HelloGina: How an evidence-based app is addressing painful sex. Interview with Daphne Petrich, US BD Lead HelloGina.

Women’s health is a very attractive market for global healthcare and wellness industry players. In 2020, almost 1 billion women could have been targeted with digital health solutions. Fertility, pregnancy, and postpartum support are the leading segments in the space, with gynecology & obstetrics and menopause still lacking behind. According to the American College of Obstetricians and Gynecologists, 3 out of 4 women experience pain during sex at some point of their lives, yet there is still a stigma around women’s sexual health. In a candid conversation with Daphne Petrich, US Business Development Lead HelloBetter / HelloGina, we delved into HelloGina, the mind and body evidence-based digital solution to painful sex, their business model and holistic service offering that empowers people with vaginas to take their sexual wellness in their own hands, as well as we learned more about the addressable market and the enormous care gap that exists, and touched upon the market trends that drive the digital women’s health market.

Women represent 49,6% of the world population reaching 3.9 billion. In 2020, R2G’s deep dive report into the global market of digital women’s health solutions has shown that by 2024, the addressable market will reach 1.46 billion women. In view of its consumer-oriented nature and large user audience, women’s health is exceptionally placed in the digital health market.

In 2022, the 1300 women’s health apps available on Android and iOS operating systems worldwide generated more than 28M annual downloads globally. In terms of estimated mobile app revenue coming from paid downloads and in app purchases, the market reached US$ 16M.

This year, R2G’s team published the “Global digital health business outlook – 2023” whitepaper that depicts opinions and predictions of the 318 key industry stakeholders, in which women’s health experienced a 22% increase from 2022 coming forth within the therapeutic areas with best business potential in 2023, after Mental health (67%), Cardiology (43%), and Metabolism & Endocrinology (36%).

Digital solutions that help track and manage fertility, pregnancy, and early maternity are pretty advanced and popular among the female population. Gynecology & obstetrics and menopause are quite niche-oriented markets. However, this does not necessarily mean small markets. Vaginismus, for example, part of the gynecology & obstetrics segment, affects about 1-7% of the global female population. It is a medical issue that impacts not only one’s sexual health, but also the mental health and severely influences different aspects of someone’s life. Partly because there is still a stigma around this topic, people with vaginas do not engage in conversations and rarely seek actively more help from their healthcare providers.

• Why is the number of diagnosed people (roughly 20,000 in the US) so insignificant compared to the addressable market (26 million in the US)?
• What makes a perfect program for such a private and sensitive solution?
• What is the role of coaches?

To learn more about this underserved market, we talked to Daphne Petrich, US Business Development Lead HelloBetter / HelloGina. Together with her we delved into HelloGina’s digital solution, their US market entry strategy, sexual wellness as a core pillar of physical health, as well as their 2023 vision.

Enjoy the interview!

Research2Guidance: Can you briefly introduce HelloGina.

Daphne Petrich: HelloGina is the only digital solution to painful sex in the market that is truly evidence-based. It acts like a sex coach, therapist, and personal trainer all wrapped into one. It combines cognitive behavioral therapy (CBT) elements with pelvic floor exercises and has been shown to reduce genital pain and improve sexual satisfaction in just 12 weeks.

HelloGina is powered by HelloBetter, a global pioneer in the e-mental health space and a leading provider of digital therapy in Germany. HelloGina is HelloBetter’s first US product and it was launched in the last quarter of 2022.

Research2Guidance: What’s the problem you’re trying to solve?

Daphne Petrich: Today, 1 in 5 people with vaginas experience pain during sex. In the US, that represents over 25M people. The official diagnosis is genito-pelvic pain disorder but most know it as vaginismus, which means the involuntary contraction of the pelvic muscles when penetration is attempted. Genito-pelvic pain, or GPPD for short, doesn’t just concern intercourse, but also the insertion of menstrual products or getting a gynecological examination. Dyspareunia is another word used, but it is an umbrella term that just translates to painful sex.

The problems related to sexual pain extend far beyond the bedroom and can significantly impact someone’s relationships, mental and physical health. Besides emotional frustration and physical pain, GPPD can reduce a person’s confidence and feeling of self-worth, leading to depression, anxiety, and exclusion from social situations. Someone with GPPD is also more likely to put their own health at risk and avoid important cervical health screenings such as pap smears.

