut down all educational institutions, mobilize the support of academia, administration and teachers who are also in the line of fire and make your voices heard, for the sake of your children and your country’s future. The world is watching and your children are living in fear. School is now a battlefield. Children are sent in buses to the front. Consider the mental anguish you are exposing your children to by your inaction. Consider the mental health of future generations.

While you’re about it, do right by your wives and partners, do right by the women you know and rely on for so much, do right by your daughters, and show them the support they deserve. Stand up for them in the same voice and help restore their access to choice. Help them restore their access to essential healthcare. Support for mothers, sisters, daughters and all children is a shared responsibility. Do not shirk away from this responsibility, I implore you.

The post Trump’s America. Deride Them, But They are Better Than You appeared first on Medika Life.

I worked with Allison to develop an individualized treatment plan that addressed nutrition (she wanted to adopt the Mediterranean diet since it seemed sustainable), exercise (we identified several forms of physical activity she enjoyed that fit her schedule) and behavior modification (for example, we shifted her meal timing earlier and discussed techniques to avoid stress-eating). As part of this plan, we also started on metformin, a great option in cases like hers, because it can help with weight loss, it can help restore ovulation, and it is generally considered safe to take during pregnancy.

After a few months, Allison had lost 20 pounds and she began to ovulate; however, she had not yet conceived so she elected to start fertility treatment.

This meant her weight management program would be even more critical.

Weight gain associated with fertility treatment

Since hormones affect weight, hormonal therapy to enhance ovulation (whether pills or the multiple shots that the in vitro fertilization process entails) often leads to weight gain. This gain can be significant, especially for patients with insulin resistance and patients who, like Allison, have overweight or obesity.

While we don’t want to add to patients’ anxiety during the stress of fertility treatment, it is important for us as providers to be mindful of the potential for weight gain. Fertility-treatment-related weight gain can have a long-term impact because successful treatment means pregnancy — and thus pregnancy weight gain — and it’s often difficult to lose the cumulative excess pounds afterward. For women with multiple pregnancies, the extra weight can add up quickly. One of my patients, for example, gained 70 pounds with her first pregnancy and then lost only 20 pounds before conceiving again. She presented to me during her second pregnancy, and we’re working on strategies to avoid excessive weight gain this time.

Excess weight is associated with various health complications during pregnancy, including hypertension, diabetes, obstructive sleep apnea and preeclampsia, as well as an increase in the child’s risk of congenital anomalies. Women’s healthcare providers often hesitate to bring up the topic of weight, but both mother and baby could benefit significantly if more fertility specialists and OB-GYNs (nonjudgmentally) asked patients’ permission to discuss the issue — and then monitored their weight at appointments and took appropriate action as needed.

Managing weight during fertility treatment

Cases like Allison’s are extremely common, so it’s important for women’s healthcare providers of all kinds to be aware of the options and limitations of weight management during fertility treatment. Most anti-obesity medications are off the table for patients during this time, but there are still a number of steps practitioners can take to help their patients avoid excessive weight gain:

• Optimize lifestyle interventions. Dietary strategies, physical activity and recommended behavioral modifications may be more effective when tailored to the patient’s specific lifestyle. Referrals to outside resources, such as a dietitian or behavioral therapist, for instance, can be great options if additional support is needed.

• Address other contributors to weight gain. Stress, lack of sleep and many factors unrelated to the conventional diet-and-exercise combo contribute to weight gain, and all of these contributors may be in play during fertility treatment. Patients benefit from a personalized plan that addresses these as well.

• Assess for drug-induced weight gain. Many medications are known to promote weight gain, so consider pausing these medications or reducing the dose during fertility treatment, if possible, when substitution with weight-neutral agents isn’t an option. Critical medications obviously need to be maintained, but a risk-benefit analysis might suggest that others should be discontinued.

