Why Cycle Syncing Won’t be a Billion $ Industry, but Female Anatomy Party Games will be
When I was 14, I had my last sex-ed class. At that point, the closest I’d come to an understanding of female anatomy was labelling where ovaries were on a low-resolution fill-in-the-blank image of female genitalia for a health test in school.
Most sex-ed curriculum is about the act of sex (or really, encouraging the lack thereof), not the implications of your sex (male or female). Don’t get me wrong, I very much think we should be rolling condoms on bananas and scaring children with pictures of chlamydia, but birth control and STDs are not where the discussion should end.
As a female, I’ve got VIP tickets to the vagina, uterus and so forth. Luckily, I didn’t let my schooling interfere with my education. I grew to become curious about my body, its bloody cycles and the implications of vaginal health on my overall health.
This is a story about tracking my hormones, breaking taboos with my friends and learning to absolutely LOVE my period (my favourite time of the month… yes, I’m weird, get over it. Endometrial shedding is cool).
This article is also an analysis of the female health industry and the future of sex-ed. If you’re a female, you know a female, or you’re interested in the future of healthcare, this is a story you can learn from.
🔴 + If you stick around, there is a surprise at the end 🔴
Soooo why is there white stuff in my underwear?
The covid-19 pandemic began, toilet paper became a luxury item, and everyone was buying pet ducks thanks to TikTok; I couldn’t stop thinking about the white discharge that was sometimes in my underwear.
While the world’s entertainment industry shut down, I had a magic show happening in my undies. Sometimes there was thick white fluid. Other times it was thin white fluid. And then, occasionally, it completely disappeared (*POOF*). It seriously felt like Penn and Teller controlled my cervical mucus glands (where the “white discharge,” aka cervical mucus, comes from).
About two months prior to hyper analyzing my underwear, I worked on a hackathon project related to perimenopause. While perimenopause sounds like an item on the Nando’s menu, it’s actually the state right before a female hits menopause (i.e. when their period stops). I won’t get into the details here, but this project scared the sh*t out of me; I was scared to be a perimenopausal woman in the current healthcare system. Granted, I am years and probably decades away from experiencing perimenopause.
However, the current status of care for older women’s decline in estrogen and the cervical fluid peek-a-boo events happening on my Costco Calvin Klein’s were enough to tip me on edge: I went down a crazy female health rabbit hole.
I pulled all-nighters for days and weeks, working on a mega article called “everything you need to know about women’s health and milking cows,” which was a whopping 70 minutes long. The British Standards Institute paid me to present my findings and subsequent international standard recommendations for women’s health technology at their annual conference (in London, but rescheduled to be virtual). Eventually, this work led to the genesis of EMM, a maternal health project my team is running in Jigawa, Nigeria, with a local non-profit and the ministry of health. (A very productive deep dive, even though I consumed a year worth of caffeine)
Ultimately, I’d summarize my deep dive into a single picture:
This image is the monthly hormonal cycle of a menstruating female. If you really want to impress your OBGYN, you can refer to it as the infradian rhythm. The infradian rhythm encompasses the physiological changes happening to prepare for one’s period roughly every month.
Here’s what’s happening at a simplified level:
(but, if you want a more scientific take, read here)
- For the first half of the cycle, estrogen is rising (progesterone is low).
- It’s produced as follicles with ova (‘eggs’) develop in the ovaries.
- As the body gets closer to ovulating (releasing the egg), estrogen rises to its peak.
- More estrogen = more cervical fluid. Cervical fluid helps transport sperm to fertilize the released egg (think slip N slide instead of playground slide).
Progesterone (thick dotted line)
- In the second half of the menstrual cycle, progesterone is rising (estrogen falls)
- With lower estrogen, there is less “fertile” cervical fluid (it becomes dryer and less constant; eventually disappearing… POOF)
- Progesterone is the “preparing for pregnancy” hormone. Hence it appears after your body releases its egg.
LH / FSH Hormones (blue and smaller dotted line )
- These two hormones have different functions, but they follow a similar curve on the chart! Particularly, they peak at ovulation.
- Luteinizing hormone (LH) and Follicle Stimulating Hormone (FSH) are the hormones that help a mature egg leave the ovary. Like a concierge for the fallopian tube — ovary hallway.
SIMPLY: my underwear were 50 shades of white because of my hormones. Not two famous magicians controlling my basic physiology.
