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What does your cycle say about you?

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Menstrual data is finally being recognised for its value in medical science, but are period tracking apps putting our privacy at risk? Femtech World editor Sarah Sinclair reports.

Period‑tracking apps don’t just collect data on our cycle. Under the banner of “personalised health insights”, they log information such as sexual activity, contraception use, exercise, moods, and sometimes even our location. This can reveal intimate insights about an individual or group, from their political preferences and social habits to sexual and gender identity, mental health problems, and reproductive choices. 

The risks associated with this, should this data fall into the wrong hands, are highlighted in a recent report from researchers at the University of Cambridge. They include intimate partner violence, risks to job prospects, workplace monitoring, and health insurance discrimination.

According to the report’s lead author, Dr Stefanie Felsberger, apps that track menstrual cycle data are a “goldmine” for consumer profiling, the financial value of which is “vastly underestimated” by those who now rely on them as a part of daily life.

Last week, Flo Health, one of the world’s leading cycle tracking apps, settled a data privacy case in the US. The company was accused of unlawfully sharing users’ data with the social media platform Meta – claims which both Flo and Meta have denied. A settlement was reached, with no admission of wrongdoing, after the judge presiding over the case highlighted an “insurmountable” lack of evidence on behalf of the claimants. 

Flo Health has always refuted claims that it has shared users’ data with third parties. Even so, the case raises legitimate questions around how much we really know about where information about such intimate details of our lives could end up.

An analysis of 29 menstrual apps by researchers in Australia last year found that existing privacy laws were not adequately protecting users and their intimate information. While consumers are protected by GDPR laws in the UK and EU, police were recently issued guidance on how to check women’s menstrual tracking apps and medical records after sudden pregnancy loss.

In the US, following the fall of Roe v Wade, more restrictive abortion laws and less consumer protections could lead to reproductive data being weaponised against women in the form of private lawsuits, and insurer profiling, with location pings and private messages already being used in cases prosecuting women for illegal abortions. 

Global downloads for the three most popular apps were estimated to exceed 250 million last year. The fact that so many women and non-binary people now rely on this technology is indicative of a desire to have more control and agency over our health, whether that’s for general wellbeing, or the management of menstrual-related symptoms and long-term health conditions. 

Women are significantly underserved by existing healthcare systems, particularly when it comes to reproductive health. Many people use these apps in an attempt to plug the gaps left by the public health system, as a report by the Women and Equalities Committee (WEC) highlighted in the UK last year. They allow users to access vital information about their hormones, cycle characteristics and symptoms, which have been overlooked – potentially for years – by healthcare professionals. 

Menstrual cycle data is not only valuable from a financial perspective. More importantly, it is crucial for advancing research and improving health outcomes. As well as flagging concerns such as pain and heavy bleeding, it can also indicate signs of medical conditions, such as diabetes, thyroid disorders, polycystic ovarian syndrome, rheumatoid arthritis and irritable bowel syndrome, research shows. Scientists at femtech startups like Qvin are harnessing menstrual blood as a potential diagnostic tool for conditions such as endometriosis and for the early detection of cervical cancer. 

The fact that this data is not routinely collected by clinicians is not a careless oversight, but yet another symptom of a modern medical system in which women – and their bodies – have been entirely overlooked. Experts writing in the Lancet Obstetrics, Gynaecology, & Women’s Health, last month, said this data was an ‘underused but powerful tool’ for understanding women’s health, which should be routinely collected along with other measures such as BMI, blood pressure and cholesterol.

Separately, University of Cambridge researchers have urged public health bodies, including the NHS, to build their own state-governed menstrual tracking apps. 

These privacy-first platforms could collect valuable insights from menstrual cycle data, while ensuring users’ privacy with on-device storage and strict consent mechanisms. With transparent opt-in processes, anonymised data collected through public tools could also be used to advance much-needed research into women’s health. 

Following the publication of the NHS 10-Year-Plan and its promise of a shift from analogue to digital, there is potential for innovation in public health, with the mention of public-private partnerships to help deliver the tools that could make a real difference to women’s health outcomes. Perhaps the digital health record Wes Streeting has promised could also integrate data collected on a patient’s menstrual cycle. 

However, for now, it remains unclear exactly how and when this digital transformation will be delivered, and as with any structural overhaul in the public sector, it’s unlikely to be anytime soon.  

In the meantime, private innovators can lead by example with products that offer transparency, minimal data collection and medical validity. And consumers can support meaningful innovation by choosing apps with encrypted, on-device data storage.

