Hilla Shaviv’s workroom in her home near Jerusalem is a sort of museum, reflecting her passion for her line of work. It abounds with vagina models of different sizes, rare tampons and other feminine hygiene products that are no longer available.
Shaviv is a biomedical engineer and an experienced entrepreneur. The last product she developed has raised almost 1 million shekels in crowd funding over the past two months, in a bid to shift it from the development stage to production.
But Shaviv is an entrepreneur who keeps forging ahead, against the odds. Her field is femtech (feminine technology), which gets a fraction of the investments into med-tech. She has developed a product intended for end consumers. But this is a category that isn’t common in Israeli hi-tech, also because of the difficulty to sell directly to the American consumer.
The product she developed combines the advantages of a tampon with those of a menstrual cup (a small cup of soft plastic, which gathers the menstruation blood before it leaves the body). The product is inserted into the vagina with an applicator and opens inside. It is supposed to provide full protection without leaks for 12 hours and be used especially by women with heavy bleeding. It’s ecologic, Shaviv says, with an anti-bacterial coating and unlike a regular tampon, it will not leave fibers in the body.
This tampon, called Tulipon, enables the user to monitor her bleeding and know whether she is suffering from over bleeding. In the future it may be instrumental in diagnosing diseases, by examining the menstrual effluents it gathers.
GalsBio’s smart tampon and cup also hopes to support diagnosis Gals Bio Ltd
The startup, called GalsBio, has raised $2 million, not including the sums raised from crowdfunding platform PipelBiz. The entire sum came from British billionaire Alan Howard’s hedge fund, which Bloomberg described earlier this year as “secretive.”
Entrepreneurship is “a complicated Via Dolorosa,” Shaviv says. “But I believe I’m doing something innovative. It no longer has to do with money – because no sum in the world is worth what I’m going through.”
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The ketchup effect
Shaviv, 50, has a BA in engineering – a degree she began pursuing at the Technion and completed in Caltech, California. Her MA, in biomedical engineering, she completed in Tel Aviv University. Her study subject was blood flows. Later, working in the medical device company Biometrix, she developed a device that tested tissue, effluents and blood around the lungs after open heart surgery.
“I started thinking that women have blood and tissue that come out every month. And some have a very long period. We know it’s tissue that’s already detached from the body, it just takes time to come out, she says. “At a certain point I decided to dive in and study the subject. From blood flows I moved to menstrual blood flows.”
“In cardiology you can’t put your finger anywhere without running into an existing patent. In contrast, when I started researching period blood flow, I found a lacuna. No patents, no innovation, just an empty space. It’s also hard to find researchers focused on periods, because research today takes place at the cell level, the micro. I deal with systems, mechanics, cramps, flows. When I set up Galimedix I realized that it didn’t make sense that in 2007 nobody could explain why half the women suffer from menstruation pains.”
Shaviv’s first startup was intended to do two things – to significantly reduce period pains and cramps and to shorten the bleeding time. “In our theory, which we published an article about, the reason for menstrual pains is what I call the ‘ketchup effect.’ Since menstruation involves tissue and blood clots, and all this mass has to come out through a thin pipe, the uterus must press to get them all out. And as long as there are particles inside – the uterus will keep pressing. We were the first to prove the link between the period fluids’ viscosity and menstrual pain.”
The device the company developed, ActiLady, releases the menses effluents rapidly by means of a specific sound wave frequency, which creates imperceptible vibrations. The device is inserted into the vagina during the period and serves as a tampon as well. The company existed about nine years until it closed before the product managed to reach stores.
Hilla Shaviv, founder of GalsBio, hopes their Tulipon will put a smart tampon on the market, despite the challenges femtech faces Eyal Toueg
“We raised altogether $5 million and proved in clinical trials that the product relieves menstruation pains. But we failed to raise more money and the company closed down,” says Shaviv.
If you had a product that had already proved effective, why couldn’t you raise more money?
“I see it in this startup as well: we have a product that works, a team, research, and still – we’re dealing with femtech, and it’s harder to get it into the market. These factors have a decisive effect on the ability to raise funds.” A Swiss B2C company that developed a similar technology at about the same time succeeded in reaching the marketing phase, but ultimately also closed down, she says.
Five years ago you set up another company that produces a unique tampon. What’s different this time?
“I accumulated a lot of experience in the first company. It was then that I encountered the menstrual cup for the first time. I thought it was a wonderful invention and wondered why it wasn’t more popular, because in fact it has existed in the market for almost 100 years, like tampons. A menstrual cup lasts five to seven years, so the big companies had no interest in marketing it. The assumption was that women wouldn’t want to deal with the menstrual blood, as using the cup requires.”
“The first product, ActiLady, was a complex project with a lot of engineering, and included a battery. The new idea was something wholly mechanical. It will combine a tampon with a cup. I thought, ‘how complicated can it be?’ Besides, I’m an entrepreneur, it’s who I am. I’m not going to work on someone else’s ideas.”
GalsBio has eight employees dealing with engineering, marketing, regulation and other matters. The best known among them is gynecologist Amos Bar, the company’s chief medical officer and author of the book “The Israeli Manual for Pregnancy and Birth.”
