What business models are working in FemTech?

What does “working” actually mean in FemTech?

In FemTech today, we should call a business model “working” only when we can see repeatable revenue at meaningful scale and some evidence that the company can eventually keep a reasonable share of that revenue.

That definition immediately removes a lot of noise. A $100 million funding round tells us investors were willing to finance growth. A unicorn valuation tells us what investors thought the company might become. Neither tells us whether customers keep paying, whether acquiring them costs too much, or whether each new patient requires another expensive clinic, clinician or piece of hardware.

We therefore put more weight on operating evidence. Progyny is already profitable and cash-generative at more than $1 billion of annual revenue. Flo has shown that millions of women will pay repeatedly for consumer health software. WELL Health publishes enough detail on Wisp for us to see both its attractive gross margins and its current customer-acquisition problem. Midi now treats more than 25,000 women a week through insurance-backed virtual care. Evvy gives us a live example of a diagnostic company trying to turn one test into a recurring care relationship.

The threshold will be slightly different for a younger private company, because profitability may still be several years away. But the core test stays the same: who pays, why do they keep paying, and how much extra cost appears when the business doubles?

Is FemTech still mostly period trackers and fertility apps?

FemTech has moved well beyond period tracking, and several of the strongest businesses currently make money from healthcare benefits, virtual medical care, prescriptions, diagnostics and regulated medical software.

The category used to be easy to picture. Period tracking, fertility tracking and pregnancy apps dominated the conversation because these were obvious problems that smartphones could address directly. Those products still matter, but they now represent only one part of the commercial market.

Progyny sells fertility and family-building benefits to employers and health plans. Maven sells a broader package covering fertility, maternity, parenting and menopause. Midi bills insurers for medical care delivered by clinicians. Wisp combines telehealth with prescriptions and health products. Evvy sells laboratory testing and then layers treatment, retesting and products on top. Natural Cycles charges for software that the FDA regulates as a contraceptive medical device. Willow and Elvie sell physical maternal-health products.

These companies barely resemble one another financially. An app can add another user for very little incremental cost. A virtual clinic needs more clinicians as visits rise. A fertility clinic needs rooms, equipment and embryologists. A diagnostic company needs another laboratory test every time a customer uses the product.

So asking whether “FemTech works” is too broad. We get a much clearer answer once we look at the individual ways these companies get paid.

Can consumer subscriptions really make money in FemTech?

Consumer subscriptions clearly work in FemTech, although the evidence suggests this is becoming a winner-heavy market where a few trusted products capture most of the value.

Flo provides the clearest proof. When the company raised its major growth round in 2024, it was already approaching five million paid subscribers and expected more than $200 million in annual gross bookings. Flo now reports around 80 million monthly active users worldwide, so the company has continued adding scale after becoming a unicorn.

Natural Cycles offers a second version of the subscription model. The company currently says more than six million people have used the product. Users pay for access to contraception, fertility planning, pregnancy, postpartum and perimenopause modes, with contraception regulated as a medical device.

These businesses share an advantage that many subscription apps lack: the underlying problem keeps coming back. Menstrual cycles recur. Contraceptive decisions recur. Fertility changes. Pregnancy creates months of repeated engagement. Perimenopause can last years.

The harder part is differentiation. A basic symptom tracker now competes with dozens of free apps and increasingly with health features built into phones and wearables. Flo has scale, years of accumulated product development and a huge free funnel. Natural Cycles has regulatory clearance and a specific contraceptive use case.

So we would rank consumer subscriptions among the proven FemTech models, but we would be much less excited about launching another generic paid tracker today.

If you want more recent data on this point, please see our latest femtech market report.

Why does Flo still work when period-tracking information is free?

Flo keeps working because users are paying for continuous personalization around their own body, and the company is steadily giving them more reasons to stay as their health needs change.

Free health information has never been scarce. Someone can search for cycle length, pregnancy symptoms or perimenopause advice in seconds. Flo's advantage comes from having the user's history already inside the product and turning that history into something more useful over time.

The latest expansion into perimenopause makes the strategy especially clear. Flo recently added a dedicated set of perimenopause features to Premium rather than treating menopause as the point where a long-time user leaves the app. The company has also been publishing large studies using its user base, including recent research with collaborators from Mayo Clinic on perimenopausal symptoms.

A woman who first downloads Flo for period tracking can potentially use the same product during contraception decisions, conception, pregnancy and later perimenopause. The acquisition happened at the beginning, while new paid use cases can be added years later.