Tech can be a force for good when it’s done with the right intention. In her latest impact venture, Amber Vodegal, the founder of the global Pregnancy Plus+ (which she sold to Phillips in 2017), is now developing a period-tracking platform that is privacy-safe and free at the point of use. 

Instead of storing data on external cloud servers, 28X will use on-device, fine-tuned open-source GenAI models with suitable guardrails to avoid sharing with third parties. Vodegal also plans to make the technology open-source to allow other developers to use and build on it.

Now that the medical and scientific value of menstrual data is finally being acknowledged, it deserves to be taken seriously by both private and public healthcare providers. This data can reveal intimate details about our lives, from our reproductive health to who we are as people. Treating it as a commodity – without our consent – is not only unethical, but undermines genuine efforts to address the gender health gap.

Pregnancy

Home blood pressure checks could lower heart risks for new mothers – study

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Home blood pressure checks after hypertensive pregnancy could cut the risk of heart attack, stroke and potentially early death, research suggests.

Women who regularly monitored their blood pressure in the weeks after giving birth, and had doctors tailor their medication if needed, had better functioning arteries nine months later than those who received routine care.

When the medication was adjusted to account for blood pressure changes, the women ended up with less stiff arteries, an effect researchers estimated could reduce the future risk of heart attack or stroke by 10 per cent.

Paul Leeson, professor of cardiovascular medicine who led the study, said the findings suggested that the weeks after birth provided a “powerful and often overlooked opportunity” to protect women’s future health.

“By simply monitoring blood pressure at home, new mothers with hypertensive pregnancies can protect their bodies from future damage,” he said.

High blood pressure, in the form of gestational hypertension or pre-eclampsia, where there are signs of organ damage, affects 5 to 10 per cent of pregnant women.

The condition can damage the mother’s organs and endanger the baby’s life.

Beyond the immediate threat to mother and baby, hypertension in pregnancy can raise the risk of long-term problems, with women three times more likely to develop high blood pressure and twice as likely to have heart disease later in life.

The Oxford team recruited 220 women who developed hypertension in pregnancy. All were on blood pressure medication but were due to reduce their dosage and eventually stop taking the drugs.

In the study, 108 women had standard care in which their medication was reduced based on a few blood pressure checks in the eight weeks after giving birth.

The remaining 112 women used a monitor to check their blood pressure at home each day.

They entered the readings into an app shared with doctors who, if needed, changed their medication day to day, with the aim of giving them better control of their blood pressure.

The new approach led to much better control of the women’s blood pressure, and in tests six to nine months later the women had less stiff arteries.

Stiff arteries are less effective at expanding and contracting, which can drive high blood pressure and ultimately the formation of clots that can block blood vessels and cause heart attacks and strokes.

Trials are now under way to find effective ways of rolling out blood pressure monitoring to women after hypertensive pregnancies. One option is for specialist NHS clinics to deliver the care.

Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, which funded the work, said the results highlighted a crucial window after birth when paying close attention to blood pressure could help protect women’s heart health for years to come.

“We now look forward to seeing results from larger studies with longer follow-up to see how this might save women’s lives,” she said.

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Researchers teach AI to spot cancer risk by squeezing individual breast cells

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An AI tool could help spot breast cancer risk by analysing how individual breast cells behave when squeezed under stress, research suggests.

Researchers at City of Hope and the University of California, Berkeley, created a microfluidic platform that assesses women’s breast cancer risk at the cellular level.

The platform squeezes individual breast epithelial cells, which line breast tissue, to measure how they deform, recover and behave under stress.

Because more than 90 per cent of women do not have a known genetic predisposition to breast cancer or a family history of the disease, the researchers said the approach could help fill a key gap in risk assessment.

Mark LaBarge, professor in the department of population sciences at City of Hope, said: “For women with a known genetic risk factor for breast cancer, there are things you can do like follow a higher-risk screening protocol. For everybody else, you’re left wondering, ‘Am I at high risk?’

“By translating physical changes in cells into quantifiable data, this tool gives women something tangible to discuss with their doctors, not just risk estimates, but evidence drawn directly from their own cells.”

The researchers developed a machine learning algorithm that identifies and measures cells showing signs of accelerated ageing, generating an individual breast cancer risk score.

They said the platform uses simple electronics that could be easy and affordable to replicate on a large scale.

Lydia Sohn, chair in mechanical engineering at UC Berkeley, said: “Our team isn’t the first to measure the mechanical properties of cells; however, other approaches require advanced imaging technology that’s expensive, cumbersome and has limited availability.