• Consider prescribing metformin. Some gynecologists and reproductive endocrinologists may be comfortable prescribing the diabetes medication, metformin, for patients with overweight, obesity or insulin resistance, or for those at high risk of weight gain. In addition to improving insulin sensitivity and helping to balance hormones, metformin is a weight-loss-promoting medication and can thus help decrease weight gain associated with fertility treatment.

• Refer to an obesity medicine specialist. While we generally can’t use anti-obesity medications during fertility treatment, patients may benefit from a comprehensive medical evaluation and a personalized treatment plan. A thorough plan is particularly important when a patient is unable to conceive quickly and undergoes fertility treatment for a prolonged period. (I currently have one patient, for example, who has gained 40 pounds over the course of seven months of fertility treatments and still isn’t pregnant.)

Supporting better outcomes for mother and child

Women with overweight or obesity who plan to become pregnant are often counseled to lose weight before trying to conceive, both to enhance fertility and to reduce the risk of health complications for themselves and their babies. This recommendation often becomes more explicit before a woman begins fertility treatment — and obesity medicine specialists like me receive many referrals at this juncture.

The more time we have to treat a patient’s obesity beforehand, the more we can do, of course, but we can still help even after treatment begins. While managing weight during fertility treatment is a challenge, it’s not a lost cause. Taking steps to counteract the potentially weight-promoting effects of hormone therapy can significantly impact the health of the woman and her future child. This is a challenge that impacts many generations to come. We can do this together!

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The breast cancer death rate dropped by nearly half (43 percent) from 1989 to 2020, according to findings published in CA: A Cancer Journal for Clinicians. Unfortunately, racial disparities persist.

This decline in breast cancer death rates is significant and may be attributed to earlier detection through awareness and screening plus management advances. While I welcome the improvements in breast cancer mortality, I want to focus on some key ways you may reduce your risk of being diagnosed with breast cancer.

Let’s get to the top ways to significantly reduce your chances of getting (or dying from) breast cancer.

1. Don’t smoke.

If you currently smoke cigarettes (and have for more than ten years), you have a higher risk of developing breast cancer. This finding is not particularly surprising, nor is the fact that the duration of smoking matters: Those smoking for 40 years have a 1.6-times greater risk of breast cancer than non-smokers.

Moreover, the number of years smoked before a first full-term pregnancy appeared to be associated with a higher risk of breast cancer than comparative years smoked after pregnancy. Cigarettes are linked to breast cancer development, and the timing of the smoking exposure matters.

Whether women who previously smoked have a higher risk of breast cancer remains under investigation.

2. Breastfeed

Breastfeeding is associated with slightly lower breast cancer risk, especially for those who opt to nurse for a year or more.

Breastfeeding is associated with only a modest risk reduction; a large pooled analysis that included individual data from 47 studies (including about 50,000 women with invasive breast cancer and 97,000 controls) estimated that for every year of breastfeeding, there appeared to be a 4.3 percent reduction in the relative risk of breast cancer. If your risk had been 15 percent, breastfeeding might drop by slightly less than one percent.

3. Postmenopausal weight loss

Some, but not all, studies show that weight loss in postmenopausal women may reduce breast cancer risk. For example, a meta-analysis that included 237,000 women with breast cancer (and four million controls) discovered weight loss associated with nearly one-fifth (18 percent) lower breast cancer risk.

The Nurse’s Health Study prospectively assessed weight change since menopause among approximately 50,000 women followed up to 24 years. Here are the results:

Women with no prior hormone therapy use who maintained a weight loss of at least 10 kilograms (22 pounds) had more than a halving of breast cancer risk than women who did not.

4. Child-bearing

A full-term pregnancy affects breast cancer, but this influence hinges upon the age of the first full-term birth. Women bearing children later in life have an increase in breast cancer risk.

The Nurses’ Health Study looked at women who never delivered a baby compared with child-bearing women. The cumulative incidence of breast cancer by age 70, compared with a woman bearing no children, was as follows:

• For women delivering a first child at age 20, the risk dropped by one-fifth (for a woman with a one in eight baseline risk in the USA or many parts of northern Europe, a decrease by about two to three percent).
• For women delivering a first child at age 25, the breast cancer risk dropped by one-tenth or just over one percent for a woman at average risk in the United States.
• For women delivering a first child at 35, the breast cancer risk rose by one-twentieth. This risk is comparable to a woman who never had a full-term pregnancy.