That may be the most useful lesson from Flo. Consumer FemTech becomes far more attractive when the product can follow the user through several health stages instead of monetizing one short episode.

Does FDA clearance make Natural Cycles harder to copy?

FDA clearance gives Natural Cycles a real commercial advantage because a competitor cannot recreate the same contraceptive proposition simply by building another fertility-tracking interface.

Natural Cycles is currently the only FDA-cleared birth-control app. The company says the method is 93% effective with typical use and 98% effective with perfect use, and its software has now gone through several FDA submissions as the product and compatible devices have evolved.

That regulatory work costs money and slows development, but it also raises the bar for competitors. A normal wellness app can copy screens, content or tracking features fairly quickly. A company making a contraceptive claim has to produce evidence, maintain medical-device quality systems and stay within regulatory requirements.

Natural Cycles is also showing how regulation can help distribution rather than merely adding compliance costs. WHOOP recently started offering eligible members a year of Natural Cycles and can feed overnight skin-temperature data directly into the app. Oura already has a longstanding integration with Natural Cycles. The regulated contraceptive layer therefore sits on top of hardware made by other companies instead of requiring Natural Cycles to manufacture every sensor itself.

It is a particularly attractive FemTech structure: recurring software revenue, medical differentiation and distribution through devices that somebody else finances and manufactures.

Is direct-to-consumer telehealth like Wisp still a good FemTech business?

Wisp shows that direct-to-consumer FemTech telehealth can generate excellent gross margins, but its latest numbers also show how quickly aggressive customer acquisition can wipe out the profit underneath them.

Wisp focuses on high-intent sexual and reproductive health problems such as UTIs, bacterial vaginosis, yeast infections, herpes and contraception. The model combines telehealth, prescribing and product delivery, giving the company more revenue per patient than an information-only app could capture.

The latest WELL Health filings make the economics unusually visible. Wisp generated C$29.3 million of revenue in its latest quarter, up from roughly C$28.0 million a year earlier. Adjusted gross margin reached 73.1%, which is extremely healthy for a healthcare business.

Yet adjusted EBITDA for the quarter was slightly negative, and Wisp lost about C$1.1 million on that measure over the first half of the year. WELL explicitly attributed the decline to higher marketing, customer-acquisition spending and investment in growth.

There is an encouraging detail underneath the headline. Management said Wisp returned to profitability in June and produced more than C$1.2 million of adjusted EBITDA in that month alone after tightening its focus on costs and margins.

So the basic transaction works. Wisp can sell reproductive-health care at a high gross margin. The unsettled question is how cheaply it can keep finding the next patient. DTC telehealth is a proven FemTech revenue model, but the final profitability can disappear surprisingly fast when acquisition gets loose.

Is insurance-paid virtual care becoming one of FemTech’s strongest models?

Insurance-backed virtual women's healthcare is currently one of the most convincing FemTech models because companies can charge for real medical care without asking patients to fund the entire treatment themselves.

Midi is the clearest example. The company now says more than 25,000 patients use its platform every week, up from roughly 20,000 when it disclosed a $150 million annual revenue run rate last year. Its insurance coverage now reaches more than 45 million women across the United States. Midi also raised another $100 million this year at a valuation above $1 billion.

Patient volume keeps rising, the company has negotiated broad insurance access, and the model has expanded from menopause into areas such as cardiology, metabolic health, sleep, dermatology, cancer survivorship and longevity. Those operating figures tell us much more than the valuation does.

Allara is following a similar route for chronic hormonal, metabolic and gynecological conditions. Its current website says more than 85,000 women have used the platform. Allara accepts insurance while keeping a self-pay option, and the company has expanded from a narrower PCOS proposition into endometriosis, thyroid conditions, fertility, perimenopause and menopause.

The economics will never resemble pure software because clinicians still have to see patients. That does not bother us much. The relevant comparison is specialist medical care, where physician time already costs money and access can be poor.

Insurance lets these companies sell a much richer service than a $10 monthly wellness subscription could support. For chronic conditions that require repeated medical decisions, we think this is one of the strongest places in FemTech right now.

If you want more recent data on this point, please see our latest femtech market report.

Why are employers still paying for fertility and women’s-health benefits?

Employers keep buying FemTech benefits because fertility, maternity and women's health have become large healthcare-spending and employee-retention issues rather than small workplace perks.

