The Soon-To-Be $50Bn Industry That’s More Pro-Woman Than Birth Control

Weight gain, irritability, cramping, anxiety, acne, irregular bleeding — these are all symptoms widely recognized as inconveniences associated with being on birth control.

According to the Center for Disease Control (CDC), almost 16% of women in the United States aged 15-44 are currently on the birth control pill, and another 8% are currently using long-acting reversible contraception (like an injection, implant, or intrauterine device (IUD)). That’s 15,265,623 women. So it must not be that bad, right, if 15 million women choose to put up with it every day?

After hearing an ad for Mirena (an IUD) on the Hallmark Channel one day last week and listening to all the possible side effects listed by the woman with the flowery, enthusiastic voice, I was struck by the thought that some of these things sounded like much more than inconvenience. Ovarian cysts? Skin rash? I wanted to know more.

My first step was to do what any real investigative journalist does, of course: I went to one of my favorite mom groups on Facebook and asked if there were any moms who had a bad experience with some form of birth control.

I got 20 comments in the first two hours. One mom told me she started the birth control pill at age 16 but quit by age 19, because it made her face swell, and made her feel nauseous, tired and angry. She said when she finally quit, her period didn’t return for more than a year. Another mom seconded this, saying she had very regular, 25-day cycles, started the pill at age 18, and five years later came off the pill to completely irregular cycles of up to 75 days which never became regular again on their own.

A third mom said that she had the Mirena IUD inserted. Days later, she started losing her eyesight. She couldn’t focus, and saw bright, blurry objects as a result of a migraine aura. While she said this was terrifying, it wasn’t over — she then had terrible leg pain, hair loss, irritability, weight gain, and anxiety.

With limited insurance coverage, she couldn’t find a doctor to remove it, so she lived with these side effects for two years, during which she also had to be careful sitting down or she’d get a painful pinch in her cervix.

Another mom reported that she had the Depo-Provera shot at age 19 and gained 100 pounds over the year and a half that she stayed on it. During that time she also experienced almost constant spotting.

Still another mom explained that she took Loestrin and felt “weird…I felt like I was always looking down on my body from above, kind of like an out of body experience.”

Further research showed that yes, these are all possible side effects of various forms of hormonal birth control. Besides this, the Pill has been linked to depression, breast cancer, and blood clots. Mirena and other devices like it have a horrible track record of migrating into other parts of the body, including the lungs.  Twenty-five percent of women with the Nexplanon implant are willing to live with headaches and fifteen percent with vaginitis, fourteen percent with weight gain. Oh, and that device can also go missing in your body. Nuvaring remains on the market despite the fact that it’s unclear whether it’s actually causing death.

Birth control has been lauded as the ticket to women’s freedom, but being subjected to all of this doesn’t exactly ring those freedom bells.

The bottom line is that if you’re a woman on birth control today, you’re expected to live with what might be annoying, painful, possibly serious, lifelong, and maybe even lethal side effects.

And this is especially interesting given that women are only fertile for an average of 6 days per month.

As one woman recently wrote in the Huffington Post:

“What does it say about our society that serious risks like depression are considered acceptable ― even by those who experience them, like me?”

But there is hope. Enter, female-focused technology, generally known as “femtech” – the apps, the devices, and the gadgets that are centered around female health and wellbeing, with a heavy focus on reproductive health and fertility awareness.

The term “femtech” came into existence in 2016, when Ida Tin, mother of 2 and CEO of the period-tracking app Clue, coined the phrase.

According to research by Frost & Sullivan, femtech is on track to be a $50 billion industry by 2025.

What is it, exactly, and what does the technology even do?

“Fertility-based awareness methods” (FBAMs), known to some as “Natural Family Planning” (NFP), refer to tracking a woman’s menstrual cycle, cervical fluid, basal body temperature, and other factors that help a woman understand when she is ovulating and therefore when she is fertile. This is information that can be used to achieve or prevent pregnancy.

