When you’ve spent close to a quarter of a century assessing investment opportunities, you pick up a few habits.
Mine is to head straight into the engine room of any report or news story that catches my attention. I want to understand what sits behind the numbers: what businesses are being built, what investors are backing, and what has changed to make those opportunities possible.
So when I prepared my September review of capital moving into women’s health, those were the questions I brought to it.
Looking through the numbers, diagnostics attracted the most disclosed funding and accounted for the largest number of financings.
But “diagnostics” tells you only so much. Within that category, iPremom is developing a blood test to predict pregnancy complications, Evvy is analysing the vaginal microbiome to inform care, and Teal Health is bringing cervical screening into the home. Each addresses a different problem, with its own scientific evidence, commercial model and route to patients.
Looking across the rest of the month, the picture broadened further. There were therapeutic developments, consumer businesses and regulatory and reimbursement milestones that could influence how (and how quickly) new products reach the market.
Together, these developments offer a much richer picture of the opportunity than a headline funding total.
They also raise the questions I care about as an investor: where is the evidence becoming stronger, what is ready to scale, and what still has a substantial development journey ahead?
The September Women’s Health Capital Review brings those developments together: which companies raised capital, who backed them, where funding concentrated, and which clinical, regulatory and payment milestones could change their prospects.
Preparing the review also brought me back to the question behind Calabar Capital: why invest in women’s health now?
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Demographics: Where Women’s Healthcare Needs Meet Purchasing Power
In my last article, I wrote about the personal journey that led me to build Calabar Capital. But the decision to build an investment firm around women’s health also rests on a judgement about timing.
The unmet needs in women’s health have been documented for some time. The gaps between what women want and what the healthcare system provides are not new.
What gave me conviction was seeing changes in who was seeking care, what science and technology could offer them, and how businesses could reach them.
I explore this in greater detail in Chapter 4 of my book, The Billion Dollar Blindspot, where I describe the convergence of three forces: demographics, technology and culture.
Each influences the economics of women’s health. Together, they help explain why opportunities that once seemed difficult to serve are becoming more commercially viable.
Start with demographics. In the United States alone, 73 million Millennial women are now between the ages of twenty-eight and forty-three. Add the older edge of Gen X (women in their late forties and fifties) and you have the largest concentration of women in peak health-need years in modern history. These cohorts are entering their peak earning years precisely when their health needs are intensifying.
Reproductive challenges, perimenopause, menopause, thyroid disorders and autoimmune conditions: many of the most common women’s health issues emerge during the same decades when income, purchasing power and financial decision-making authority are at their highest. The result is a structural convergence: peak health need and peak spending power now occur at the same time.
This generation of women is also behaving differently from past cohorts:
Higher educational attainment correlates with higher income and stronger expectations around healthcare quality.
Delayed childbearing compresses reproductive timelines into shorter, more intense windows, increasing urgency and willingness to seek specialised care.
Digital fluency removes many of the barriers that once slowed the adoption of remote care, diagnostics and digitally delivered services.
At the same time, the concentration of this demographic in professional sectors that provide comprehensive employee benefits creates a parallel demand channel.
Employers have an economic incentive to support services that reduce absenteeism, improve retention and manage long-term healthcare costs. Women’s health solutions are increasingly reaching the market through both employer benefits and direct consumer demand.
These conditions did not exist at scale for previous generations. Earlier cohorts had lower earning power, less decision authority, and healthcare systems built around episodic care rather than long-term management. The demand was always present, but purchasing power and market visibility were more dispersed.
Then there is ageing. I often tell people that much of the developed world is getting older and, at older ages, increasingly female. For me, that opens a much broader discussion about women’s health: what happens to cardiovascular health, bone health, sleep and cognitive function as women move through midlife and beyond?
In short, the demographic need gives businesses addressing these conditions a reason to exist. The next question is whether we now have the scientific understanding and technology to meet it more effectively. That is where the convergence becomes particularly interesting.
Science and Technology: New Possibilities for Women’s Healthcare
The scientific and technological changes become tangible when you look at what they could make possible for a patient.
Consider a woman in the first trimester of pregnancy. She wants to know whether her pregnancy is progressing well. Her clinician wants to identify risks early enough to intervene. A blood sample that could reveal signs of a complication months before symptoms appear would give that conversation a different starting point.
That is the possibility iPremom is working towards. The company, which raised €15 million in September, analyses cell-free RNA (molecular signals circulating in maternal blood) to assess pregnancy-complication risk from the first trimester. Its platform drew on more than 26,000 samples linked to 10,000 pregnancies, with further validation and regulatory work ahead.
Several developments come together here. Research into pregnancy biology identifies signals worth measuring. Molecular diagnostics allow those signals to be captured in blood. Predictive modelling helps interpret them. The next step is establishing how that information can guide care reliably.
Evvy illustrates another part of this change. It combines vaginal microbiome testing with biological data, machine learning and clinician-directed care. The company reports serving more than 100,000 patients and 3,000 practitioners. Its September $40 million Series B will support further validation of new diagnostic and care models.
Testing generates information about female biology. Linking that information to symptoms and outcomes gives researchers material to investigate. Over time, those findings may help distinguish between conditions or support more targeted treatment. Better understanding can also change how existing treatments are used.
In September, AbbVie reported positive Phase 3 results for atogepant in menstrual migraine. The study evaluated an existing migraine medicine using a regimen timed around menstruation.
Here, the development begins with recognising a particular pattern of disease and studying a treatment approach around it. That opens possibilities within markets that already have clinicians, patients and established medicines. Innovation can involve a new molecule, but it can also come from understanding more precisely when and how a treatment should be used.
