Japanese femtech firms like Fermata revolutionize women’s sexual health

TOKYO — The cosmetics section of Isetan luxury department store offered a retail experience last month that no doubt sparked a double take on Tokyo shoppers: a pop-up store with a sprawling display of colorful menstrual cups, vibrators, kegel balls and period underwear.

It was a jarring spectacle at the historic institution, which for decades has offered a sanitized version of what it means to be a woman. A shopper-friendly chart of the capacity of each menstrual cup, down to the milliliter, and a diagram illustrating pelvic floor muscle training showed women’s health issues in a rare and direct way in Japan dominated by men.

“A lot of times, people think it’s taboo to use these products, but we want to create an environment or a community where people don’t feel that barrier,” said Amina Sugimoto, 33, of Fermata, an e-commerce company. she founded with another woman in 2019 and the brand behind the temporary store.

Sugimoto is among a group of women entrepreneurs revolutionizing the sexual and reproductive wellness space in Japan to respond to needs that are shared but often ignored by half the population. They join a growing cohort of women across the Asia-Pacific region creating products and services for women who are neglected by mainstream companies, male-led governments and patriarchal societies.

These women are also forging career paths outside of corporate Japan, where it is notoriously difficult for women to thrive and rise to leadership levels. They are creating companies in which both women and men work to increase social awareness of reproductive care, and they have enlisted younger male politicians to push for policy changes that regulate women’s health products.

The “femtech” industry (companies that focus on services, technology and products that meet the biological needs of women) is a growing sector worldwide. The Asia-Pacific region is expected to see most of the boom in the next five years, according to some market analysts. Japan’s Ministry of Economy estimates that by 2025, the market impact of femtech companies in the country will reach $16 billion.

These companies serve a variety of women’s biological needs, including menstruation, pregnancy, contraception, and menopause. According to Nikkei Asia, in many Asian countries, particularly in Southeast Asia, its services and products are critical to women and girls who have inadequate access to menstrual hygiene products and education.

In Japan, these companies are promoting the use of oral contraceptives. Japan adopted birth control pills in 1999, becoming the last industrialized country to do so. Yet just a few years ago, fewer than 3 percent of Japanese women used the pill, according to a 2019 United Nations report on contraceptive use and estimates from the Japan Family Planning Association. That low percentage was attributed to a lack of awareness and education, as well as social stigma.

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Arisa Sakanashi, 32, founded Mederi in 2019 to bridge this gap, hoping to normalize talking about and pursuing fertility and contraceptive options. At the time, she was in another round of infertility treatment after trying for a baby for several years, and she wanted her company to help women who lacked information and a support network through the process.

A Japanese government survey in 2021 found that people increasingly felt that infertility treatment was difficult to access and pay for. As of April 1, infertility treatments are covered by the national health insurance in an effort to increase the birth rate.

Mederi provides advice on and access to birth control pills, as well as items like infertility supplements and home test kits for vaginal bacteria. Birth control pills are not covered by national health insurance, but Sakanashi’s company covers the costs for its employees and provides days off for infertility treatment. She is trying to persuade other companies to do the same.

“I founded the company in the hope that more people would become aware and have access,” he said. “Femtech is starting to get attention, but talking about pills and menstruation is still taboo.”

With femtech companies still a new trend in Japan, Sakanashi had trouble getting financing for Mederi. But a few years ago, he saw a tweet from Japanese billionaire entrepreneur Yusaku Maezawa offering financial help to startup founders. She applied for her and, after a year-long vetting process, she was accepted and mentored by Maezawa.

When femtech companies burst onto the scene in Japan in 2019, government laws and regulations for sanitary products defined them as “white in color” and generally disposable, meaning only white pads and tampons and not newer solutions. Companies like Fermata could not advertise the purpose of underwear and menstrual cups.

Sugimoto recalled taking several menstrual products to a largely male group of policymakers and talking about how they’re used, hoping to educate them about women’s experiences and get regulatory updates.

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“I show them menstrual cups and period underwear and say, ‘Pads and tampons have been replaced by these, which one do you prefer?’” she said. Each time, lawmakers chose menstrual cups or period underwear. The strategy was more effective, she said, than simply complaining about what women experience and hoping they understand.

“I mean, I don’t understand what his [male] the bodies are coming through,” Sugimoto said.

Fermata is now working with a government group to get exemptions for individual products from decades-old regulations.

Japan consistently ranks low among advanced countries in the World Economic Forum’s gender gap analysis, which looks at how nations fare on equality in politics, economics, education and health. These startup founders are helping to bridge that gap, raising more awareness of gender equality issues, LGBTQ rights, and the experiences of non-binary people.

A key focus is creating communities and events that can challenge social norms and educate audiences beyond cities like Tokyo. The founders of Fermata have traveled to rural Japan to introduce feminine care products and spark conversations about reproductive health.

In 2019, Shiho Shimoyamada, who identifies as non-binary and is Japan’s first openly gay professional athlete, launched Rebolt to educate people about gender diversity and women’s experiences in traditionally male-dominated industries. The company created a line of gender-neutral sanitary briefs to provide alternatives for women who have only used sanitary pads, as well as those seeking less feminine options for period underwear.

“Our company was born with the idea that society should not define what is normal. I feel that society is full of expectations and demands of how women should be, how athletes should be,” said Shimoyamada, 27, a footballer.

Rebolt’s customer base started with athletes, but now includes those who work in physically demanding jobs like construction, as well as parents who want to talk to their kids about menstruation. She hopes to expand her product line and conducts seminars on social equality for young athletes.

“When I came out, I was overwhelmed by the response I received and realized that there were many things I could do myself to change society, such as raising my voice and creating products and services,” Shimoyamada said. “So my job is really a means of getting closer to the society that I want.”

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