I used to think my period was the “weird” week of the month; it’s different and odd compared to every other week. But every day is different in the female body (even if you’re not gushing blood). Hormones, eggs, the lining of our uterus, body temperature, etc., fluctuate often. There is no weird day because every day is weird.
These reoccurring changes in the body contribute to the cycle of cervical fluid — or what I thought was a magic show. If you pay close enough attention, cervical fluid changes in a consistent pattern (just like the seasons in a year happen in a consistent pattern).
Penn and Teller, you have not fooled me; I know where my cervical fluid is comin’ and goin’ (but that Elephant you made disappear in front of my eyes at your 2019 Vegas show… I am missing explanations).
I turned into an infradian rhythm girl scout.
Some people hang degrees on their walls. I hang billboard-size diagrams of the infradian rhythm on mine. I turned my whiteboard into massive hormone graph.
Having an image the size of a car in your bedroom really gets it ingrained in your head. This definitely informed my zoom socialization game — every conversation turned into me dictating my utter fascination with female hormones.
I had one particular zoom group (#2020 things) called “boss ladies Minga,” where we’d work on ideas to improve the community of a women-in-STEM group we were a part of (called Boss Ladies). One evening we spent hours upon hours discussing the amazingness of this subject and how we wish we learnt it earlier.
And then, over the months, I talked to ~100 females, all with the same response: I wish I knew this earlier.
Fertility Awareness Method Interjection
When I started speaking to people, I wasn’t just talking about a two-dimensional graph. In April 2020, I started doing FAM (fertility awareness method). I spoke about FAM so much that people thought luteinizing hormone was my mother’s name.
FAM is a ‘natural’ way to identify when you’re most fertile. You can use it as birth control (i.e. don’t have sex when you’re most fertile) or as a conception method (i.e. have sex when you’re most fertile). Or as a fun science experiment. I did it for the experiment.
I wanted to use FAM to see my infradian rhythm in action.
Thus I went wild on Amazon. It drastically confused my ads — I went from broke student to expectant mother in the eyes of big tech.
But anyway, I bought a few things:
- Basal body thermometer. You can track body temperature changes, which map to your cycle.
- Cups to pee in (this will become unweird in a second).
- Luteinizing hormone tests. These detect the surge in LH (i.e. when ovulation typically occurs)… by dipping them in your pee!
I focused on 3 FAM methods:
- Seeing changes in basal body temperature
- Identifying my ‘spike’ in LH
- Observing my cervical fluid.
Method #1 lasted a few weeks, but eventually, it got very tedious. You need to wake up every day at more or less the same time and take your temperature immediately. By the time I stopped, I could already predict my cycles, including ovulation and my period to the day. Temperature wasn’t necessary to further my experiment.
Method #2 was extremely fun. At first, I kept missing my LH spike, thinking it wasn’t happening. But as I got to know my cycle more (through method #3) I began catching my LH spikes. I use this as a validation method for where I’m in my cycle.
Method #3 involves sticking two fingers up my vagina and observing what comes out. Roughly, this is the pattern of cervical fluid I was looking for:
As unappealing as method #3 (scopping out the insides of my vagina) may sound, it has been one of the most enlightening experiences of my life. I may be portraying myself as a hippy vaginal fortune teller, but I knew what my body was doing and why. I felt in touch with my hormones and moods, and I celebrated all my sensations. Even when my uterus having a UFC fight with itself.
This knowledge of my body allowed me to praise it. So while some females despise their period: some skip their sugar pills to avoid it, and many wish it never existed. I treasure it.
When you define the symptoms of a period — extreme blood loss, cramps, and headaches — literally nothing about them seems worth celebrating. The only reason you might buy cake is to satisfy your chocolate cravings. But when you understand why these symptoms are happening, you can celebrate your body for completing another infradian rhythm.
I should caveat: I have never been on hormonal birth control, and my menstrual cycles have been regular for years. Females who have been on or are currently on hormonal birth control and/or have irregular periods may not find their infradian rhythm.
Scaling Female-Self Awareness
Given that you’ve read about me shoving fingers in my vagina to achieve personal enlightenment, you might infer that I have a very weeny filter for taboo topics.
It’s benefited me immensely.
On a call with my friend Adam, I was blabbering about infradian rhythms and how so many girls I knew wish they knew more about them. He was then the person who encouraged me to take things a step forward.