The issue is that those affected are not getting diagnosed by professionals and therefore not getting the care they need. Just last week, the mayor of New York, Eric Adams, stated that women suffering from vaginal discomfort are more likely to get misdiagnosed than they are of getting correctly diagnosed. Healthcare systems have systematically misdiagnosed vaginal pain, leaving it untreated. In the US, there were only 19.5 thousand vaginismus and dyspareunia diagnoses in 2021. That’s leaving a lot of people uncared for.

Research2Guidance: The number of diagnosed women is so insignificant compared to the addressable market. Why do you think this is the case?

Daphne Petrich: It’s a combination of different factors. The three biggest causes we’ve identified are stigma, misdiagnosis, and high costs.

Stigma. Those affected do not even know that there is an official diagnosis and treatment for what they are experiencing. I can no longer count the number of times I spoke about HelloGina to someone and they looked at me with wide eyes and answered: “I think I have this. I thought I was the only one.”

The second issue is misdiagnosis. The focus on women’s health as reproductive and maternal health means other areas of women’s health, including sexual health, have been left behind. Providers are not diagnosing genito-pelvic pain disorders because they haven’t been trained to do so. Many women see 4 or 5 providers before actually getting a diagnosis.

Finally, in a best-case scenario, where you get the right diagnosis at the right time, it is highly unlikely that a high-quality treatment will be within reach. Ideally, you’d want to see a sex therapist and a pelvic floor physical therapist to address fear, pain, and muscle tension simultaneously. Unfortunately, we have a shortage of both provider types. The likelihood that both are available within your geographic location or that it doesn’t cost thousands of dollars is basically non-existent. Many leave their practitioner’s office with a set of dilators and no idea of what comes next.

Research2Guidance: How do you make sure that your program is right for someone and that you make a difference in their lives?

Daphne Petrich: On Helloginahealth.com one can find a thoroughly designed questionnaire that will help determine whether or not our program is right for the person. If so, the program can be bought directly on our website, and once you’ve activated your account, you can access HelloGina through our smartphone app or through a web browser.

In terms of the experience, it is a blend of beautifully designed interactive content – audio, video, text, and illustrations… Concepts and exercises are introduced to help individuals reconnect with their bodies. It is worth noting, that it is a long journey before any type of insertion exercise is introduced. For many of those affected, fear can play an important role in perpetuating the pain. We find it helps to address the mental aspect, namely this fear of insertion and of pain before introducing the relaxation and muscle relief exercises.

It is important to note that we are not a treatment. We are providing an evidence-based tool to help those affected learn about themselves and equip themselves with the tools to overcome their problems. The self-paced nature of our program means it is entirely up to our users when they would like to work on themselves. It is a personal and sensitive problem and some weeks one does not have the mental space, the time, or even the privacy to dive into the program.

Research2Guidance: This is indeed such a personal & sensitive issue, having a coach to be there when one needs it, makes a difference. How many coaches do you have? And what is their role?

Daphne Petrich: Right now, we have 4 dedicated HelloGina coaches on the team. They are being led by Charlotte Kirchhoff, who co-developed the program and successfully evaluated its effectiveness in two randomized controlled trials.

HelloGina coaches follow each customer from the first to the last unit. They provide support or feedback on demand and answer any question in a text format. One could have a very logistical concern or something along the lines of “I do not understand what I am meant to be practicing this week” or maybe share some doubts or inability to really go through with one of the exercises. Coaches are part of the journey.

Our coaches are there to support, motivate and validate the emotions of our customers. Everyone’s context and objectives are different and so is every HelloGina journey. The program is built to optimize for success and introduces many different exercises. Some units may resonate more than others. The coach is there to say “Hey, if that did not resonate don’t give up, that is normal, this program is about you finding what works for you.”

Research2Guidance: In 2020, our deep dive into the global market of digital women’s health solutions has shown that nearly 1 billion women can be targeted with digital health solutions. Women’s health market also has managed to develop into one of the biggest & most consumer-oriented digital healthcare markets. How big is the market that you are addressing? Why have you chosen to enter the US market?

Daphne Petrich: A year ago, I joined HelloBetter to lead our international expansion strategy. HelloGina quickly became my passion project for two reasons: the size of the impact, and the business opportunity.

It took us some time to actually realize how big the care gap actually was, which is normal considering how under-researched this topic is. There are 167 million women in the US, 80% of which are over 18. If 20% are experiencing recurring pain during intercourse, tampon insertion, gynecologist exams etc., one is left with 26 million affected individuals. In 2021 in the US, there were fewer than 20 000 diagnoses. We asked ourselves: “Who is addressing this massive unmet need?”

