Today we have the pleasure of spending time with Sarah Bolt who, at the age of 40, took stock of her marketing job and decided not only to find a role with a wider positive social impact but also start her own firm. TechBritannia Co-conspirator Rose Ross discovers Sarah’s inspiration for her company Forth and what drove her to move into Femtech.

Sarah reveals how the eHealth market has tended to focus on male healthcare and how her mission is to empower women by providing information about their hormone levels and patterns. This is particularly important for issues such as the perimenopause which is a topic that hasn’t been talked about enough in the past, despite the strong and long-term effects it can have on health and moods.

The chat also includes the good news that Forth has recently raised more funding, a difficult task in an investment market seemly obsessed with male-founded firms. Watch the full podcast here:

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Interview transcript:

Rose Ross: Hi, everybody. My name is Rose Ross, and I’m the co-founder of TechBritannia, and I’m delighted to be recording this #WeAreTechBritannia podcast with Sarah Bolt from Forth. Hello Sarah, how are you?

Sarah Bolt: Hi Rose, I’m good thank you, very good.

Rose Ross: Fantastic. Well, you’ve had a very interesting career and you are up for a nomination for an everywoman Award which is a NatWest initiative. So, let’s find out a little bit more about you and about Forth. Do you want to give a little bit of a potted history of your career and your journey so far, and then we can talk a little bit about for Forth?

Sarah Bolt: Yeah absolutely. So, to put it in context, Forth is a digital health tech company. I’m not a medically trained person, my background is largely in marketing. I’ve spent longer than I want to imagine in marketing, over 30 years. But when I hit 40 I was working as a new product development manager for Dyson, I had two young boys, I was commuting three hours every day, and I just thought, “do you know what? Life is not enjoyable, it’s just not working for me”. I think hitting 40 is just one of those ages where for me, I looked at my life and thought “well, what is going to be my legacy in life, what imprint am I going to leave behind?” And I just decided vacuum cleaners really didn’t do it for me, so I resigned from my role, and basically made a decision that I wanted to work within a business that had more social purpose and made more of an impact on society. And I’d reached the conclusion that healthcare was the area that I wanted to work within.

So, I took myself back to university. I did a Master’s in what’s called social marketing, it’s nothing to do with social media, it’s about social impact, and marketing for public good. So, I did a Master’s degree in that, at the same time I started working for the NHS on behaviour change campaigns. I then went on to become a strategy planner and work for private healthcare companies. And it was while doing that work in around 2013-2014 that I really started to notice the beginning of this trend towards digital health. And, as our smartphones became smarter and more sophisticated, there was an opportunity for them to get more involved in our own personalised healthcare and give people more data on their own bodies. I just found it really fascinating.

When Fitbit was first launched in the UK, I ran out and I bought it and I loved it; I’d love the way that what it had done was taken an old concept – pedometers had been around for a very long time, since the 1980s, but they totally reinvented it for today’s digital consumer. It was that idea which just sparked an idea in my mind about, well that is amazing, but how can we give people more relevant and in-depth information about their health, about what’s going on inside their body, the part that they can’t see. And that really was the lightbulb moment for me for starting Forth.

Rose Ross: Brilliant. Could you tell us a little bit more about Forth as an app because it has a particular application, that I understand, which looks at the menopause within women. And obviously women are constantly aware of changes in their body, whether that’s through puberty, having kids, getting older, the menopause, the perimenopause, and all of these other amazing… we are very hormonal creatures, as are men but perhaps in different ways. So, what inspired this to look at?

Menopause has become a much more talked about topic. It was a bit taboo, it was seen as quite negative, women effectively coming to the end of their shelf life, which is brutal!

Sarah Bolt: Well, that’s one way of viewing it, I guess, yes!

Rose Ross: In one sense, purely in one sense. But it isn’t something I don’t think that most women would discuss, they’ll talk amongst themselves, but it’s not really something that you’d want to necessarily talk about generally speaking, but it’s important, isn’t it? It’s important.

Sarah Bolt: Well, I think the world is changing, and the things about menstrual cycles, hormone health, menopause, perimenopause, it’s all being talked about much more in the open now, and I think it’s not before time actually that that’s happening. But, initially with Forth, we have a wider wellbeing mission as well. So, for us at Forth, what we set about doing is, we wanted to turn people into citizen scientists, by giving them information about what was happening in their own bodies, and then educating them so they could take responsibility for their health, and then they could improve.

