IntroductionNatural Cycles1 is a revolutionary contraceptive app that has broken into an industry saturated with long-standing clinical methods. Many women may feel uncomfortable placing their futures in the hands of a digital app in absence of medication or prescriptions. However, Natural Cycles has gained the trust of millions through the effective communication of its data and efficacy. Combined with its natural, community-oriented campaign, Natural Cycles shows the value of medical communications for femtech start-ups.
The One and OnlyNatural Cycles is the world’s first and only CE and FDA approved digital birth control1,2,3. The app has revolutionised the contraceptive market with an aim to educate and empower women - to take control of their fertility through the use of cycle calendars and personal statistics without any hormones or side-effects4. The technology pairs a traditional method of charting body temperature with an algorithm that learns the pattern of each woman’s unique cycle to predict their fertility window5. Women simply measure their temperature using a Natural Cycles thermometer (accurate to two decimals) as soon as they wake up, and record it in the app for the algorithm to work out whether they are fertile on that day or not (expressed as ‘green’ or ‘red’ days)6.
Undoubtedly, Natural Cycles is a pioneer in the fast-growing femtech space, (‘female technology’ start-ups which are expected to grow over 13% between 2020-20267) but this has not come without its problems. Elina Berglund, the co-founder and CEO of Natural Cycles, expresses that although she had assumed the app was something that all women needed and wanted (a hormone-free, prescription-free contraception), it quickly became apparent that they needed to be heavily informed about it first8. Natural Cycles is a novel technology so scepticism was expected - building trust is a challenge for anything that is the first of its kind9. But for something that can be as life-changing as contraception, trust is of paramount importance.
Trust Is KeyTo build this trust, Berglund has emphasised the company’s use and communication of research and data. Natural Cycles communicates its safety using the ‘Pearl Index' which is the benchmark for contraception efficacy10. Under the Pearl Index, with typical use, Natural Cycles is on par with the contraceptive pill, slightly below LARCs (long-acting reversible contraception, such as the copper coil), and significantly better than other methods, such as condoms alone11. This impressive comparison presents itself as universal communication of the product’s efficacy - by drawing upon comparisons with widely used and widely known clinical/prescription contraceptives which all women are familiar with. As a result, the digital app is catapulted into the more ‘trustworthy’ world of clinical pharma.
Another way Natural Cycles has gained trust is through its CE and FDA approval. There are several other menstrual cycle apps in the femtech space (such as Flo), however Natural Cycles remains the only one which is an FDA and CE approved contraception. While health and medical apps are rapidly growing in digital space (numbers have doubled between 2015 and 201812), not all of them currently require approval. Considering that these apps can have serious impacts on health, regulatory bodies are expressing greater concern over their management, and the FDA eventually hopes to monitor and regulate all health apps in the US13.
The RegulatorsFDA/CE approval (particularly FDA, which is far stricter in what can be communicated) presents greater challenges to the femtech space. Products such as Natural Cycles, which are revolutionising experienced industries in novel ways, may struggle to establish that trust and communication within the limits of regulatory bodies. An example of this is the FDA’s restrictions on implying superiority of any medical product. However, Natural Cycles is an example of a campaign that has managed to draw effective comparisons using data that clearly implies superiority without explicitly saying so, with its use of proven data such as the Pearl Index, and its friendly disclaimers such as ‘no contraception is 100% effective’ - which is to the point, but not deterring.
ConclusionAn app that is visually appealing and community directed, combined with a campaign that is easy to digest, has together allowed Natural Cycles to attract a fast-growing loyal community of users, with over 1.2 million registered ‘cyclers’ across 162 countries14. By communicating its FDA/CE approval, efficacy, and ‘naturalness’, who wouldn’t be interested in this hormone-free, prescription-free contraceptive, empowering women to take back control in a medical realm that is often saturated with side-effects and uncertainty?
Natural Cycles is the perfect example of the value of medical communications when demanding the success of a new medical product. Whether it’s a digital solution or an old-school ointment, it is well known that excellent data and research may not always be enough to breakthrough in an experienced industry. And when a product directly impacts a woman’s life, the way data and research is communicated to prospective patients and healthcare professionals is even more paramount. In light of this, Natural Cycles is a great example of how healthcare communications can be used to create something powerful – an empowered female digital community that is 1.2 million-strong.
By Pari Shahabi