We looked everywhere for an answer. The verdict? Close to nobody. There are maybe a dozen incredible providers in the whole country who see patients and provide high-quality care. Some of them have even taken it upon themselves to educate via social media. All in all, people with vaginas are left to their own devices with regard to care. They’re scrolling through Reddit, asking for advice on Facebook support groups, and watching YouTube channels. They’ve built an incredible online community and support each other on the day-to-day challenges associated with having GPPD. While the power of this community is heartwarming, it’s not enough. They deserve solutions that work.

We ventured into the US with HelloGina because sexual pain is where the care gap is the largest. There are incredible companies in the US tackling depression, anxiety, insomnia etc. But when it came to vaginismus and dyspareunia, we saw a white space. And that is why from having an idea it became a necessity to put our evidence-based tool into the market to empower those affected to get the care they deserve.

Research2Guidance: What is your business model?

Daphne Petrich: We decided to launch with a direct-to-consumer strategy to reach people where they are. As I previously mentioned, due to the strong stigma, the systemic misdiagnosis, and the high costs of available treatments, people with vaginas are not receiving the care they need. HelloGina was designed for radical accessibility. It is a safe space to learn and heal for individuals with GPPD. They can access the program anonymously from the comfort of their own home. Finally, the personalized program is available for $289, which is the cost of seeing a specialist once.

This year, we will be growing our footprint through direct-to-consumer marketing and establishing partnerships with providers who align with our mission. Genito-pelvic pain doesn’t discriminate and affects people from all walks of life. We have customers in their twenties, thirties, forties, fifties, and so forth. To reach everyone we need to partner with platforms that are able to cater to those specific demographics.

At present, we are in a conversation with various partners who are very good at enabling this first point of contact with women at specific points in time. For example, menopause clinics are aggregating solutions that cater to the needs of their patients to improve the standard of care for people 40+. We want to partner and integrate our solution into already great platforms that share the same love for evidence as us and are looking to bridge the gap in care for women and people with vaginas.

Research2Guidance: What are the market trends that drive the women’s health market?

Daphne Petrich: I love this question. There’s a sexual health revolution happening right now. Especially in the US.

First of all, The Economist published three articles about sexual health in Q4 of 2022. I am happy to share that our German prescription digital treatment for Vaginismus was mentioned in one of them. If you think about it, it is really new for The Economist to be deep diving into the growth of sex toy sales or the gap in care for sexual problems. One of their articles’ headlines was “Sexual problems can wreck lives. Yet remedies are often simple.” In the article, the author made a prediction that app-based therapies for sexual disorders will become popular. I don’t disagree!

I think this is part of a bigger trend – sexual wellness and even sexual pleasure being accepted as a core pillar of physical health. And this mindset shift is what allowed the sex toy industry to see major growth in 2021. Sex toys were rebranded as sexual wellness devices and recorded almost the same sales volume as the haircare industry. Nowadays, people can buy these products at Boots or Walgreens.

Just the idea that pleasure and sexual wellness are entering the mainstream is a massive shift. And it is going to contribute to opening up what women’s health really means – yes, it is fertility, yes, it is maternity, but it is also sexual health. So in my opinion to really deliver on this ‘pleasure revolution’ as I like to call it, we need to also address the massive gap in sexual health care. Beyond GPPD this entails normalizing conversations around vulvovaginal health. It needs to be addressed from every angle – policy, innovation, and healthcare.

Research2Guidance: What is ahead for HelloGina?

Daphne Petrich: Now that we’ve launched, the real work starts. I’m particularly excited about 2023. We have an incredible product that works – not just in terms of generating wanted results, but it’s a delightful UX experience. This year is about finding our people. By this, I mean HelloGina users but also partners. It’s about finding out where we can add value and understanding what changes need to be implemented to grow that value through time.

Research2Guidance: Daphne, thank you for this interesting and insightful conversation. We wish you and your colleagues at HelloGina and HelloBetter to stay healthy and have a very successful year.

ABOUT HelloGina
HelloGina empowers people with vaginas to improve their mental and sexual well-being on their own terms. Designed by a team of leading experts in sexual and mental health, their 12-week program helps people with vaginas overcome unwanted pain during sexual intercourse and make space for pleasure. To learn more, please visit: https://www.helloginahealth.com/

To learn more about HelloBetter, a global pioneer in the e-mental health space and a leading provider of digital therapy in Germany, please visit: https://hellobetter.de/en/ , LinkedIn