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Can period trackers support better healthcare?

By Amanda Shea, head of science at Clue

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When the pain and health concerns of women and people with cycles are still so often normalised or brushed off as imagined, period tracking is becoming an increasingly powerful tool for better, more personalised healthcare support.

Clue, together with the Bill and Melinda Gates Foundation, recently conducted a study looking into how self-tracked data in period tracking apps can support more accurate diagnoses and individualised management of conditions like heavy menstrual bleeding (HMB).

Estimated to impact around 30 per cent of women, HMB has long been difficult to diagnose, often going under-recognised.

This is thanks, at least in part, to the normalisation of pain and problem periods as something you “just have to live with”.

Different people may have vastly different understandings of what constitutes a heavy period – with personal bias and cultural norms coming into play.

Consider, for example, the perception of someone who comes from a family where heavy periods are considered the norm and complaints are considered an overreaction.

Such people may downplay their own experience and not be likely to seek help, or to even acknowledge their period as being heavy, despite having the clinical symptoms.

Where HMB was previously clinically defined as the loss of more than 80mL of blood in one menstrual period diagnostics have recently shifted toward a more holistic understanding of what makes a period “heavy”. And it’s much more than blood loss alone.

Many clinical organisations now define HMB as excessive menstrual blood loss that interferes with a person’s physical, social, emotional, or material quality of life.

This shift in definition was both necessary (anyone measured their menstrual blood loss lately?) and long overdue.

In one study, only 26 per cent of people who described their period as “heavy”, actually had blood loss higher than the 80 mL clinical norm.

Removing standardised clinical criteria for diagnosing conditions like HMB increases the need to more thoroughly understand individual experiences.

As a period tracking app with a large, diverse user base and unprecedented dataset, at Clue, we were interested in how self-tracked data could support more accurate diagnoses and personalised healthcare by informing individual assessments of HMB.

Our study compared the de-identified real-time tracked data of over 6500 consenting Clue users, to their responses to an online questionnaire which asked them about their last period.

We found that for those who reported having a heavy or very heavy period in the questionnaire, actual flow heaviness was not always the most influential factor.

Instead of just days of heavy flow, period “heaviness” was associated with a variety of additional factors including increased app-tracked period length, increased pain and other physical symptoms such as fatigue and digestive issues, as well as greater disruption of daily activities such as the ability to participate in sexual activity, social and leisure activities, school or work.

Notably, almost 20 per cent of respondents who stated that they had heavy or very heavy periods had not tracked any days of heavy flow, but did track period length and quality of life indicators such as pain and disruptions to daily life similar to those who had tracked heavy flow.

This reinforces why a personalised approach is needed for healthcare support, as the characteristics of individual definitions of “heavy menstrual bleeding” – while sharing some similarities – can vary considerably from person to person.

To support those who are experiencing disruptive menstrual periods or other reproductive health challenges, a holistic approach to care is essential.

Apps like Clue can facilitate quick and simple tracking of a variety of cycle-related experiences in real-time, including things like pain, sleep, mood, and energy.

Our study also found that those who experienced long periods were more likely to underestimate their number of bleeding days, even in their most recent periods, underlying another challenge for accurate diagnoses.

By removing the burden of having to accurately recall previous periods or subtle changes over time, one’s tracked period data can become a powerful, detailed health record – and the basis for more confidently self-advocating with your healthcare provider, through having a deeper understanding of your unique patterns and concerns.

User centric, personalised, digital healthcare is the next frontier. We’re just beginning to see what’s possible when self-tracking can help give women and people with cycles the self-knowledge, insight, and data to back up and validate experiences that have otherwise been invisible and hard to communicate and quantify to their healthcare providers.

 

Amanda Shea is the head of science at the Berlin-based period tracker app Clue.

Insight

Research uncovers potential new target for breast cancer therapy

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Targeting CD1d altered immune cells slowed tumour growth and improved immunotherapy responses in mouse models of breast cancer, researchers found.