So, we’re not diagnostic, we’re very much in the wellbeing market, so that’s what we do. What we thought was, well actually what we can do here is combine technology with science, so we are that mesh, I guess, that knits the both together. So, we as a service, collect small biological samples at home from people, and then we take that data and turn that data into intuitive graphics, and further bioinformatics. So, that’s what we started out to do, and as I’ve developed the company, I’ve become more and more interested in female health and become more aware, I guess, of the gender data divide in healthcare.

And there is a gender data divide in healthcare, because a lot of the information we have on the human body is actually derived from the male human body, not the female human body. So, there is this massive data gap on how females react. So, the female body will react differently to certain pharmaceuticals, they will present with different diseases differently, so for example, for heart attacks, women present completely different than men in heart attacks, which is why more women die of heart attacks than men. And I think that will be a surprising statistic for people, because we associate heart attacks, I think, more with males, but actually more women are prone to dying with it, because it’s not picked up, because they don’t spot the signs.

So, I was really interested in female health, and I’d been going through the perimenopause myself, whilst I was developing Forth the company, and realised what a huge impact it actually has on a woman’s life, and the way that they feel on a day-to-day basis. And I think for me that was just being pushed under the carpet. My mother never talked to me about it, I didn’t even think about the menopause at all, and assumed well, that would be some time in my 50s that would happen, and didn’t really realise, actually the impact of that can happen from your early 40s, it starts to impact on your health and how you feel. I started to talk about it with my friends, and they all experienced really bad symptoms from depression, into the mind fog, the general forgetfulness. No one had really warned us that this was going to happen to such an extent, and it would be such a big impact on our lives.

That really started us, at Forth, at looking into how we could improve the information given to women around hormones, because we felt for too long hormones had really been, in women, …and they are important in men as well…, but hormones have been really talked about largely in terms of fertility and reproduction, and actually hormones have such a massive impact on your general wellbeing and your health, for men and women. This wasn’t being recognised and talked about, and women didn’t really understand how their hormones actually fluctuate throughout their menstrual cycle, and the impact any changes in those hormones was going to have on them, particularly with women in the perimenopause. Women want certainty that they’re entering the perimenopause so they can understand. Almost, we need to put a label on things that helps us deal with it, and women are not able to get this label for various different reasons.

So, we looked at how can we combine a minimum amount of blood samples and combine AI to actually give women more certainty. We won an innovation grant from SMARTCymru which is from the Welsh Government, to develop this product which combines AI with blood sample collection and medical expertise, as well, to give women a very personal insight into how each of their four key hormones fluctuate throughout the entire length of their own individual cycle. And from that they can then take action, whether it be, “Well, actually my hormones are at such a level, I want to go onto HRT”, or if you’re younger, then “Actually I need to delve deeper into why my hormones are fluctuating in a non-standard pattern”.

Rose Ross: Fascinating, isn’t it? Really so complex, but when you were talking I hadn’t really thought about this data divide, and I’m sure it’s true for other types of – I wouldn’t say minorities, because women are actually in the majority, but different people, and it’s horses for courses with medicine, and I was a huge fan of House, and I always used to love the fact that most of the problems were the fact that there were two conditions layered on top of one another, or one was presenting like another. So, it’s a little bit of a puzzle really for most women, because you’ve talked about the four hormones and testosterone is one of them, I presume that you you’re looking at. And as you say, for all of these various elements, hormonal imbalance say, for example, changes can impact so many different aspects of your life and therefore impact your quality of life. And a lot of it is avoidable, there are things that women can do that aren’t necessarily HRT, but also understanding how your body interacts with caffeine, alcohol, how important exercise is, this is something that’s been big, hasn’t it, over the whole of the pandemic, we’ve all been reassessing these things. And hopefully more people are taking exercise, but it’s such a great opportunity to have a huge impact on half of the population.

Sarah Bolt: We are really so excited by it, because it truly is ground-breaking, and it gives women the insight that they’ve been looking for, that has been a bit missing for them. And yes, you don’t need to jump to HRT, that is every woman’s own personal decision what they do, but you get to realise that actually, there are some lifestyle factors that really are at play in hormones as well. For example, sleep, inadequate sleep, disrupted sleep will affect your hormone pattern. Also, your nutrition will affect your hormone pattern, doing exercise will impact your hormone pattern. And that’s why you hear… I’m not going to say extreme athletes but professional athletes, that’s why you hear with female pros that sometimes they have problems with their hormones, and that is because they might not be fueling sufficiently, so their energy in/energy out matrix is off-kilt. That will have a massive impact on their hormones, which will then lead them into having more injuries, because oestradiol is really important for bone health, and so your bones become weakened.