My thesis was that if an amazon order for FAM materials changed my life, could giving people that same order change theirs?
I messaged a small women-in-STEM group chat I was in, and I got 20 people interested. I chose four that had regular periods and were not on birth control to participate in my experiment.
I spent $500 on the initial product. (with the same money, I could have got 100 ice creams. If this doesn’t illustrate my investment into this idea, I’m not sure what will).
Kits included FAM materials, notebooks to monitor results and general female empowerment items ❤
The purpose was to help them understand their female bodies.
- 5 markers
- 2 red pens (to track period)
- A grid notebook (i am v passionate ab this subject: I religiously avoid lined paper)
- LH strips
- Pee cups
- Thermometer (sometimes)
- In the flo book by Alissa Vitti
- Menstrual cups (super practical, more of an anecdote to get comfortable controlling the-world-down-there)
- Creativity card deck (purpose: for my testers that wanted to track / analyze creativity correlations with their cycle, this was the “activity” they could judge their creativity based on… not a perfect method, but I think it served as a fun gift!)
- Link to an online resource hub I created
Along with the kit, we also met ~once a month.
The intention was to build a space to talk about ‘sex-ed’ beyond the classroom. We discussed things like:
- Cervix sizes and how they differ
- Mood tracking with your cycle
- Noticeable patterns
- Scooping! (aka looking at cervical fluid)
- Copper IUDs and why they seem scary
- How to properly use menstrual cups and tampons
- UTIs and why they’re so common
- What amount of period bleeding is concerning?
These discussions had the essence of fresh-baked chocolate chip cookies: wholesome and homey. I feel so lucky to have been in them!
But I learned that my thinking was wrong.
Cycle syncing and FAM isn’t the value-add here. They will not be the next big thing in female health and femtech.
The value of this experiment wasn’t the kit. The technical tracking of body temperature, luteinizing hormones, and even mood/productivity was exciting but not a long-term investment for the users. Here’s what makes it a bad product:
- 72% of women practicing contraception rely primarily on hormonal methods. This suppresses the natural infradian rhythm, which makes these women non-viable users of the kit. Pair this with perimenopausal women or postmenopausal women who either have irregular/disappearing periods (former) or no periods (latter). And there are pregnant women: about 6.2 million in the US in 2010. Lastly, it takes 2–3 years on average for a girl’s period to become regular once she first gets it. This leaves a small portion of the population with the ability to cycle sync, and therefore use the kit. In analytical speak, the total anual market (TAM) is small.
- There is no immediate reward for doing this manual, granular tracking. I know I mentioned “body enlightenment,” but that doesn’t exactly sell in the market. It’s hard to monetize or describe the short-term reward. Other female health products don’t have this struggle: IVF gives you babies, birth control gives you no babies, curing diseases gives you no pain; being reactive in your healthcare, unfortunately, doesn’t give you a short-term return. You could argue it’s good for your long-term health, but try telling that to a busy woman on a budget.
- After a few weeks of time investment, tracking becomes intuitive. You don’t need to log your temperature every day to estimate your estrogen levels.
- It’s no cold-hard-statistic, but I know that I, and many females around me, eventually lose interest in our period trackers. I use it for a few months, and then I stop seeing the benefit. It’s hard to solve the retention problem when there’s no incentive to stay on.
Long-story-short cycle syncing is restrained by:
- High usage of hormonal birth control and prevalence of females with menarche (early, irregular periods), perimenopause, menopause and pregnancy. Small market segment.
- No short-term incentive or value.
- A retention problem.
It’s low lifetime value of customers, with small numbers of potential customers. Bad combo.
So is this post just the log of a failed experiment? Nope. Just because some of my assumptions were disproven doesn’t mean the results of this experiment were useless.
First, let’s hear from my guinea pigs (who have become my great friends ❤)
What product testers said:
“Izzy, this focus group has served as inspiration for my current project (open-source database for female physiological data). I’ve also learned about my low cervix and am working on switching to a menstrual cup. I also love the kits, and I’m continuing to track, which is great because I’ve always struggled with consistency. Paper and colours make all the difference I’ve learned. I’ve also enjoyed talking to you all, so I’m happy I’ve found a space to discuss these topics. Thanks :DDD”
“Thanks for organizing Izzy! I really enjoyed getting to know everyone and talking about things that aren’t normally talked about. :) Main learning for me is that I don’t know much about my biology and how it’s related to my mood. Similar to the sleeping ring, I wish there was a ring of some sort for this… not necessarily a ring but just a product that centralizes all the data and creates insights.”