The findings suggest blocking the molecule could make the environment around breast tumours more favourable to anti-cancer immune responses.

Further work is needed to understand how these immune changes occur and how the approach could be safely used in patients.

Researchers from King’s College London, the Francis Crick Institute and University College London investigated how immune cells inside breast tumours influence cancer growth.

They focused on myeloid cells, a group of immune cells found in large numbers within tumours that can either support an immune attack against cancer or contribute to tumour growth and immune evasion.

The team examined CD1d, a molecule found on the surface of myeloid and other immune and tissue cells that helps regulate immune responses.

When CD1d was genetically removed from cells in a mouse model of breast cancer, the mice were more resistant to tumour growth. Researchers also saw changes in myeloid cell populations, including increased activity among cells that can help attack cancer.

The team then blocked CD1d using an antibody and again observed changes in myeloid cells and slower tumour growth. Blocking CD1d also improved responses to immunotherapy in the mouse model.

Researchers used single-cell RNA sequencing, a technique that examines gene activity in individual cells, to investigate the immune changes in more detail.

They identified a population of myeloid cells called monocytes that expressed genes associated with inflammation, an important part of the immune response. These cells were particularly important in restricting tumour growth in the mouse models.

A similar pattern of gene activity was identified in data from human breast cancer tumours. Its presence in myeloid cells was associated with positive responses to immunotherapy in breast cancer patients.

However, the findings in people were based on gene expression data and did not test CD1d-targeting treatment in patients.

Professor Patricia Barral, professor of immunobiology at King’s College London and senior author of the study, said: “Many breast cancers do not respond well to current immunotherapies.

“Our findings reveal a previously unrecognised mechanism by which immune cells within tumours are regulated.

“While CD1d is best known for helping immune cells recognise lipid molecules, we found that it also plays a role in shaping the behaviour of myeloid cells within tumours.

“These findings suggest that targeting the immune cells that surround and support tumours could boost anti-cancer immunity and potentially improve treatment responses in the future.”

Researchers now plan to investigate how the immune changes occur and how they can be safely harnessed in patients.

They also want to examine whether targeting CD1d could enhance existing treatments and influence treatment responses in different cancer types.

The work was supported by UKRI BBSRC, Breast Cancer Now and the Cancer Research UK City of London Centre.

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Fertility rate in England and Wales hits record low, new figures reveal

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The fertility rate in England and Wales fell to a record low of 1.39 children per woman in 2025, down from 1.41 a year earlier.

New figures show that parts of London and cities with major universities accounted for many of the areas with the lowest local fertility rates.

The City of London recorded the lowest rate in 2025 at 0.37 children per woman, followed by Cambridge at 0.87 and the London boroughs of Islington and Westminster at 0.90.

The Office for National Statistics (ONS) defines the fertility rate as the average number of live children women would expect to have over their childbearing lives.

Brighton & Hove recorded a rate of 0.95, followed by Southwark at 0.97 and Norwich at 0.98.

Exeter, Oxford and York, along with the London boroughs of Camden and Hammersmith & Fulham, each recorded 1.01 children per woman.

At the other end of the table, Pendle in Lancashire and Luton in Bedfordshire had the highest rate at 1.93.

They were followed by Oldham in Greater Manchester at 1.87, Bradford in West Yorkshire at 1.84 and Barking & Dagenham in London at 1.83.

The overall fertility rate for England and Wales declined from 1.41 in 2024 to 1.39 in 2025.

A rate of around 2.1 is needed for a population to remain stable over time when the impact of migration is excluded.

Twelve of the 25 local authorities with the lowest fertility rates in 2025 were in London.

In Wales, Swansea recorded the lowest fertility rate at 1.18, while Carmarthenshire, the Isle of Anglesey and Newport each had the highest rate at 1.48.