It happens in men as well with testosterone. You hear about cyclists that their bone health starts to deteriorate when they’re in their 30s, and that part of that is to do with their hormone levels and their lack of impact exercise as well. So, hormones are really important. Our Chief Medical Officer is an endocrinology expert, and hormones are her passion, she will just talk day-in day-out on hormones, because they are so integral to everything that goes on in our bodies.

Rose Ross: Exactly. So, how do you see the future panning out? Is this something that you will work with the NHS around? There are lots of societies I would imagine that look at these types of things. What’s, I wouldn’t say your go-to market strategy, but how are you going to be partnering, engaging with women and giving them access to this? Because this sounds like it should be something that all women across a long period – because it could be used in puberty as well, because that’s a bit of a minefield for us women.

Sarah Bolt: Yes, from the time that you have a menstrual cycle, and you have a regular, natural menstrual cycle, you can start monitoring hormones. So, you could start monitoring them for all stages of your life, particularly where women make a decision to have children later in life, you could actually start monitoring your hormones and seeing when they’re starting to go into decline. So, there’s all kinds of applications for it.

For us, would we work with the NHS? Yes, we’d love to work with the NHS, but the traditional pathway of innovation in the NHS is 20 years, and, yeah, we’d be waiting a very long time if we just held on for them. And what we find now, and what we find with our general service as well, is that people are making their decisions themselves that they want this information. So, our go-to market of our business from the start has been, let’s go direct to the consumer, let them decide, let them create noise about it, and then the rest – the corporates and the institutions – will follow. And that will be our strategy as well with female hormone mapping. Although, we also see obviously in female clinics, that they would find the way that we map hormones very-very useful.

There’s also the possibility for us that we just supply a technology platform to people, so they could access the report and how the report works anywhere in the world by just inputting key data information, and then our system would spill out the actual mapping report for them.

Rose Ross: Yes, so that would fit into existing healthcare structures and system, and be mapping it.

Sarah Bolt: Yes, exactly.

Rose Ross: Do you see academia or the university hospitals finding something like this incredibly useful?

Sarah Bolt: I think what we’re finding already with the results is, there’s lots about hormones that we don’t understand, and doing this work is actually pulling up some inter-relational patterns that we’re not aware of. So, it’s going to be really interesting more clinical studies that we can do with it, and how we can present data going forward, and what we really learn from it.

So, I think there is the opportunity to work with academia, there’s also the opportunity to work with the professional sports industries in it. I think there’s also opportunities to work with people like the MOD, where you’re looking at female soldiers, and the influence of training on female soldiers’ health and their hormone levels as well. So, there’s really lots of areas that this could be applied for.

Rose Ross: Well, interestingly enough I was listening to the Head of Strategic Commands’ J-Hub, which is their innovation hub, and I can’t remember the gentleman’s surname, but his name is Peter. So, I will connect you if I can because I was thinking about that and I thought, is that too spurious? But they said that they are working with a lot of organisations that they wouldn’t normally be able to, as in smaller organisations. I think that’d be fascinating, but I also think it’d be fascinating to be looking at the impact on both male and female soldiers.

Sarah Bolt: Yes. I learned that we have plans afoot as well, to look at hormones within men as well. But for us, and as a female founder… that’s the thing about being a female founder, or being a founder in any business is, you can get to spend times on your passions as well, and direct the business towards some things like that, obviously if it makes commercial sense. So, for us, certainly next year our focus is very much on female health and female hormone mapping, and I think it’s come at really the right time as well, because Femtech is really advancing at the moment, there’s a lot of noise around Femtech. It’s not getting all the investment it needs, but there is a lot more investment going to female-led Femtech solutions out there now, than there was a year ago.

Rose Ross: So, that’s interesting what you’re saying, it’s not getting the investment that it needs, and obviously I’m not sure what your investment model is, perhaps you can dive into that at some stage, but why do you think Femtech is not getting that interest?

Sarah Bolt: Well, I think it’s female-led businesses don’t get as much investment. I think the UK Government did a study a couple of years ago, which is kind of frightening when you hear these stats. So, for every pound that is invested in a startup, one pence of it goes to a female founder-led business. Ten pence go to a mixed gender-led business, male and female. And 89 pence goes to male-founded businesses. So, you can see that there is a big difference in the amount of investment going into female-led businesses, and Femtech businesses are largely led by females because they understand the problem much better that they’re trying to solve. But, I think the situation is changing. I’ve led three investment raises for the business, we just closed out one just last week.

Rose Ross: Oh, congratulations!