Israel – a tampon powerhouse
In 2020 the femtech field raised only 3 percent of the investments in health med tech companies, according to ? By October only $14 billion were invested in it, but the future looks rosier. According to an estimate by the market research firm Global Market Insights, cited by the Economist, the femtech market is expected to grow from $22.5 billion to more than $65 billion by 2027.
“Israel is a tampon production power,” says Shaviv, referring to the Albaad plant in Caesarea. “According to Deloitte report from May 2020, the tampon market income in the United States was about $1 billion a year. Some 11 percent of the tampon sales in the United States are in the private brand category – a market shared by only two companies: Albaad and First Quality.
Deloitte says many women prefer buying tampons made by First Quality, a private brand, mainly for their price, but also for their quality, innovation and customer service. By the end of 2025 the global tampon market value is expected to reach $6.34 billion, compared to $3 billion today.
Some tampons are made of organic cotton; others prevent TSS (toxic shock syndrome). There are even tampons with an addition of CBD, a naturally occurring cannabidiol, for pain relief. Recently, a tampon with a mini liner hit the shelves. Tampliner, as it is called, was picked as one of the 100 best inventions of 2020 by Time magazine. But the basic tampon model hasn’t changed in decades.
Shaviv’s Tulipon isn’t like the tampons available in the market today. It’s intended to solve the problem of dealing with the cup – the insertion, the extraction, the cleaning and disinfection, and also the tampons’ leakage problem.
“There’s a lot of engineering at play here,” says Shaviv. “The Tulipon is made of a perishable biopolymer substance, and when you insert it into the body it opens like a cup. To extract it, you pull a string, the valve closes, the structure collapses and it comes out.” The blood is contained inside the tampon, which is similar to a small container, and is kept in it after it comes out.
This tampon cannot be thrown into the toilet. Of course, it cannot be thrown into the trash. To decompose it must be put in compost. Shaviv says there are now developments enabling plastic to decompose in the toilet by means of bacteria and this is likely to become more prevalent in the future.
With a small gauge on the tampon, and with the applicator’s help, the user can monitor her blood loss. “I give lectures and have found that women don’t know basic things like how much we bleed every month. In average, 40 ml, about like a shot of alcohol. But if a woman bleeds more than 80 ml, it could indicate a problem – like myomas, polycystic ovaries, iron shortage or other things. Medical literature says some 20 percent are heavy bleeders, but in reality the rate is probably much higher. Women aren’t aware of it, and doctors have no way of checking,” she says.
“It’s the first biomarker we can measure that doesn’t exist in any other product,” she adds (a biomarker is a biological indicator of a disease).
GalsBio’s tampons are currently produced in a 3d printer, then undergo a cleaning and assembling process in a sterile facility in Haifa. The printing is also the reason for the production’s high cost – $40 for a single tampon. The crowdfunding is supposed to provide the money to complete the development stage and move to the production stage by using injection rather than printing, which will reduce the cost to that of a regular tampon made of organic cotton.
GalsBio will not sell Tulipon as a brand in itself, but join private existing feminine hygiene brands offering customers a subscription, like Veeda, Moxie or The Tom Co.
“The goal is to enter an existing brand, prove marketing feasibility, and show not only that the product works, but that customers return to buy more. On the basis of these sales we can approach the large tampon manufacturers,” says Shaviv. “The company isn’t going to set up a tampon factory, but rather focus on the area of disease diagnosis.”
Will Shaviv’s product reach the shelves this time? It appears that despite the uphill battle she describes, which marks the way of quite a few startup companies – especially in a difficult field like femtech – Shaviv is not giving up. “It’s my life’s mission,” she says. “And I want to leave my mark. That’s what gives me the drive.”
One of ten
Shaviv’s vision for the next few years is to enable women to monitor their health by means of the menses blood preserved in the Tulipon. This will be done by a laboratory, or even in the user’s own home, depending on the test.
An activist holds a placard as she takes part in a performance with others to protest against the taxation on menstrual hygiene products in Lalitpur near Kathamndu on January 8, 2022.PRAKASH MATHEMA – AFP
Today there are several biomarkers that have proved correlation between menstrual and venous blood – like cholesterol and blood sugar level average, for example, Shaviv says. However, it’s still not profitable to perform these tests by means of menstrual blood.
On the other hand, there are studies of biomarkers that can be found in the menses fluids that could be of great value. GalsBio is in touch with a group of American researchers who have identified endometriosis in the menses blood – a gynecological, inflammatory chronic disorder that can cause intense pain and grave damage.
According to studies, one of 10 women suffers from endometriosis and the actual rate may be higher, because this disorder is extremely difficult to diagnose. On average, it takes seven years to obtain the correct diagnosis. GalsBio’s advantage is Tulipon, which preserves a good amount of the menses fluids and thus serves as a gathering device.
Another femtech company is the Israeli Gina Life, which was founded in 2015 and is developing a smart pad, which may be on the shelf by 2025 and help in the early diagnosis of medical conditions and diseases like endometriosis and ovarian cancer.
In GalsBio’s vision, the next generation Tulipon-Pro could serve as a home lab by which users can monitor their iron, magnesium, B12 and folic acid levels. For more complicated tests they could send the samples to a laboratory.
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