The Vagina Business - The hidden economics of women’s health
Jan 15, 2026
Women’s health represents one of the largest mismatches between human need and economic logic. Half the population spends decades navigating menstruation, fertility, pregnancy, contraception, menopause, and chronic pain conditions that are either poorly understood or systematically under-researched. Yet until very recently, these realities barely registered in mainstream medical research or investment priorities.
Marina Gerner’s The Vagina Business approaches this gap as a market failure rather than a cultural anecdote. Her central argument is precise. When medicine ignores a category of patients, markets do not stay empty. They fill with products, narratives, and incentives that compensate for missing knowledge. Some of these solutions are useful. Many are inefficient. Some are actively harmful.
The book documents how male bodies became the default model for clinical trials, diagnostics, and drug development. This design choice created downstream consequences. Women’s symptoms were frequently misdiagnosed. Pain was minimized. Conditions such as endometriosis or menopause-related disorders remained underfunded for decades. The absence of rigorous research pushed women toward over-the-counter fixes, wellness myths, and privately funded interventions that operate outside strong evidence frameworks.
Gerner does something important here. She does not frame the problem as moral outrage. She frames it as distorted incentives. Investors historically avoided women’s health because it was perceived as niche, complicated, or risky. Regulators lacked pressure to modernize standards. Pharmaceutical companies optimized for scale rather than specificity. The outcome was predictable. Large demand met shallow supply.
The emergence of femtech changed the equation. Digital diagnostics, hormone tracking, fertility platforms, menopause treatments, and pain-management tools began attracting capital once founders translated lived experience into investable categories. Gerner shows where this translation works and where it fails. Innovation creates value when it is anchored in science, clinical validation, and transparency. It destroys value when it relies on shame, fear, or exaggerated promises.
One of the book’s strongest contributions is its treatment of trust. Women learned, over time, to distrust medical systems that dismissed their experiences. That distrust became a commercial opportunity. Brands positioned themselves as allies against an uncaring system. In some cases, this alignment empowered users. In others, it replaced one authority gap with another.
For leaders, investors, and policymakers, the lesson is concrete. Markets built on exclusion generate inefficiencies that eventually surface as reputational risk, regulatory pressure, or missed growth. Women’s health is not an ethical side project. It is a structural blind spot with measurable economic consequences. Delayed diagnoses reduce productivity. Poor pain management increases healthcare costs. Misinformation scales faster than evidence when institutions stay silent.
The book ultimately argues for a rebalancing. Better data collection. Inclusive clinical trials. Clear regulatory standards. Smarter capital allocation. These are not abstract ideals. They are operating requirements for functioning markets.
Read carefully, The Vagina Business is less about anatomy and more about systems. It shows how ignoring a fundamental reality produces fragile solutions. It also shows how addressing that reality creates durable value. Any organization serious about innovation, health, or long-term growth will recognize the pattern far beyond women’s health.