Breast cells fully differentiate during and after pregnancy, which may protect the breast from cancer. On the other hand, having a first birth at a later age may increase the risk by giving additional stimulation to breast cells that are more likely to develop (and more likely to be damaged).

5. Move

The available research suggests that physical activity is associated with a lower risk of breast cancer. A meta-analysis of 139 studies discovered:

Higher physical activity levels appeared to lower breast cancer risk by nearly one-quarter (a drop by 22 percent in relative risk). This risk reduction appeared similar in pre- and postmenopausal women and for high- versus light-intensity movement.

Because higher weight in premenopausal women is associated with a lower breast cancer risk (higher weight raises the risk in postmenopausal women), the drop in risk is not because of weight loss associated with physical activity.

Blood levels of hormones (such as estrogen), insulin, and insulin growth factor-1 (IGF-1) may impact risk.

6. Watch the alcohol

Alcohol consumption is associated with a higher risk of breast cancer driven by estrogen or progesterone hormones. For example, a study of nearly 52,000 postmenopausal Swedish women discovered this:

Increased alcohol intake appeared associated with estrogen receptor-positive breast cancer, with a 1.35-fold increase (if you have a baseline risk of 12 percent, it will rise by about four percent).

Could folic acid intake decrease the alcohol-associated increase in breast cancer risk? Observational studies hint that those who consume alcohol should take a multivitamin with folic acid, but our grain has supplemental folate in the USA.

7. Get appropriate screening

Women between the ages of 40 and 44 should consider beginning annual mammograms. Women ages 44 to 54 years should have annual screening, and those 55 and older have the option to test every one or two years. Breast cancers discovered by annual mammograms are usually smaller and less advanced than those discovered during mammograms every two years.

8. Get to know your genes

Modern medicine has made assessing one’s risk of developing various forms of cancer much simpler. This understanding of risk can be especially helpful for women with inherited gene mutations that make them particularly vulnerable to breast cancer. The American Cancer Society explains, “When it comes to breast cancer risk, the most important inherited gene changes are in the BRCA1 and BRCA2 genes. Women (and men) with one of these gene changes are said to have Hereditary Breast and Ovarian Cancer (HBOC) syndrome.”

9. Risk-reducing surgery or medicines

Some medicines may significantly reduce the chances of developing the disease for women with a higher-than-average breast cancer risk. Because risk-reducing drugs such as tamoxifen, raloxifene, or aromatase inhibitors have potential side effects, you will need to balance the pros and cons of the medicine.

This approach of using medicines to help reduce disease risk is chemoprevention. If you are considering this approach, first have a health care provider help determine your breast cancer risk.

The American Cancer Society explains that some important breast cancer risk factors include:

• Older age
• Having close relatives with a breast cancer history
• Having more menstrual cycles
• Having a history of invasive breast cancer or ductal carcinoma in situ (DCIS)
• A history of breast lobular carcinoma in situ (LCIS, atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
• Having a gene mutation associated with a family cancer syndrome (such as a BRCA mutation)

10. Eat well

A limited number of studies suggest that there may be a connection between eating fruits and vegetables regularly and a lower risk of developing some aggressive forms of breast cancer.

I hope this article helps you understand how lifestyle influences breast cancer risk. Thank you for joining me today.

The post 10 Top Tips to Drop Your Breast Cancer Risk appeared first on Medika Life.

The past week has been difficult for liberally-minded individuals in the United States. Through a series of Supreme Court rulings, citizens lost several fundamental rights. Miranda rights, mandating that those arrested are informed of their rights, and Roe v Wade, giving women freedom in their reproductive health choices, were both repealed. The latter is particularly troubling for me as a physician, given the substantial evidence of harm when women’s bodies are under the state’s control rather than a woman’s (read a detailed statement by the Journal of the American Medical Association here). Why would someone ignore clear evidence that something can overall improve the lives of citizens?

