The Center for Data Innovation spoke to Ida Tin, co-founder and chief executive officer of Clue, a Berlin-based company that produces an app to help women keep track of their menstrual cycles and general health. Tin discussed the benefits of using algorithms to track and monitor menstrual cycles, and the added usefulness of other health and lifestyle data.
Nick Wallace: What are the benefits of being able to log your menstrual cycles in an app, and where does Clue’s algorithm come into play?
Ida Tin: When people start tracking their cycles, what we see is that they become more aware of their bodies. So it’s two things: their own biological supercomputer starts working more, and the computer in their phone can work with them. That allows people to take better care of themselves. They can see if something is off or plan their lives around what they are experiencing.
When we collect data and have technological assistance, we can capture the data so that you can remember it. You can share the data: you can bring it to your doctor, or show it to your partner. We can also make predictions and do pattern recognitions. These are things you cannot do as well on your own. For instance, we can take somebody’s data and compare it with what normal ranges might be.
Also, when you have this kind of tracking going on on a mobile device, you can give people information, and that’s really important, because we see that it’s not enough to collect data and just mirror it back in a graph. You need to give people a context that they can understand this data in. You need to interpret the data and then people need to have some sort of understanding of what that interpretation means.
So, for instance, if you say your cycle is on average 45 days—what does that mean? Should I be worried? Not worried? Well, if it always used to be 28, and suddenly it’s 45, then you should be worried. But if you usually have 45 day cycles, maybe it’s not a problem—but it might be a sign that something else is off, so maybe you should talk to a doctor. We give this kind of context with all the information we supply in the app and on social media. Ultimately, we’re asking a lot when we ask for all this personal data—what we give back cannot just be the same data, it needs to be meaningful information that people can make sense of.
You also have to be aware that when you talk about the body and female health, the knowledge levels are surprisingly low. Whether it’s America, Europe, South America, Asia, or anywhere else, people don’t know the most basic biology. So you need to educate as you give the data back.
That’s the biology part, but then there’s the whole social part. There’s so much taboo and shame and other things that make people uncomfortable. For people even to be able to hear or understand, you sometimes have to peel away a layer of discomfort, or shame—social elements that make it hard for people to process the information in meaningful ways.
Wallace: Clue also collects a lot of other health data and lifestyle data. What role does all that data play in the advice and predictions it can deliver?
Tin: What we’ve learned over the years is that the female cycle is related to so many different areas of life, and so many different areas of life affect the cycle. Your overall wellbeing can very much be affected by your reproductive health, and the other way around, your cycles and your reproductive health are very much affected by your general health, and even your psychological health. It wasn’t meaningful to limit the tracking just to biology. We needed to expand it somewhat.
It’s also important to remember that Clue is not just about periods, it’s actually about the full cycle, and you have a whole variety of symptoms that occur throughout the cycle. You have mood swings, your sex drive is changing, your skin, your hair, you can have migraines related to your cycle, you can have tender breasts—the are so many different things that to really help you live well, you need to understand the full cycle.
Even beyond that, there are things that are affecting your wellbeing and your health, which might be conditions like endometriosis or PCOS (polycystic ovary syndrome)—those are very common diseases that people have—or it could be things like the side-effects of birth control. All these different things are related to the cycle, but they’re broader than just what’s happening in this one cycle.
Then there is the societal level, where understanding that we build muscle tissue differently throughout the cycle, our immune system works differently throughout the cycle, even our sense of vision and smell is changing—there isn’t a lot of knowledge about what this biology is doing to us. We feel it would be helpful if that information was more widely available.
This is why we’re doing science collaborations with researchers, where we make part of our datasets available so they can conduct research and expand what we know about female health, because there’s still a lot of dark areas on the academic map. We have chosen that as part of our mission at Clue, to help move females forward both in research and on a more social and cultural level
Wallace: Can you tell me a bit more about that research? Is it all medical research, or are you working in the social sciences too?
Tin: We have done research in both fields. We’ve done work on understanding bleeding patterns for adolescent women, for example, because it’s just not well covered in the academic literature—what’s actually normal if you have just started having periods? The world doesn’t know. The clinical experience tells the researchers we’re working with that a lot of young people believe an awful lot more than they maybe should. But young people don’t know that, so they act on what they think which can have a huge health cost for them.
That would be a medical example, but we have also done things like figuring out how people talk about periods all across the world. We did the world’s largest study on euphemisms for periods. We had 100,000 replies from people all around the world telling us what words they used to not say period. It was absolutely mind-boggling what people do, the creativity was enormous, just to avoid saying period.That was more on the social side.
We also did a study with the Kinsey Institute on intimacy and sex. Again, we had about 140,000 replies. It’s really fascinating how we can reach out to our user base with scientific questions and get data back incredibly fast, so we can take this data and give it to the researchers, get the insights back and give it to the users. It’s wonderful that we can do that. And we’d like to do much more of that, because we’re researchers—there’s no way an academic researcher at the Kinsey Institute would ever have 140,000 replies within two days.
I think we can play a big role as a consumer app in doing research, and even doing research where the users can say, “these are the things we care about,” and we can match that with researchers so that we actually do science on things that can really benefit people. I think that’s a really cool dynamic that’s a really new thing in the academic world. We get data from so many different age groups and races that we can reach an audience that’s very hard to match if you’re just sitting as one researcher somewhere.