“In contrast, MechanoAge uses computer chips that are simpler than an Apple Watch and ‘RadioShack parts’ that are cheap and easy to assemble, potentially making the device highly scalable.”

About 6 per cent of women who develop breast cancer carry known genetic mutations.

For women outside this group, risk is usually estimated indirectly using population models or measures such as breast density, which can both overestimate and underestimate individual risk.

The researchers said there is currently no non-genetic test that can identify women at higher risk of breast cancer.

Screening mammograms can detect cancer only once it has started to grow, but the MechanoAge platform aims to assess risk earlier by looking for physical changes in individual cells.

Using the platform, the researchers found that breast cells appear to have a “mechanical age” separate from a person’s chronological age, based on how the cells respond to stress.

They said this is the first time mechanical age has been quantified in biological cells.

Sohn said: “We learned that the older the mechanical age, as determined by how cells respond to being squeezed through our microfluidic device, the higher the risk for breast cancer.”

In this type of mechano-node-pore sensing, an electrical current is measured across a liquid-filled channel.

As cells pass through, they disrupt the current, generating measurements about their size and shape. By narrowing parts of the channel, researchers squeeze the cells and then measure how long each one takes to return to its normal shape.

The team found that cells from older women were stiffer and took longer to bounce back after being squeezed.

They also identified a subset of younger women whose cells behaved more like those from older women. These cells came from women with genetic mutations linked to a higher breast cancer risk.

The researchers then refined the algorithm to assign a risk score based on the cells’ measured mechanical and physical properties. They said it successfully identified women with known genetic risks.

The team then used it to compare cells from healthy women, women with a family history of breast cancer, and cells taken from the healthy breast of women with breast cancer in the other breast.

LaBarge said: “With accuracy, we were able to figure out which women were at high risk of breast cancer and which women didn’t seem to be.”

The work grew out of more than 12 years of collaboration between the two labs, combining engineering with cancer and ageing biology.

Sohn said: “It’s a true collaboration. We’ve learned a lot from each other.

LaBarge added: “In my view, this is what happens when you have a real collaboration that develops over a long time. This result is not what we imagined at the beginning.”

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Experimental drug drowns triple-negative breast cancer cells in toxic fats

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An experimental drug slowed triple-negative breast cancer in mice by flooding tumour cells with toxic fats.

Triple-negative breast cancer lacks three common drug targets, making it one of the hardest-to-treat and most aggressive forms of the disease.

The compound, known as DH20931, appears to push cancer cells past their limits by triggering a surge in ceramides, fat-like molecules that place the cells under intense stress until they self-destruct.

In lab experiments, the drug also made standard chemotherapy more effective. When combined with doxorubicin, researchers were able to reduce the dose needed to kill cancer cells by about fivefold.

The drug targets an enzyme known as CerS2 to sharply increase production of these lipids and stress cancer cells. Healthy cells, by contrast, showed lower sensitivity to the drug in lab tests.

While the early results are promising, further preclinical and clinical trials would still be needed to determine the safety and effectiveness of DH20931 in humans.

Satya Narayan, a professor in the University of Florida’s College of Medicine, led the study with an international group of collaborators.

The researchers published their results on human-derived tumours on 21 April and presented their findings on combination therapy at the annual meeting of the American Association for Cancer Research in San Diego.

Narayan likened the drug’s effects to a home’s electrical system handling a power surge.

While healthy cells act like a properly grounded and installed circuit, cancer cells are more like a jumble of mismatched wires and faulty fuses. DH20931 overwhelms cells not with electricity, but with fats.

He said: “When that surge goes into the cancer cells, they cannot handle the amount of power they are getting. The fuses burn out, the cell can’t handle the surge and it dies.”

The compound was developed at the University of Florida in the lab of Sukwong Hong.

Hong, now a professor at the Gwangju Institute of Science and Technology in South Korea, created DH20931 as one of many drug candidates tested for efficacy in Narayan’s lab.

In the study, researchers implanted human triple-negative breast cancer tumours into mice and treated them with DH20931.

The drug significantly slowed tumour growth without causing noticeable weight loss or signs of toxicity in the animals. In separate lab experiments, it also showed activity against other breast cancer subtypes.

In addition to increasing lipid levels, DH20931 triggers a second stress signal by flooding cells with calcium.

Together, these effects disrupt the mitochondria, the structures that produce a cell’s energy, ultimately leading to cell death.

Narayan said: “It does not just follow one pathway but it goes through multiple pathways. It’s a two-hit hypothesis.

“These pathways are common in all breast cancer types and other solid tumours, so we think this drug can be useful not only in triple-negative breast cancer but potentially other cancers as well.”

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