Maven currently works with more than 2,300 employers and health plans, operates in more than 175 countries and reports 15 million lives under management. That current figure shows how far employer-funded women's health has moved from a niche HR experiment.

Progyny gives us harder financial proof. In its latest quarter, the company generated $350.5 million of revenue, $28.1 million of net income and $62.1 million of adjusted EBITDA. Trailing 12-month operating cash flow was just over $200 million. Progyny was serving 604 fertility and family-building clients and averaged more than seven million covered members.

Those figures put the category in a different league from most private FemTech startups. Progyny now expects roughly $1.36 billion to $1.385 billion of revenue for the full year.

There is a catch. One large customer that did not renew had a visible effect on growth. Reported quarterly revenue grew 5.3%, while Progyny said growth would have been 11% after excluding that client's revenue from the prior-year comparison.

Enterprise FemTech therefore trades consumer churn for account concentration. Losing one employer can hurt. Still, a single successful contract can distribute a benefit to tens of thousands of people without paying Google, Meta or TikTok to acquire each employee individually.

That distribution advantage is hard to beat.

Is selling fertility benefits better than owning fertility clinics?

Selling and administering fertility benefits currently looks like the cleaner business model, while owning a large clinic network can still work if expansion stays disciplined and clinics actually fill up.

Progyny has already shown what the lighter version can produce. As we saw above, the company is profitable, generates cash and can serve millions of covered members without owning a nationwide network of IVF clinics.

Kindbody chose a more integrated route. It combined employer benefits, technology, laboratories and owned fertility clinics. The attraction is obvious: Kindbody can potentially capture a larger share of the money spent during a fertility journey.

The cost of that ambition became visible after the company's rapid expansion. Kindbody had raised more than $290 million and reached a $1.8 billion valuation in 2023, yet later financing discussions were reported at a far lower proposed valuation after operating losses and weak clinic-level profitability had surfaced.

Kindbody is still operating today and its strategy is evolving. The company recently unveiled a new fertility platform that will be piloted with employer clients representing more than three million covered lives. It also plans a shared-savings model in which part of its fees will depend on whether it actually reduces an employer's fertility spending. That is an interesting shift because it ties the economics more closely to measurable savings.

We would therefore avoid declaring the integrated clinic model broken. The evidence is narrower: scaling physical fertility capacity ahead of utilization can burn an enormous amount of capital, while benefits administration has already proved that it can reach similar employer budgets with fewer fixed assets.

Fertility model	What is working	Where it gets difficult
Benefits administration	Large employer contracts, recurring annual relationships, proven profitability at Progyny	Customer concentration and relatively low gross margins
Owned clinic network	More revenue captured from each patient and greater control of care	Clinics, labs, staff and equipment must stay highly utilized
Hybrid benefits + clinics	Can combine distribution with care delivery and outcome guarantees	Management complexity rises quickly
Our view today	The benefits layer has the cleaner proof	Clinic ownership needs much stricter capital discipline

If you want more recent data on this point, please see our latest femtech market report.

Can FemTech hardware work without subscriptions?

FemTech hardware can absolutely create valuable businesses, but relying mainly on one expensive device sale gives the company much less room for error than recurring software or healthcare revenue.

Elvie is the clearest case. The company helped turn wearable breast pumps into a major consumer category and built one of FemTech's best-known brands. It also raised well over $100 million. The business still entered administration before Willow acquired substantially all of its operations and assets.

The acquisition itself tells us something useful. Willow wanted Elvie's products, technology, brand and customer base. The problem was the standalone company's ability to finance continued growth.

A breast pump has a difficult revenue rhythm. A satisfied customer may keep the product for the whole period she needs it. Manufacturing has to happen before the sale. Inventory sits on the balance sheet. Returns and warranties cost money. Retail distribution takes margin. New generations require more engineering and tooling.

The hardware models we like better add several ways to earn from the installed customer base. Replacement parts and accessories help. Insurance reimbursement can lower the purchase barrier. Several products can reuse the same brand and distribution network. Software can keep the customer engaged between purchases.

Willow's decision to combine its own maternal-health products with Elvie therefore makes more commercial sense than treating each wearable as a standalone gadget business.

Are at-home women’s-health tests becoming real recurring businesses?

At-home diagnostics are starting to develop a credible recurring FemTech model, although we still have much less financial proof here than in subscriptions, benefits or virtual care.