Keeping track of all of this data can be difficult. When used correctly, FBAMs can be up to 99% effective, but user error has been a detriment to their reputations for success and wider adaptation in today’s world.

The femtech industry claims that it can simplify tracking and reduce the opportunity for error, helping women to understand their bodies and their fertility to the point that women can either avoid or achieve pregnancy without using hormonal birth control at all.

Kindara is one mobile femtech app founded in 2011. It helps women track all of these factors and chart them visually on their phones each day, using data accrued month to month to predict ovulation and menstruation. Married couple Will Sacks and Kati Bicknell co-founded the app in 2011 because they were “looking for effective birth control that wasn’t the pill”:

“Kati had been on the pill for 10 years and she didn’t like the side effects. She introduced me to the fertility awareness method and I was blown away by how little I understood about female fertility. I was actually outraged that I had never been taught how reproduction actually works.

Once we started tracking her fertility signs I learned all about how her body worked and also discovered an added intimacy in our relationship. We wanted to share this with other couples … It’s really sad that millions of women suffer through the side effects of hormonal contraception or the stress of potential fertility problems and don’t even know there are effective alternative options.” (Will Sacks, from an interview with Business Insider)

Kindara also makes an oral thermometer that automatically sends daily temperature readings to the app via blootooth. It’s called “Wink.”

Ava, another leading femtech company, makes a medical bracelet that women can wear at night. It records their temperatures and other physiological factors to let them know when they are entering their fertile window.

At $299, Ava is more of an investment than Kindara or most of its competitor apps, which are free, but as was shared in a recent Forbes article, “research [Ava] conducted in the UK found that nearly two-thirds of women don’t know how long their fertile window lasts within their cycle … and 10 percent of of women have spent more than £200 to increase their chances of getting pregnant.”

Most of these gadgets and apps are marketed as technology that can help couples who are trying to get pregnant, but in August 2018, one app called Natural Cycles was approved by the FDA to be marketed as birth control (the first ever digital form). Physicist and mother Elina Berglund co-founded the app with her husband Raoul out of a desire to better understand her own fertility.

And according to Kindara reports, 30% of users are also utilizing their app to avoid pregnancy.

The list goes on and on — Moody, Clue, Flo, Daysy, Woom, Clear Blue, Ovia (which in fact offers its technology as an option that employers could include as an employee health benefit) and numerous others are in this market with significant funding.

There are even some companies dedicated to providing support and care in remote and rural areas such as some parts of India.

While there is some skepticism about this technology and how effective it will be, the femtech industry — led by women, many of whom are mothers — is blazing a trail to make family planning healthier for women.  

“[O]vulation-cycle tracking applications such as Clue, Maya, Glow and Ava have not only made fertility management affordable and effective,” says an article recently published by Forbes, “but have also reduced undue side effects associated with conventional products such as contraceptive pills and intrauterine devices or even cycles of infertility treatment for women struggling to conceive.”

Modern birth control might be failing us as women, but thankfully, modern tech has our backs.

For further reading:

• ‘Fitbit for your period’: the rise of fertility tracking (The Guardian)
• This Couple’s App Helped 10,000 Women Get Pregnant And They Say It Can Replace Birth Control Too (Business Insider)
• ‘People find anything about the vagina hard to talk about’ (BBC News)
• How Start-Ups Could Build a $50bn FemTech Industry (Forbes)
• Digital contraceptives and period trackers: the rise of femtech (The Guardian)
• Women’s Healthcare Comes Out Of The Shadows: Femtech Shows The Way To Billion-Dollar Opportunities (Forbes)

Author’s Note:

There has been some concern about what will be done with all of the very sensitive user data collected by apps like Kindara and its hundreds of competitors. Kindara swears they will not sell it, but competitor “Glow,” founded by former PayPal CEO Max Levchin, has come under fire for sharing some of this data with advertisers (and inadvertently at one point, stalkers).