Vagina Business Book Introduction

When I talk with patients in the clinic, I often feel that talk about the female body is still a topic that makes one lower one's voice. People choose their words before words like menstruation, menopause, vaginal dryness, and sexual health, hesitate, and only at the very end of the visit broach it with "actually…" That is why I was very glad when I first read journalist Marina Gerner's 『The Vagina Business』. This article is not medical information addressing a specific disease, but an introductory piece that borrows one book to think together about "why women's health was put on the back burner for so long."

The subtitle of 『The Vagina Business』 is "The innovative breakthroughs that can change women's health." The author, Marina Gerner, is a reporter who has long covered the economy and technology. The occasion for her stepping into this topic was, she says, covering a startup. She encountered a wearable technology that detects women's cardiac signals, but watching how neither investors nor the media paid much attention, she came to hold a question.

That question led to a book. Gerner interviewed over 100 founders, researchers, and investors in 15 countries to trace technologies across the whole of a woman's life—menstruation, contraception, pregnancy and childbirth, menopause, and sexual health. The book's core message is simple. The female body has long not been the "default" in both medicine and industry, and now that structure is beginning to change.

In the clinic, it is not uncommon for patients to blame themselves, calling their symptoms "because I'm sensitive." That at the root of that self-blame lies not an individual problem but long-standing social neglect, this book calmly points out.

The gap in women's health research is not an abstract story. The case I most often encounter in clinical practice is endometriosis. Endometriosis is known to affect about one in ten women of reproductive age, yet it is consistently reported that, from the onset of symptoms to diagnosis, an average of several years passes. A review pooling studies from several countries also found diagnostic delay averaging several years.

Why is it so late? It is because menstrual cramps are regarded as "just the way it is," or pain is explained as "due to stress," and the chance for precise evaluation is missed, which is common. Gerner says this delay is not a matter of individual patience but a problem of a system that has not taken women's pain seriously.

The point that, historically, women were not sufficiently included in clinical trials also plays a part. There was a long period in which women's participation was restricted on the grounds that the hormonal cycle "complicates the variables," and as a result, areas remain where sex differences in drug response or disease patterns have not been sufficiently elucidated. The point that irregular periods or hormonal changes can be a signal beyond mere discomfort has also been emphasized in the article addressing menstruation as a barometer of women's health.

The concept Gerner emphasizes most in the book is "FemTech." It is a term for the technology industry that addresses women's health, with a wide scope from menstrual-tracking apps to infertility diagnosis, pelvic-floor health devices, and menopause-management solutions.

Estimates of the market size differ by institution, but Gerner introduces that FemTech's potential market size could reach about 1 trillion dollars. The interesting part is the gap with the flow of investment. In several analyses, the share of venture investment received by all-female founding teams is reported to remain in the low single digits. It means the distance between the market's potential and the actual allocation of capital is that large.

The counterargument Gerner throws out is clear-cut. Women's health is not a "niche." Survey results that women in the US and elsewhere handle a considerable part of household healthcare decisions have been cited many times. On that basis, the book concludes that investing in women's health is not charity but an obvious economic opportunity. The following table organizes the "gap between expectation and reality" that the book points out.

Another barrier Gerner points to is "not being talked about." Even when good technology and products emerge, the channels to make them known are often blocked. The book points out the asymmetry whereby some platforms and media restrict content related to menstruation, menopause, vaginal health, and sexual health on the grounds that it is "sensitive," while ads addressing men's health are exposed relatively freely.

This asymmetry leads to an information gap. It takes even longer for accurate information to reach the very people who need it. In clinical practice, I feel a similar texture. They are basic facts you could know just by searching, but out of embarrassment people cannot ask and let symptoms grow. The more freely information flows back and forth, the earlier the timing of diagnosis and treatment is brought.

『The Vagina Business』 does not stop at criticism; it proposes a direction of change we can begin in daily life. Not grand policy, but change that starts from attitude and conversation.

• Learning: it starts from understanding women's hormonal cycle and biological rhythm. Knowing your own body is the starting point of all health management.
• Talking: perception changes when we speak of the vagina, menstruation, and menopause not as embarrassing words but as everyday words.
• Viewing it as investment: a gaze that sees women's health not as an object of pity but as a legitimate industry is needed.
• Doing it together: the book emphasizes that women's health is not women's affair alone but a problem of the whole family and society.
• Breaking the stigma: that uncomfortable conversations ultimately create change is the message that runs through the entire book.

Among these, the part I most empathize with as a doctor is "talking." When a patient in the clinic can speak of her symptoms in accurate words, diagnosis becomes much faster. I think relieving embarrassment is also part of care.

Gerner writes that even in a society regarded as relatively open, it is not easy to put the word "vagina" into one's mouth. In a Korean clinic, that difficulty often feels even greater. The cases of those who put off regular checkups and come only after symptoms have deepened are a cross-section of that. As for why this hesitation delays checkups, I have separately addressed why regular checkups matter.

What matters is the order. Only when we speak of "vagina" and "menopause" without embarrassment does research begin, technology advance, and the female body receive the attention it deserves. The starting point of change the book speaks of also lies, after all, in "an atmosphere in which one can speak."

So I read this book not as a mere industry report but as encouragement from outside the clinic. For topics that are common yet not much talked about, like menopausal changes, knowing together the causes and mechanisms of menopausal body change lets you look at your own body more comfortably. A small curiosity leads to a checkup and consultation, and that single step is the surest way to protect health.

If you have a question that came up while reading the book or a women's health concern you usually hesitated over, please feel free to inquire by chat. Our Wooahan Women's Clinic takes as its principle honestly guiding only the necessary tests, without overtreatment.

Written by: Lee Dong-hee, Director · OB-GYN specialist · View doctor profile

First published October 25, 2025 · Last reviewed May 30, 2026

References: Marina Gerner, The Vagina Business (2024), McKinsey Health Institute women's health report (2024), Endometriosis diagnostic delay scoping review (2024)

This article is intended to provide general health information and does not replace individual diagnosis or treatment. If you have symptoms, please consult through an examination.