Across these examples, scientific understanding is becoming something a company can develop into a test, a service or a treatment approach. Each still has questions to answer. But they show how the convergence described in my book is taking shape in practice.
Culture and Narrative: How Women’s Health Needs are Becoming Visible Demand
For these businesses to grow, women also need to know that a solution exists, trust it enough to try it and have a way to access it.
What is changing now is how readily those needs can be recognised, discussed and connected to potential solutions. This is where the third force, culture and narrative, becomes economically important.
In the book, I describe how digital communities, more open discussion and employer recognition are bringing together experiences that were once largely private.
Symptoms women might previously have struggled to explain are becoming part of a shared conversation. For companies, that makes patterns of demand easier to identify. For women, it can make seeking help feel both more legitimate and more practical.
Think about sleep during the menopausal transition. A woman waking repeatedly through the night can now encounter others describing the same experience, explanations from clinicians and services addressing midlife health. She has more opportunities to connect what she is experiencing with a question she can bring to a healthcare professional.
That changes the starting point for a business offering an effective solution. It may be reaching a woman who already recognises the problem and is actively looking for help. The company still has to earn her trust and demonstrate value but the conversation can begin further along.
Narrative matters here because it shapes what people recognise as a problem worth addressing and how they value the available options. As awareness grows, credible explanations become increasingly important: what does a product actually do, what evidence supports it, and what benefit can someone reasonably expect?
Clear communication can help informed demand grow while challenging the misinformation and exaggerated promises circulating alongside it.This is the cultural change within the convergence.
Demographic trends are concentrating healthcare need and purchasing influence. Science and technology are expanding what companies can deliver. At the same time, women’s experiences are becoming more visible, expectations of care are rising, and businesses have more ways to reach people seeking solutions.
Those changes reinforce one another, improving the conditions for companies to serve needs that have existed for decades.
Where that gives me investment conviction
Looking across those changes, three areas stand out to me: AI-powered prediction and diagnostics, sex-specific therapeutics, and interventions that help women live more years in good health.
They connect directly to the convergence I have described:
Better biological data and analytical tools create possibilities for earlier, more useful information.
A more precise understanding of disease creates opportunities for treatments that account for female biology.
Ageing populations and rising expectations of care create sustained demand for solutions that preserve health and function.
These are the areas where my conviction is strongest, and where we want to build exposure through Calabar Capital.
Conviction in an opportunity still has to translate into an investment decision. We want to understand the evidence, the team’s ability to execute, how the business will reach its customers and what will support its economics as it grows. The price we pay and the capital required to reach the next milestones also matter.
Time is part of that judgement. We are building a ten-year vehicle, so we need a credible path to realising value and returning capital within that horizon.
In my next essay, I’ll explain how we assess opportunities at different levels of maturity (from proven markets to emerging approaches and moonshot ideas) and how we decide what belongs in the portfolio.
For the transactions and developments behind this discussion, you can explore the September Women’s Health Capital Review. The underlying argument about demographics, technology and culture is developed in the book The Billion Dollar Blindspot.
My new book, The Billion Dollar Blindspot is now available on Amazon and in bookstores.
About Maryann Selfe
Maryann Selfe is an institutional investor and the Founder and Chief Investment Officer of Calabar Capital, an investment platform backing exceptional managers and founders in women’s health. She is the author of The Billion Dollar Blindspot and writes about women’s-health investing and capital allocation.
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The Billion Dollar Blindspot is an independent publication. Its content is provided for informational and educational purposes only and does not constitute financial advice, an investment recommendation or an offer to buy or sell any security.
Sources and references
[i] Freddie Mac. “Millennial Household Formation — Potential for Another 2 Million Households.” U.S. Economic, Housing and Mortgage Market Outlook, October 2023, pp. 3–5. Read the report.
[ii] Selfe, Maryann. The Billion Dollar Blindspot, Chapter 4. The discussion of demographics, technology and culture draws on excerpts adapted from the book. Available on Amazon.
[iii] Selfe, Maryann. “Women’s Health Capital Review — September 2026.” The Billion Dollar Blindspot. Source for the finding that diagnostics accounted for the largest number of financings and the most disclosed funding in the September review. Read the review.
[iv] Amadeus Capital Partners. “iPremom raises €15m to transform pregnancy care with molecular diagnostics.” 2 September 2026. Source for the €15 million seed financing and the platform’s development using more than 26,000 samples linked to 10,000 pregnancies. Read the announcement.
[v] Evvy. “Evvy Raises $40M Series B to Scale AI-Powered Precision Diagnostics & Care Platform for Women’s Health.” Business Wire, 15 September 2026. Source for the $40 million Series B and the company-reported figures of more than 100,000 patients and 3,000 practitioners. Read the announcement.
[vi] AbbVie. “AbbVie Extends Migraine Leadership with Positive Phase 3 Atogepant Results in Menstrual Migraine.” 10 September 2026. Source for the Phase 3 LUNA results and the treatment regimen timed around menstruation. Read the announcement.
I really appreciate the shift from headline funding numbers to what is actually changing underneath them. Looking at evidence, access, and long-term viability gives a much clearer picture of opportunity. What do you think investors still overlook most in women’s health?
I loved this! The atogepant example is interesting - the LUNA trial enrolled 468 women and dosed for only seven days around each period, starting three days before it, and the reduction was 1.20 migraine days in that window against 0.40 on placebo. Those are topline results released by AbbVie and not yet peer-reviewed, and the drug is already approved for preventing migraine in general, so what's new is the short, cycle-timed dosing and a possible first approval specifically for menstrual migraine! I'd love to know your thoughts on this when the effect is under a day?