“Izzy, this was so fun. Thank you for putting this together! For me, the first few weeks were really exciting, but then I went on the pill and the hormone tracking no longer was applicable to me. But once I’m off the pill I’m going to re-read the book & get into more tracking again. I’m really interested in any personalized health data systems, services, or products, so it’s 10000% something I’m overall interested in. I think when I do it, I might honestly go to an extreme for 2 months by implementing “controls” (e.g. keeping diet very stable, doing very similar workouts, etc.) because I’m a bit obsessive about tracking what factors impacts my body. I liked the calls cause a) I just like talking to y’all and b) these are conversations you don’t really have with anyone else so there’s things you just are the same for all women (ex. Cervix shape/location). I think it would have even been fun to have a group [document] where were wrote down major themes we were noticing, etc.”
“Thank you so much, Izzy, for setting this up, and it’s been lovely getting to chat with you all! I’ve learned a ton, and I’m going to keep tracking a bunch of my metrics 🤍🤍 I found this experience super interesting because I learned a ton about my body and found some patterns. I found that it could be confusing when other factors come into play, like you said. Like if I’m eating different foods (e.g. when I lost my period) or having a hard time, my cycle would change a bit and so would my patterns. I loved the calls because it felt empowering to have convos about female biology and I hope to continue fostering more convos around these topics in my life.”
As you may infer from my bolding, a common denominator across all of them is the piece about empowering conversations. As I’ve spoken to over a hundred girls about this subject, they agree: the conversations are missing.
But also, if we take two steps back and analyze cycle syncing, we’d see that the excitement is less about your LH strips coming out positive and more about education on your body. I.e. I reached ‘nirvagina’ by observing and connecting with my body.
Whether you’re on birth control, have endometriosis, can cycle sync or anything in between, you deserve to understand yourself.
Females, particularly, are underserved in healthcare. I could do a Ph.D. just in the statistics that show the disparity, but I’ll highlight one for the sake of brevity: “5x more research to male erectile dysfunction (affecting 19% of men) than to premenstrual syndrome which affects 90% of women” (source).
What is the next thing for female education?
When education takes the form of Healthline articles and 1997 research papers, that isn’t exactly the most engaging learning method for a 15-year-old. (Only the obsessive whackos like me snack on the status quo of female health research).
Information must be bite-sized, comfortable and jargon-free (think: no name brand).
Although my focus group was a kind and supportive community, it doesn’t make these topics much easier to talk about. It still feels weird (even for the girl writing about reaching Nirvagina on the internet).
After texting a few of my closest friends a few questions about shaving vaginas, I knew the state of peer-to-peer (P2P) education is not operating at its maximum. It felt like I crossed a societal boundary. Like food went down my trachea instead of my esophagus.
It’s odd that we almost have “right” and “wrong” taboo topics we can talk about. Period cramps are right. Shaving vaginas are wrong. Talking about pee is right. Poo is wrong.
Even though certain topics are more widespread than others, I’d rather talk about more delicate health topics with my best friend than a stranger decades older than me with an English teaching degree.
But if I can’t text my best friend about shaving vaginas, we have a lot of room to grow.
A Case Study
The we’re not really strangers (WNRS) game is a card game built to strengthen relationships. Some games specialize in dating, romantic relationships, friendships or even relationships with yourself. The basic gist is that cards you pull at random ask a question to you/the group.
Their questions are unique. Like “what is the most pain you’ve been in that wasn’t physical.” Very deep, but also very not-widely-discussed.
As of May 2021, they have 3.9M followers on Instagram, which has more than doubled in the last year.
I have a new experiment. 👩🔬
WNRS card game experience adapted for peer-based female health conversations. It’s called **Boob Blurb.**
I have a free 27 piece digital set for the first 1000 people to download HERE. I hope you love it, share it and have some enlightening conversations.
It’s clear to me that vaginas need more love and attention. If you want to continue hearing about my thoughts on women’s health, you can sign up for my monthly newsletter here.
My last sex-ed class may have been when I was 14, but my education is just beginning.
✌️ Izzy Grandic