Oct 8, 2021
CORTADO VENTURES
Innovating the Taboo
Cortado’s investment in Watkins Conti, addressing a massive and underserved market
Recently Cortado announced our investment in Edmond based Watkins Conti Products. We invest in ambitious companies tackling big problems and in teams with the “right stuff” to make it happen. Here we discuss our thinking behind our investments and the trends that drive our conviction. Thank you to Patrick Sweeney, Cortado Research Fellow and Harvard Business School Research Associate, for his considerable help bringing together the research and narrative. Today we also welcome the insights of celebrity guest Dr. Donnica Moore.
Dr. Moore is a highly regarded physician, educator, and media commentator who has had over 850 television interviews including “The Dr. Oz Show”, “Good Morning America Health”, and “The Oprah Winfrey Show”. Dr. Moore as has more than 180 published articles in medical journals and consumer magazines and over 30 awards for her achievements in medicine and business. She was honored as one of the “Top 25 Women Entrepreneurs” by Leading Women Entrepreneurs in 2017 and she earned her medical degree from the State University of New York School of Medicine at Buffalo. Her work has been featured in Business Week, The New York Times, and The Wall Street Journal.
Introduction to Watkins Conti Products
Watkins Conti is a healthcare company that develops and commercializes products to address women’s health issues. The company has developed its first product, the Yōni.Fit, to address both the causes and the symptoms of stress urinary incontinence (SUI) or involuntary urine leakage in women. The company has plans for expansion beyond the Yōni.Fit to other women’s health products including at-home STD testing and yeast monitoring. The Yōni.Fit is a nonsurgical, intravaginal device made of medical grade silicone for women suffering from SUI. Pre-clinical testing has been going exceptionally well, far exceeding requirements to commercialize the product. The market for biotech addressing women’s health issues is booming, and CEO Allison Conti is an experienced business and thought leader. As a thought leader, Allison is removing the taboo and enabling women throughout the country to speak out. Allison is regularly asked to speak and share her journey to becoming her own boss and succeeding in the world of technology innovation and venture capital — an area too often dominated by men.
The Problem that Watkins Conti is Tackling
Urinary incontinence is a condition that impacts many people’s lives. Urinary incontinence is involuntary leakage of urine caused by a lack of control over the bladder. While both men and women suffer from urine incontinence it is twice as common in women. In fact, it’s estimated that 1 in 4 women suffer from urinary incontinence. As women age, they are more likely to suffer from this problem and by age 65 up to 75% of women report having urine leakage[1]. Despite urinary incontinence being such a common problem in women only about one-third of them have talked to a doctor about it[2]. This is likely due to women feeling embarrassed about their symptoms or thinking it’s normal to experience incontinence and it can’t be helped. While it is true that urinary incontinence increases with age there are treatments, and one doesn’t need to let it disrupt their life. Additionally, urinary incontinence can lead to urinary tract infections (UTI) and missed work.
There are several types of incontinence with the most common being stress urinary incontinence (SUI)[3]. SUI is involuntary urine leakage when the bladder is under pressure from physical activities such as laughing, coughing, sneezing, running, jumping, or lifting. In fact, a study from the University of Michigan of over 1,000 women who have SUI found that 79% experienced leakage while coughing or sneezing, 49% while laughing, and 37% while exercising[4].This occurs because the pelvic floor muscles are weak and don’t have the ability to support the organs as they should. Women who have had children are more likely to suffer from SUI, but chronic coughing and lower back nerve damage are also contributing factors[5].
Up until recently there haven’t been many therapeutic options for women suffering from SUI. Transvaginal surgery, urethral sphincter injections, electronic stimulation, pelvic floor therapy, and adult diapers are currently the most common treatment options. There are no approved medications that treat SUI in the United States[6]. Given the historical lack of treatment options and the stigma behind seeking treatment women wait on average 6.5 years from the first time they experience symptoms until they obtain a diagnosis for their bladder control problems. In other words, this market is full of very unsatisfied customers that are seeking a solution that addresses both the causes and the symptoms of SUI while being easy to use and allowing for privacy. This is exactly what Watkins Conti, an Edmond, Oklahoma based start-up is doing.
