Before we started to think of women as three-dimensional human beings, TV shows could serve us up groups of female friend stereotypes. You remember. The sexy one. The ditzy one. The uptight one. And for a while that's what innovation in women's health wearables has felt like. The fertility one. The breastfeeding one. The pelvic floor one.
Of course, when it comes to health tech rather than TV characters, the more specific the better. But despite some brilliant ideas – from smart bras and bracelets that cool you down to a fingernail UV sensor – and a few notable investment rounds, we haven't seen a runaway, mainstream success either. We haven't seen the Oculus Rift of women's connected health tech yet.
Still, we're excited about what's happening in the space for two reasons – the ambition of the women's health startups currently on the scene and the fact that the big players are finally, finally, getting involved.
Round two for women's health startups
"This is an exciting time for women's health tech because of the convergence of three trends – we are all talking more openly about our bodies; the internet and innovations in sensor technology mean real-time body monitoring is now possible; and finally, our perceptions of health and wellness have dramatically changed from one of doctor-patient to individuals taking control for themselves."
That's Tania Boler, founder of women's health tech startup Elvie, which is based in London. The launch of its first product, the Elvie connected pelvic floor trainer, lead to a $6m investment round led by Octopus Ventures in March 2017. But Boler is interested in being more than a one-gadget-wonder. "We will be launching our second disruptive connected lifestyle product for women later this year, which will be aimed specifically at new mothers," she says. "We plan to have four products on the market by 2020."
We've also heard plenty of anecdotes around women-led, health-focused companies struggling to find investment in the bro culture of Silicon Valley. But Marija Butkovic, founder and CEO of the Women of Wearables network, is encouraged by a shift that she is seeing in this respect.
"There's still a lot that needs to be done, especially when it comes to investing in female-led businesses," she explains, "but the situation is the same in any tech vertical. It's our reality – women just need to fight more for funding. The good thing is that women's health has stopped being a taboo topic as businesses and investors are becoming increasingly aware of the opportunities within this space. I've seen so many great collaborations lately, so much support, coming from both men and women."
Butkovic points to pregnancy and family planning as particular areas of untapped potential for women's health and wearable tech as materials and sensors continue to advance: "Every single day I'm amazed by achievements that are happening in health tech and fem tech, and how these correlate to wearable technology in particular."
I said that we haven't seen a breakthrough, mainstream product yet – but it's worth noting that on the Google Play store at least, devices like Elvie, Ava's fertility tracking bracelet and OhMiBod's Lovelife all have 10,000+ downloads each from Android phones. That's without the iOS figures too – and remember that some innovative women's health devices, like the Willow connected breast pumps, are currently iPhone only.
For bigger numbers, we can look to Bellabeat, which has sold more than 700,000 units of its women's health focused, leaf-shaped trackers including the Leaf Urban. Its latest product is the Spring smart water bottle but it's the 360-view of its app which is looking more and more forward thinking.
Since the beginning, the Bellabeat app has put activity and sleep tracking alongside menstrual cycle tracking, developing algorithms to tease out insights on how these all fit together. The platform now includes susceptibility to stress predictions based on all this data, and hydration reminders too. Period, activity and sleep tracking in one place sound familiar? That's because Fitbit is also getting serious about women's health.
Fitbit's Female Health Tracking
Fitbit was founded 11 years ago, so we're not going to give James Park and Eric Friedman any prizes for rolling out period tracking to the Fitbit app in 2018. That said, we are very excited about what that means now it's finally here.
Female health tracking was launched alongside the Fitbit Versa, its new slim, comfortable sporty smartwatch that should do very well with women who want something with a bigger screen than the almost perfect Fitbit Alta HR. But it will actually be available to any user, who identifies as female, as an opt-in feature in the Fitbit app – the difference being that Versa and Ionic users will be able to view menstrual cycle data onscreen. Which makes sense.
Tracking periods was a much requested feature from Fitbit's female users, as Lucy Sheehan, Fitbit's head of marketing for the UK, explains: "The number one thing that people are asking for is to have everything in one place. You can see what's happening with your cycle but also see what happens elsewhere in your life – what's it doing to your sleep patterns? What's it doing to your resting heart rate? Do I or don't I feel like exercising?"
To start with, it will require your input, of course, such as guessing your average cycle length (clue: it's probably not 28 days) and length of period. But as you continue to log your data each month, the app will be able to predict how many days you'll be on your period as well as your ovulation stage for an estimated fertile window. You can also log symptoms including headaches, cramps, acne, vomiting and tender breasts as well as how heavy your flow is on each day and anything unusual in your fluids – handy if you want to show your doctor.
Down the line, the Fitbit app will start to provide insights into how your activity, sleep and menstrual cycle affect one another too. "If you look at what we have already when it comes to sleep data," says Sheehan, "every day when you log on, you get delivered an insight – today mine is about having more regular sleep time that'll help my overall sleep rhythm. So what we'll be able to do, in the same way we have for sleep, is take the data we've got, understand it and bring those insights to life."
Those connections are actually more useful than you might think if, like most of us, you're not very in tune with how your hormones change over the course of your cycle. Dr Dawn Harper, a doctor and TV expert for Channel 4's Embarrassing Bodies, told us at a Fitbit event in London that many women come to her and don't know much about their last period or the stages of their cycle and that she'd love to see the NHS give a Fitbit tracker out to everyone. (She might get her wish.)
Not only that but Harper's overview of a typical cycle could predict how Fitbit and its health experts will use this data in the future. "Day one of your period – oestrogen and testosterone levels are at bottom," says Harper. "But they start to rise very quickly. Your energy levels improve, you are more alert and socialable. At that point, according to research from Australia, you're likely to be subconsciously eating 12% less calories. It's a good time to start a healthy eating regime. Then you go into week two – your testosterone and oestrogen rise. Women have a higher libido, their memory and mental agility is better – so if you've got a presentation, you can schedule accordingly.
"Then you ovulate and bang, oestrogen and testosterone go down, progesterone goes up. That's when you start to feel more sluggish. Interestingly, if women make themselves exercise now, they get a greater fat burn for the same amount of exercise that they would at different points of their cycle. The fourth week is when the progesterone levels are really rising. Migraine sufferers will find they have migraines, women's sleep isn't as good, irritable bowel syndrome can flare at that point."
A database of women's health
The neat thing about what Fitbit is doing, though, according to Harper, is that every women is different, even between her own cycles. The idea is that the app gets to know you better and better and predictions get more and more accurate. That's not all – Fitbit plans to build an (anonymous) database of women's menstrual cycle data and that could be both an immensely useful research tool and a signal boost to women's health tech in general.
"The really powerful thing about this is we're going to be able to collect a really great database of female health and that doesn't exist at the moment," says Sheehan, "and that will really help us to power what comes next."
Dr. Harper agrees: "The world's your oyster I think. Of course people want it to be anonymous and it must be – but it can be and still be very valid. I think it would tell us an awful lot about what's happening to women. We know that women are starting their periods earlier than ever before and that's probably down to the fact that kids are getting bigger. So we know that but I think there would be so much more that we could access."
Additional reporting by Conor Allison