Evvy is a useful company to watch because its product has changed noticeably. The company now says more than 100,000 people have used its vaginal-health platform. A one-time vaginal microbiome test costs $159, while a subscription brings the price down to $129 per test and sends four tests per year.

That converts one customer from a $159 transaction into as much as $516 of annual testing revenue before any additional purchases.

Evvy has also added an expanded STI and PCR panel, a separate UTI+ test, prescription treatment for eligible patients, probiotics and symptom-relief products. Its current UTI+ test costs $248, while several supplements and vaginal-health products sit in the $39 to $59 range.

The model is visibly shifting. The first product answered, “What is in my vaginal microbiome?” The current proposition can test, treat, retest and maintain.

That direction is much more attractive. Every laboratory test still carries a physical processing cost, so the business will never have the marginal economics of an app. But the same diagnostic result can now lead into treatment and months of follow-up purchases.

We would call this model promising rather than fully proven. Evvy has meaningful usage and a much better revenue architecture than a few years ago, but it has not disclosed the revenue, retention or profitability figures that would let us compare it cleanly with companies such as Progyny or Wisp.

Can FemTech safely make money from ads and user data?

Advertising and health-data monetization look like poor core business models for FemTech today because reproductive-health companies need unusually high levels of user trust.

Flo's history explains the risk. The U.S. Federal Trade Commission previously alleged that Flo shared sensitive app information with analytics providers despite privacy promises to users. The case ended in a settlement and pushed privacy much higher on the agenda for the whole cycle-tracking category.

Flo's current model goes in a different direction. Its privacy materials now state explicitly that Premium subscriptions fund the business and that the company does not sell user data. Flo has also built Anonymous Mode so health information can be separated from identifying information.

The incentives are cleaner when users are the customers. Better privacy can help subscription retention. A reproductive-health app funded primarily by advertising faces a harder problem because intimate information increases the value of targeting at exactly the moment when users have the strongest reason to distrust that targeting.

The sensitivity is also rising as FemTech companies collect more than menstrual dates. Products now handle contraception, fertility plans, pregnancy, miscarriage, menopause symptoms, sexual health, medications and genetic or microbiome information.

Free, ad-supported tools will continue to exist. We simply would not rank advertising as an attractive foundation for building a major FemTech company these days.

If you want more recent data on this point, please see our latest femtech market report.

Who is the best FemTech payer: consumers, employers or insurers?

There is no single best FemTech payer, but consumers currently work best for simple repeatable products, employers for high-value benefits, and insurers for care that genuinely needs clinicians.

Consumers give a company speed. Flo, Natural Cycles and Wisp can reach a new user without waiting through an enterprise procurement cycle. That makes direct distribution powerful when the problem is easy to understand and the consumer is already searching for a solution. The weak point is acquisition cost and churn.

Employers give FemTech companies distribution. One sales process can open the product to thousands of employees. Fertility and maternity work especially well here because the underlying costs are large enough for employers to care about navigation, outcomes and spending.

Insurance gives clinical FemTech companies permission to deliver more expensive care. A woman may hesitate to spend hundreds of dollars every month on specialist visits, laboratory work and follow-ups. Once those services are reimbursed, companies such as Midi and Allara can build a much deeper clinical relationship.

The strongest companies are increasingly willing to use more than one payer, but the first model still needs to stand on its own.

Payer	Where it works best today	Main advantage	Main weakness
Consumer	Tracking, contraception, sexual health, simple diagnostics	Fast purchase and global distribution	CAC, churn and price sensitivity
Employer / health plan	Fertility, maternity, menopause, care navigation	Large contracts and built-in distribution	Long sales cycles and client concentration
Insurer	Menopause, hormonal conditions, chronic specialty care	Supports much richer medical care	Billing complexity and clinician costs
Hybrid	Broader women's-health platforms	Higher lifetime value across several needs	More operational complexity

Are the best FemTech companies becoming full women’s-health platforms?

The strongest FemTech companies are increasingly expanding across several stages of women's health because keeping an existing patient or member is often cheaper than winning a new one from scratch.

Maven is one of the clearest recent examples. The company built most of its scale through employers and health plans, then opened virtual care directly to consumers nationwide this year. It has since expanded that clinic with hormonal care and GLP-1 services.

Midi started with menopause and perimenopause. Today its clinical scope includes cardiometabolic health, sleep, obesity, dermatology, cancer survivorship and longevity. Flo recently pushed further into perimenopause. Evvy has moved from vaginal microbiome testing into UTIs, prescription treatment and recurring products.