These next few years will see an increase in women dying from complications of forced pregnancies and poverty. Pregnancy can be hazardous for some women, such as those at risk of blood clots. Being prevented from having an abortion can leave a woman (and her fetus) vulnerable to permanent disability from a stroke and blood clot, even if put on anticoagulants. Women with chronic conditions could be required to stop their medications if they accidentally become pregnant due to known toxicity against the fetus, exacerbating health crises that could harm both the woman and her fetus. Finally, women without the financial resources to support the medical appointments required for a healthy pregnancy, not to mention helping a born child and subsequently affording pediatrician appointments, will often have to take on debt, limiting their and their child’s lifetime achievement. Why restrict family planning methods while at the same time opposing funding towards supporting those with less financial resources?

This article is not about showcasing this decision placing discriminatory burdens overwhelmingly on the poor and people of colour. It is about finding peace today, so together, we can maintain a state of mind needed to ensure women regain the rights they lost and gain even more, given that women were not treated as equals to men even before this decision. Read on to learn how you can find peace in our more troubled world.

There are many ways that one can respond to life stressors. In psychiatry, they are classified as mature and immature ego defences, briefly summarized by Psychology Today here. Mature defences typically lead to more lasting relief of suffering, whereas immature ones can propagate it. Examples of mature defences include using humour, converting one’s suffering into doing good (altruism), and converting one’s suffering into a passion for one’s work or hobbies. Examples of immature defences include passive aggression that can harm one’s interpersonal relationships, acting out where one may seek peace through purchasing copious amounts of financial goods or excess consumption of alcohol, or denial where one cannot acknowledge the reality of a given situation.

Fortunately, through mindfulness and practice, one can learn to replace immature ego defences with mature ones, as I have done throughout my adult life. While it took effort, feeling at greater peace with myself and my life choices affords me more energy to invest in others and my hobbies. It has helped me pursue advocacy work with global health and challenge COVID-19 misinformation. But how does one foster these mature ego defences?

Altruism:

Altruism is where one challenges their suffering by doing kind things for others. So when one is perhaps facing guilt over harmful comments said to a romantic partner or friend during a disagreement, one could challenge this by doing something nice for them or simply apologizing. In another scenario, when one is worried about their parents getting older or an illness in the family, one could pursue volunteer work at their local hospital or homeless shelter. Lastly, if one is feeling hopeless, given the recent Supreme Court rulings, one could become an advocate for those seeking to exercise autonomy over their reproductive choices. There is much one could do towards this principle, with one simply needing to feel like they are improving another person’s life. Tell me in a comment the ways you like to help others.

Humour:

Humour is when one can attempt to make light of difficult situations to ease the felt burden. For students or working professionals, one could make jokes about how a pressing deadline was good for their skin because they did not have much time for showering. However, one should be careful about humour because it can be easy to tell a “joke” that hurts someone’s feelings or propagates harmful ideas, which could lead to a disagreement and more suffering. Making jokes about your boss due to an increased workload or being required to work on weekends could easily strain that relationship, potentially leading to one becoming unemployed. Suggesting calls for violence are “jokes” can make others feel unsafe, causing others to suffer and fear for their lives. Such logic was used by individuals who stormed the Capital on January 6, 2021.

Sublimation and Suppression:

Sublimation is where one converts the energy or suffering from an “unacceptable action” into an action that is more acceptable. So instead of shouting at a driver who cut you off in traffic, you put those feelings on hold (suppression) and bring all that energy out in your video game or gym/sports session later that day. Rather than sending a passive-aggressive message to a friend who you feel did not return your call or text message fast enough, you can take care of chores in your apartment or house instead. Rather than telling people on the internet who do not share your views that they and their opinions are worthless, regardless of the topic, one can volunteer with organizations that advance the issue you care about. Clearly, these mature defences can overlap.

