The Lowdown, founded in 2019, is a platform for reviews and advice where users discuss side effects and benefits of different types of contraception, and it connects users with medical consultations and prescriptions for birth control. Users can participate in surveys and leave reviews, which the Lowdown uses along with medical professionals to provide medically vetted information. Founder Alice Pelton said they have seen a 60% increase in US-based users since the beginning of May. “I can only attribute this to the Roe v. Wade leak in early May,” Pelton said in an email. After the Dobbs decision in July, and US users surged again. Before Roe was overturned, the company was already discussing adding reviews of abortion experiences, and it says it will likely add them later this year.
Natural Cycles and Clue are both fertility awareness methods, and both therefore recommend using additional contraception like condoms on high-risk days. However, they are buoyed by algorithms and data that should make them more effective for the typical user than just tracking a period on a calendar would be. For instance, Natural Cycles also considers the user’s basal body temperature, which is one indicator of fertility. As of Aug. 2, users can also measure their temperature with the Oura ring.
Apple also recently announced its new Apple Watch Series 8 will be able to track temperature changes that can indicate ovulation — though Apple says these ovulation windows will be retrospective, and the feature is not FDA approved to use as contraception. Apple’s data will be encrypted and stored on the devices themselves, making it more secure than apps that share or sell data. This could be more appealing for users who are worried about period- and ovulation-tracking data being shared with law enforcement.
Natural Cycles, which is currently the only FDA-approved fertility tracking and birth control app on the market claims its effectiveness with typical use is 93%, and Clue says theirs is 92%. However, in the past few years, users of Natural Cycles raised questions about its effectiveness after they got pregnant while using the app. (In 2018, the Swedish Medical Products Agency found that the app’s failure rate was in line with the company’s effectiveness rate, but it asked Natural Cycles to make the risks of pregnancy clearer, which it did.)
Natural Cycles also shares anonymized data with researchers for clinical studies with user consent. Their on-staff research teams work with researchers from institutions, who must sign a data privacy agreement. When Clue sends data to researchers, it is anonymized as well, so no data point can be traced back to an individual person.
However, the security of these datasets is the subject of a lot of scrutiny and concern as states move to criminalize birth control and abortion. Users are afraid that information about their cycles could be shared with law enforcement. This data could, for example, become evidence of a pregnancy that ended. “Women’s health as a whole has been stigmatized. But now there’s a potential for it, not only to be stigmatized, but criminalized, so that creates a huge problem in terms of are users going to trust these tech companies with their data. And are companies going to be as interested to get into this space,” Kraft said.
The Lowdown, Clue, and Natural Cycles are based in the EU and therefore follow the strictest privacy and security law in the world, the General Data Protection Regulation (GDPR). This means that the companies don’t have to respond to a subpoena or request from US law enforcement to turn over data, even if the user is based in the US. Users are covered by this law regardless of where they live. When the Dobbs decision was leaked in May, Natural Cycles also began working on developing an anonymous mode. In this mode, the company itself wouldn’t even be able to identify the user.
The Lowdown makes money by selling consultations to doctors and prescriptions, along with selling products to help people with symptoms and side effects. It doesn’t track people’s cycles and doesn’t sell data from its reviews, and while users have to sign up with an email address, they can create an anonymous account that doesn’t use their name. Clue and Natural Cycles also said they don’t sell their users’ data and instead make money through subscriptions. Elina Berglund, the cofounder and CEO of Natural Cycles, said the company is also working with its legal team on how to keep its data safe. “It’s a new area to navigate, and laws are still changing. So, we want to be on top of it also from the legal side,” she said.