There were 585,396 live births in England and Wales in 2025, down from 594,677 in 2024 and the lowest number since 1977.

Live births fell across every region in England. The West Midlands recorded the largest percentage decline at 3.1 per cent, while the North East had the smallest at 0.3 per cent.

The average age of parents also increased slightly.

Mothers had a provisional standardised mean age of 31.1 in 2025, compared with 31.0 in 2024. Fathers had an average age of 34.0, up from 33.9.

In 1975, the average age was 26.4 for mothers and 29.5 for fathers.

The proportion of births where the mother was born outside the UK also increased, from 20.8 per cent in 2005 to 27.5 per cent in 2015 and 34.6 per cent in 2025.

India was the most common country of birth for non-UK-born mothers in 2025 for the fourth consecutive year.

It was followed by Pakistan, Nigeria and Romania.

In 2025, 56.4 per cent of births were to parents who were both born in the UK, down from 62.7 per cent in 2015.

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Women shouldering hidden burden of navigating healthcare system – study

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Women face a hidden burden navigating healthcare, with many repeatedly retelling their medical history, a national study suggests.

The findings indicate that Canadian women are taking on cognitive, emotional and administrative work alongside managing their health, including coordinating providers and advocating for care.

More than half of women surveyed, 53 per cent, reported a past or current chronic condition, while 64 per cent said there were health topics they struggled to raise with their doctor.

Sarah Hoffman, president and CEO of Pacific Blue Cross, said: “These findings challenge us to think differently about women’s healthcare and highlight the hidden work required to navigate the system.

“For many women, managing their health has also come to mean managing the healthcare system itself.

“They are acting as project managers of their own care, shouldering the invisible labour of coordinating between providers, retelling their medical history and advocating to be heard.

 “The gap between men and women is meaningful and raises important questions about why younger women report lower levels of confidence and support.

“It also challenges us to consider whether we are actually making progress in women’s care, and whether the next generation is being equipped with the confidence and voice to advocate for their health.”

Overall, 71 per cent of Canadians described their doctors as supportive and 88 per cent expected their appointments to go well.

Among women living with chronic conditions, 71 per cent reported having to repeat their complete health history multiple times a year.

Younger women were particularly likely to report difficulties discussing their health. The study found 81 per cent of Gen Z women aged 18 to 30 and 73 per cent of Millennial women aged 31 to 45 had health topics they struggled to raise with their doctor.

Among Gen Z women with chronic illness, 92 per cent reported having to repeat their complete health history.

The study also found differences between young women and men. While 95 per cent of Gen Z men expected a doctor’s appointment to go well, the figure was 82 per cent among Gen Z women.

Similarly, 82 per cent of Gen Z men said they felt supported by their family doctor, compared with 66 per cent of Gen Z women.

Reasons for holding back health concerns varied between generations.

Among Gen Z women, 30 per cent cited fear of dismissal and 29 per cent fear of judgement.

Embarrassment was the most common barrier among Millennial, Gen X and Boomer women, reported by 29 per cent, 27 per cent and 35 per cent respectively.

Women who felt they needed to prove themselves to be taken seriously said they adapted how they approached appointments.

Strategies included researching medical information, repeatedly describing or justifying symptoms, bringing written notes or documentation, tracking symptom timelines, making repeat visits and emphasising how symptoms affected their daily lives.

The study also found an association between feeling supported by a doctor and expecting appointments to go well.

Canadians who described their physician as supportive were nearly four times more likely to expect appointments to go well than those who felt unsupported, at 98 per cent compared with 25 per cent.

Overall, 66 per cent of Canadians said they described their symptoms accurately. This fell to 48 per cent among those who said they felt unsupported by their doctor.

The 2026 Blue Cross Women’s Health Study surveyed 2,045 adult Canadians online in March 2026 through independent research company Research + Knowledge = Insights.

The survey had a reported margin of error of plus or minus 2 per cent, 19 times out of 20.

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