Sometimes it can feel like the world is collapsing around us. There is a certain amount of truth to this as the status quo seemingly continues with the rich getting richer, the poor getting poorer, and inequality becoming more of a norm than the exception. Like Siddhartha Gautama, I too find it startling, for example, that wealth can be juxtaposed on the same street with poverty. In Montreal, I see beggars looking for donations on the side of the road as Ferraris drive by. That suggests that something is not right with our society as it stands. Feeling frustration is a perfectly acceptable reaction. What is important is what we do with those feelings. We can react to our world in a way that harms us and others, or we can face our challenges in a way that motivates equality and prosperity. We can wallow in fear and misery, or we can take those feelings and make something better of them. It is not always easy to do the latter. We can get stuck with the former. What is important is that we ultimately find the strength inside ourselves to overcome our limitations and create a more equal world collectively.

The post Medical Buddhism appeared first on Medika Life.

Earlier this year she was named one of the 50 top healthcare influencers by respected journal Medika Life  – in part a recognition of her work addressing inequalities, racism and sexism in maternal health.

The post HT World Correspondent and Medika Editor Gil Bashe Talks with the Medika50 Influencer Who Put Everything On the Line for Patients appeared first on Medika Life.

There is no shortage of people who carry excess weight but have impeccable blood pressure and cholesterol levels and no known health problems. Consider the example of professional athletes whose livelihoods are dependent on being heavy, such as football linemen or sumo wrestlers.

At first glance, it is easy to notice their rotund shape, but they also possess greater physical endurance and strength than the average person. On the other hand, some maintain a thin figure but eat poorly, seldom exercise, and have a host of health issues.  Granted, most of us don’t train like professional athletes but it gets to the heart of the question: What matters more when it comes to health– weight or fitness?

Some studies do suggest that regular physical activity can mitigate some of the negative effects of being overweight, which does lend credibility to the idea of being both. Regardless of your weight, exercising regularly is sure to be a good thing. However, even when controlling for physical activity level, those who are overweight tend to be at higher risk of disease than their normal-weight peers.

Here are three reasons why being overweight does not always harmonize with being fit:

1. Fat is a hormonally and metabolically active tissue – Fat cells do more than just add inches. They can influence the balance of hormones and energy systems in our bodies. For example, fat cells can increase cortisol levels, which can further contribute to weight gain, and can promote insulin resistance, which can lead to diabetes.   It can also release substances that contribute to a steady level of chronic inflammation in the body – which increases risk of some cancers.
2. Excess weight, irrespective of fitness level, can be a risk factor for development of disease. While some people may be overweight but still maintain healthy blood pressure, cholesterol, and glucose levels, it is important to recognize that they are a snapshot of their present health status. The reality is that being chronically overweight carries the risk of developing other health problems in the future, although there is no way to predict exactly when that might occur.  Health is about the long-term strategy. Some of these health problems include diabetes, high blood pressure, heart disease, and stroke. Certainly, maintaining a regular physical activity regimen to keep fit may delay the development of these conditions, but losing body fat is another important way to reduce the risk of developing them.
3. Carrying extra fat can put undue stress on various body structures. Many discussions about fitness focus on cardiovascular health and reducing the risk of some cancers, but being overweight can also worsen back and joint pain. Chronic back and joint pains are significant causes of disability as we get older.  Extra fat around the neck can also contribute to the development of obstructive sleep apnea by causing the airway to collapse while sleeping.

The COVID pandemic has taught us important lessons about the importance of self-care. It’s not just about our lifespan, but also our health span.  That requires each of us to do our part in striving for a healthier lifestyle, whether that means eating more healthfully, exercising more consistently, or implementing better stress reduction techniques. While it’s possible to achieve good health despite being overweight, reducing excess body fat is yet another way to further optimize health and fitness and reduce the development of chronic disease.

The post How Many Pounds You Weigh vs How Fit You Are… appeared first on Medika Life.