The economics are fairly simple. A company may already have the user's trust, medical history, insurance eligibility, employer relationship or payment details. The next health problem can therefore be easier to serve than the first.

We would still be skeptical of platform expansion for its own sake. The good extensions reuse something the company already has. Maven can reuse its clinician network and payer relationships. Midi can reuse insurance contracts and a midlife patient base. Flo can reuse years of longitudinal user data and an enormous app audience.

A company adding unrelated women's-health products without reusing distribution or clinical infrastructure is just adding complexity. The platform model becomes interesting when the same relationship generates more revenue over a longer part of a woman's life.

Which FemTech business models look weakest right now?

The weakest FemTech models currently combine expensive delivery with weak repeat purchasing, or depend on a product that users can easily replace with a free alternative.

Standalone premium hardware sits high on that list. Manufacturing, inventory, product development and retail distribution continue costing money while each consumer may buy only once.

Aggressive clinic roll-ups also require caution. Physical clinics can be profitable businesses, but opening locations faster than demand develops creates rent, staffing and equipment costs that cannot be switched off like cloud servers.

Generic paid trackers have the opposite problem. Their operating costs can be low, yet users have little reason to pay when basic tracking is widely available for free. The successful subscription examples have built something much harder to replace, whether through scale, trust, regulatory clearance or deeper personalization.

One-off diagnostics face another challenge. Every new sale brings another laboratory cost, and the company has to persuade the customer to buy again. The economics improve considerably once testing becomes the front door to treatment, retesting and recurring products.

Advertising-funded reproductive health sits at the bottom of our ranking because the monetization model can work against the trust the product needs.

We would therefore be careful with any FemTech pitch built mainly around the size of an underserved female population. Huge unmet need can coexist with a weak business model. The recurring mechanism still has to make sense.

If you want more recent data on this point, please see our latest femtech market report.

What business models are actually working in FemTech?

The FemTech business models working best today are employer-funded benefits, insurance-backed virtual care, differentiated consumer subscriptions and direct telehealth tied to prescriptions or repeat treatment.

Those models now have very different kinds of proof behind them. Progyny shows that employer-funded women's-health benefits can become a large profitable public business. Flo shows that consumer health subscriptions can reach enormous scale. Midi shows how quickly insurance-backed women's specialty care can grow. Wisp demonstrates high gross margins in direct telehealth while also exposing the danger of overspending on acquisition. Natural Cycles shows how a regulated medical function can make subscription software harder to copy.

Hardware and diagnostics sit one level below those leaders. Both can work, especially when companies add reimbursement, accessories, repeat testing, prescriptions or other recurring revenue. The standalone versions are harder.

Owned clinic networks can also become valuable healthcare businesses, but we would underwrite them like healthcare infrastructure rather than software. How full are the clinics? How much does the next location cost? How long before it makes money? Those questions matter more than app downloads or venture valuations.

The pattern across the winners is fairly clear. FemTech works best when the health need repeats, the company has a cheap or protected way to reach the patient, and somebody has a strong reason to keep paying. The payer can be the woman, her employer or her insurer. What matters is that the relationship continues.

That is why we would resist talking about a single winning “FemTech business model.” Several models are working, but the strongest ones currently look much more like recurring healthcare businesses than like a collection of clever products for women.

FemTech business model	Evidence today	Our judgment
Employer / health-plan benefits	Large recurring contracts with public proof of profitability at scale	Proven and one of the strongest
Insurance-backed virtual specialty care	Fast patient growth, broad reimbursement and high revenue potential	Working strongly; profitability still developing
Differentiated consumer subscription	Millions of paying or engaged users around recurring health needs	Proven, but increasingly winner-heavy
DTC telehealth + prescriptions	High gross margins and repeat medical demand	Proven, although CAC can consume the profit
Regulated health software	Subscription economics plus medical-device differentiation	Very attractive when the medical claim is meaningful
Diagnostics + recurring care	Testing can lead into treatment, retesting and products	Promising; public financial proof remains limited
Hardware + accessories / reimbursement	Real consumer demand with several ways to extend revenue	Viable, but harder than software
Owned clinic networks	Can capture a large share of treatment spending	Works only with disciplined expansion and high utilization
Advertising / sensitive-data monetization	Easy to understand commercially but poorly aligned with reproductive-health trust	One of the least attractive models

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