Until now, people have generally contacted us with research questions and asked us if we want to collaborate, and I would love us to be more proactive in challenging the questions that users have for researchers. But it takes a little bit of time to get that right.
Wallace: What’s your professional background, and how did you end up developing an app like Clue?
Tin: I have no professional background! I went to a very creative business school in Denmark called the Kaospilots, where I graduated in 2004. Then I started a motorcycle touring agency with my dad, so we did high-end motorcycle tours all over the world—I was a motorcycle tour guide.
Then I wrote a book, which just came out in English, called Directress. It’s really not a commercial project, but when it was published in Denmark in 2009 it became a small bestseller there, so I had it translated. I spent two years traveling the American deserts to see if I could use the desert as my office…a crazy experiment.
I grew up traveling on motorcycles with my parents, they were adventurers and they went all around the world with me. So I’ve seen a lot of the world and a lot of women’s lives, since I was an infant. It sits very deeply in me, this sense that if women cannot control what is going on with their body, then it’s very difficult to create a balanced world. There’s a lot of things that just start with women feeling they have agency over their own body and childbearing.
And then there was also just my own experiences—I tried to be on the pill and experienced a lot of side effects. I was in a steady relationship from the age of 16, and thinking, “why is this so difficult?” I started looking into patent databases to do some research on what innovation there is in female health and family planning, and I was shocked, it was like there’s been almost no innovation since the pill came out in the 1950s! There has been so much innovation in the world and in technology since then, yet for this incredibly basic human need, nobody’s done anything.
I had the idea when the first smartphones came out, thinking that if you could collect enough data and have it on your phone, which is a really intimate interface to technology, it would be so helpful—something that could say, “hey, today you will not become pregnant!” I thought that would be such a cool thing to have.
Then I had an idea for a piece of hardware, a home diagnostic tool to measure hormones at home so you would know very accurately and quickly where in your cycle you are. I tried to build that for quite some years, but it was very challenging technologically, so we decided we’re not the right team to do this.
At the same time, we recognized that even without this piece of hardware, we’re entering into a world where we get data from all these different sensors and wearables, and in the end we could see that what we would be really good at building is this communication point to the user, where we can talk about things in a language that people can understand, and where people can be seen and heard and make us understand the questions they have. We can then connect with all kinds of data from many different sources and give it back to the user. That was a better place for us to be than building hardware.
We launched the app in the summer of 2013. I met Moritz von Butlar, my first co-founder, while studying public policy in Berlin. Moritz was a hardware person, and I was describing this idea I had, and he said, “I think maybe I can help build that.” Then my partner—he was working in a different start-up—he decided that he also wanted to do this, and he’s still here. Then we met a couple of other people—there were five of us when we started the company at the end of 2012. We had five angel investors who each put in €10,000, and now we’ve raised €30 million, and we’re 55 people.
Wallace: Everything points to there being more data available for personalized medicine in future, from genomics to the Internet of Things. Where do you see the data-driven approach to women’s health going in the next five to ten years?
Tin: That’s a wonderful question and I wish more people were asking themselves that. I think there is a place in the world for a company—and we’re hoping to be that company—that can be a kind of companion (I’m struggling to find the right word), an AI to help you navigate your body. We’ve chosen female bodies because they have this very unique set of needs related to reproductive health.
Right now it’s very fragmented: a user will have data on their running app and their period app and their pregnancy app, and their health records and their DNA testing, and their hormone strip-tests that they pee on to know if they’re ovulating—there’s data in all these different places, and it’s not a great experience, and you’re not leveraging the opportunity for each type of data to inform use of the other, you’re not bringing data from, say, your gynecologist to your running coach—that might be helpful.
I think there is a task in trying to build a system where you can take all this data and put it together, and enable not just the Clue app, but also the running app, and the doctor. I know many people are trying to create this in different spaces of health, but I haven’t seen that integrated platform emerge yet, and I think it needs to come.
My motivation for trying to build that is that it’s important what ethics you build it on. When you feed data back, it isn’t neutral, you have a voice, you give it a flavor. And I think it’s important to have a progressive voice around female health in the world, that it’s ok to have this body and live in-tune with it. Because for thousands of years we’ve been asked not to have this biology, to put it off to the side.
I would like to try and make sure that when we start connecting all this data and it starts becoming really powerful that it’s done on a foundation that feels like it’s actually trying to do something helpful for women, and not just exploiting it commercially, or even suppressing it. It’s a very sensitive part of life experience and it’s very central, it connects to our identity, our sexuality, our family, and it relates to everybody on this planet. I feel a responsibility to try and do this and do it right. I don’t think I want to just leave this to Google or Facebook.
Beyond that, I think there’ll be a lot of products solving problems for women related to their bodies. We already have a term for it, it’s called femtech, which refers to all these connected devices, whether a connected breast pump, or a connected sex toy, or DNA testing to know if your baby will have genetic defects from the biology of you and your partner. There are so many analytics tools. There’s new products, like organic tampons—all kinds of stuff!
We’re also getting used to demanding technology that serves us. We expect it to give good recommendations for movies. Where’s the recommendation engine for birth control? I think women will start demanding that technology works for them, which it really isn’t still, to a large degree. I think that’s where we will see a change—people will demand things that fit them.