This is particularly true for women who’ve been through childbirth.

A hernia can often present with symptoms that on the surface, appear to be totally unrelated and it’s easy to misdiagnose these as heartburn, tummy trouble, or a host of other things. You shouldn’t self-diagnose, particularly if you have persistent symptoms. Your doctor is best placed to correctly assess your health.

Symptoms that persist over time and are accompanied by pain, even mild, are your body’s way of telling you somethings up. Don’t ignore them.

Women are particularly prone to developing umbilical hernias near the belly button and smaller, less noticeable hernias (little, to no bulge) which can be misdiagnosed as fibroids, ovarian cysts, or endometriosis based on the region of pain. Getting a cramp or painful sensation in your belly when you have a good laugh? That could very well be an umbilical hernia.

The symptoms listed below are commonly associated with other conditions but can be an indicator of a silent hernia and if you suffer continuously from one or more of these symptoms consider chatting to your doctor.

Constipation

Constipation can mean there is a blockage or constriction in the large intestine that is interfering with digestion. This symptom is often accompanied by a difficulty to pass gas, and you’ll feel bloated.

Heartburn

This is probably the hardest symptom to associate with a hernia as there is a list of conditions as long as your arm that could potentially cause heartburn. A hiatal hernia in the upper abdomen can cause a feeling like heartburn along with chest pain. It allows stomach acid to leak into the esophagus causing inflammation which mimics heartburn.

The ‘heartburn’ associated with a hiatal hernia will be particularly pronounced when you are lying down on a flat surface. Activity in this position (I won’t elaborate) can also drastically aggravate symptoms. Elevating the head of your bead slightly or propping yourself up with pillows while you sleep will help reduce acid reflux.

Feeling Full

An inguinal hernia can lead to a person feeling like they had an enormous meal when in fact they did not. This is a very common type of hernia and can also make you feel bloated. It is often accompanied by pain in the groin and lower abdomen.

Inguinal hernias are also fairly common in women and often overlooked. They are notoriously difficult to diagnose because sonograms and CT scans don’t always pick them up. These can present with chronic lower abdominal pain as a distinctive symptom.

Nausea And Vomiting

These aren’t symptoms we would normally associate with a hernia, but an upset stomach can indicate a serious condition known as an incarcerated hernia. In these cases, the hernia doesn’t return in place by a gentle push and can require immediate medical attention. If you’ve ever had appendicitis the feeling and the pain associated are not dissimilar.

Abdominal pain that leads to nausea and vomiting should be considered a medical emergency and you should seek immediate medical assistance.

Fever

A fever in conjunction with a hernia is a sign that you need medical assistance. The fever can be indicative of a “strangulated” hernia which is not getting enough blood flow and you will require immediate medical assistance. If you develop a fever that is accompanied by any of the other symptoms listed here, then that fever may be related to a hernia.

Pain Induced by Movement

If you experience pain when you lift heavy objects, or a feeling of pressure in your abdomen when you bend over this could be a silent indicator of a hernia. Other common signs to be aware of are pain when you cough and tightness in the groin or abdomen.

Pain In your Pelvic Area

As they rarely cause a noticeable bulge, some hernias in women are misdiagnosed as fibroids, ovarian cysts, or endometriosis, based on the region of pain you are experiencing. Occasionally, these small but very painful hernias may cause pain in your legs or back. An MRI is usually required to correctly identify the source of the pain.

For women, umbilical hernias near the belly button are an issue and you are prone to these, particularly after childbirth. Labor can also result in a hernia, particularly when the birth weight is high. If you experience pain every time you have a good laugh, that can be a hidden sign of this type of hernia.

Weakness

Occasionally a feeling of muscle fatigue and weakness in the upper leg and groin can be a sign of a hernia. Consider the other symptoms mentioned above if you are experiencing this and speak to your healthcare provider.

The post Women Need to be Aware of These Eight Silent Signs of a Hernia appeared first on Medika Life.