Sarah Bolt: Yeah, thank you. So, the situation is changing, and I think VCs have spotted that actually there is this growing opportunity for them in Femtech, and in the hormonal health market. So, they are looking at this and they’re starting specific funds, there’s funds being led by female investors as well. So, I think the times are a-changing. Still got a long way to go but times are a-changing.

Rose Ross: Well, hopefully, you’ll be a big part of that with the kind of stuff that you’re doing, empowering women…

Sarah Bolt: I hope so.

Rose Ross: … to live, I hate to coin this phrase, to live their best life but without the impact of some of the things that hormonal imbalances, or hormonal issues can cause.

Sarah Bolt: I think that phrase is actually really important, because the strapline of our business is, ‘Your personal best,’ and it is tying into people’s motivation I guess, to want to live their best life, to want to feel at their best and their increased engagement of, ‘What can I do to help improve that, to help improve my life and my health so that I can feel at my best?’

Rose Ross: Well, a lot of people do invest on trying to do the King Canute with age, don’t they, with stuff on the outside. But, this is something that actually could not only have a positive impact on how you look, because obviously if you’re happier and healthier, you’re always going to look better, right? And also your weight is probably going to be more reflective of where you want to be, rather than perhaps not. But, I think the way that you feel inside is also really important. Let’s face it, people haven’t seen us apart from on a Zoom call for the last two years.

Sarah Bolt: Yeah.

Rose Ross: That internal relationship with how you feel is incredibly important. And I think another thing that you’ve mentioned, it was actually when you were talking about your own experiences of having kids, and then obviously realising that you were perimenopausal; because women are – not deciding to delay – but are delaying when they have kids, you are starting to butt up against perimenopausal, potentially when you’ve got very young children. Which let’s face it, they’re not a great combination, no sleep, lots of stress, probably juggling quite a high profile, or at least a very intense job to keep the money coming in.

Sarah Bolt: Women in their 40s have a lot of things coming at them all at once. So, you’re right, they are having children later, so they still might have young children or teenage children, not sure which is worse.

Rose Ross: Right now I’d say 17 about to turn 18 are absolutely the worst!

Sarah Bolt: Also they’re thinking about their career, they’re starting to look at their career about changes that they may want to make in that. They might also have their parents who are getting older, and there might be some care issues are around that to be dealing with. And you’re often in long-term relationships, which comes with another challenge as well. And on top of all that you become perimenopausal. It’s a hard time for women, I think, in their 40s.

Rose Ross: Well, I’d say in the 50s, because I’m 54 and I’ve got all of those going on.

Sarah Bolt: And continues, yes.

Rose Ross: Yes, it doesn’t stop. I hate to tell you this, it doesn’t stop!

Sarah Bolt: It’s relentless!

Rose Ross: Never, it just goes on and on, and on.

Is there anything else you’d like to share with people, because you’ve put you’ve had a lot of experience, you’ve done the whole shift, pivoted around in your own career. What’s next for Sarah, what would you like to achieve? If we have this conversation again in five years’ time, what would you like to have been the highlights of that time?

Sarah Bolt: I guess the purpose for me has always been to make an impact. So, if I can deliver on a business that makes a difference to people’s lives, then that’s kind of job done really, for me, and I really hope that the innovations that we’re making in healthcare, female hormone mapping being an example of that, can really help give people that extra insight that they need throughout their health. In five years’ time I’d like to see what we develop in female hormone mapping being a blueprint for how you actually measure hormones in women, right across the world. I mean, if we can do that within five years then I think, tick, I’ve done a really good job.

Rose Ross: Well, I am absolutely convinced you’ll be having that type of conversation, perhaps not the whole world, but I think hopefully there should be a good proportion of it thinking about things from a Forth perspective.

Sarah Bolt: Yeah, absolutely. When you’ve got a business there’s always lots to do, because you don’t stand still, and that’s, I think, one of the things that you have to do as a business, I would say you stand still at your peril. You’ve got to always be looking, because life is always fluid, and it’s constantly moving. So, you have to move with it, and hopefully what we’ll do is come up with some innovations to lead it as well.

Rose Ross: Fantastic. Well, I wish you the very best of luck. Thank you so much for joining us.

Yes, that was Sarah Bolt from Forth, who’s the CEO and founder, and I’m sure she’ll be telling us more about the new raise, and what comes of that in the future. I wish you the very best of luck with the award on the 7th of December.

Sarah Bolt: Thank you, thanks for that.

Rose Ross: Well, I’m Rose Ross, and I am the co-founder of TechBritannia. And if you’d like to find out more about what we’re up to, please visit the website at www.techbritannia.co.uk, or visit us via social on Twitter @TechBritannia, and find us on LinkedIn. Thank you very much.