Market and Trends
It’s estimated that between 15 to 30 million women are affected by SUI in the United States[7]. The global Urinary Incontinence Device market generated $2.1 billion of revenue in 2020 and is forecasted to grow to $6.17 billion by 2030, resulting in compound annual growth rate (CAGR) of 11.8%[8]. As mentioned before this market is underserved and unsatisfied with the current solutions for SUI treatment. This is evident by the fact women wait on average 6.5 years to seek diagnoses. Additionally, the Mayo Clinic estimates that only 45% of women who experience weekly urinary incontinence discuss the problem with their medical providers[9]. Femtech (female Technology) products have traditionally been overlooked and underfunded by venture capital firms. They’ve likely been overlooked since femtech founders have a higher propensity to be female and the effects of homophily (tendency of individuals to associate/invest with similar other) are strong on venture capital. In fact, only 13.03% of all venture-backed startups from 2015 to 2019 had a female founder.[10] From 2007 to 2021 capital invested in femtech companies has gone from $45 million to $2.56 billion, respectively[11]. There are massive market opportunities in this space given 80% of household healthcare spending is done by women and on average working age females spend 29% more per capita on healthcare when compared to males in the same age group[12]. Customers in the space have historically missed out on innovation that can satiate their unmet demand which has left them very unsatisfied. This is why what Watkins Conti is doing is so important.
Competitive Advantage
Watkins Conti is a women’s healthcare company that focuses on direct-to-consumer products that solve taboo problems. The company was founded in 2016 by Allison Watkins Conti who after suffering from SUI and receiving unsuccessful pelvic floor therapy, realized that there weren’t any good options for treatment available. This is where the company got its inspiration for their flagship product, Yōni.Fit. The product is a nonsurgical intravaginal device made of medical grade silicone for women suffering from SUI. The device is inserted into the vagina similarly to a tampon. It works by placing an appropriate amount of pressure to the bladder neck, preventing leakage. It’s also designed to provide support to the pelvic organs, helping to counteract pelvic organ prolapse, thereby addressing a primary cause of SUI. The device is intended to be worn daily and will last about 30 days before it needs to be replaced. Watkins Conti Products intends to offer Yōni.Fit over the counter via a monthly subscription. To get started, customers will receive a Yōni.Fit Kit which includes multiple sizes of the device and at home fitting instructions so that they can find their ideal size and fit. This product is groundbreaking for women who suffer from urinary incontinence as it not only safely addresses and prevents involuntary leaking, but it will allow women to manage their intimate personal care from the comfort of their homes. Many women experience leaking after giving birth. There is a perception that this is normal due to how common this issue is, and women typically do not realize that this is a chronic condition, therefore they tend to just deal with the urine leakage. Yōni.Fit is proving to change that and the medical community has taken notice. In fact, Dr. Donnica Moore said that:
“Yōni.Fit will be a great solution for the tens of millions of women not getting therapy for SUI as it allows for at-home use which gives women more privacy about an issue that has such a negative stigma. Additionally, doctors look for treatments like Yōni.Fit which have the lowest risk of side effects and the highest potential reward. Women shouldn’t need a diaper bag after their children turn three years old, for themselves! This new therapy offers relief and hope to women who suffer from SUI.”
Yōni.Fit is currently in comparator-controlled, single-blinded, multicenter clinical trials to demonstrate the effectiveness, user acceptance, safety, and tolerability of the product in the temporary management of SUI in women, led by Erik Sokol, MD, associate professor of obstetrics and gynecology at the Stanford University School of Medicine. The multi-site trial is also being conducted at NYU Langone Medical Center in Manhattan and Thomas Jefferson University in Philadelphia. Follow these links for more information on recruitment and registration for the trials.
[1] https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/is-urine-incontinence-normal-for-women
[2] https://www.sciencedaily.com/releases/2018/11/181101085113.htm
[3] https://phoenixpt.com/statistics/
[4] https://www.sciencedaily.com/releases/2018/11/181101085113.htm
[5] https://my.clevelandclinic.org/health/diseases/17596-urinary-incontinence
[6] https://www.mayoclinic.org/diseases-conditions/stress-incontinence/diagnosis-treatment/drc-20355732
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197263/
[8] https://www.globenewswire.com/news-release/2021/09/07/2292169/0/en/Global-Urinary-Incontinence-Device-Market-to-Reach-6-17-Billion-by-2030-Allied-Market-Research.html
[9] https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/is-urine-incontinence-normal-for-women
[10] Calder-Wang, Sophie and Gompers, Paul A. and Sweeney, Patrick, Venture Capital’s ‘Me Too’ Moment (August 2, 2021). Jacobs Levy Equity Management Center for Quantitative Financial Research Paper , NBER Working Paper No. w28679, Available at SSRN: https://ssrn.com/abstract=3897470 or http://dx.doi.org/10.2139/ssrn.3897470
[11] https://my.pitchbook.com/search-results/s107690556/deal_chart
[12] https://blog.bccresearch.com/femtech-market-trends-you-need-to-know
