Exhausted and disoriented, I arrive tempest-tossed on the shores of our dystopia to tell you the good news: Apps are birth control now.
On Monday, the period-tracking app Clue announced that it had received clearance from the FDA in the U.S. to launch a digital birth control function that will use statistical modelling to closely track users’ menstrual cycles in order to help them better understand their odds of fertility.
Although it declined to list an exact price or launch date for the birth control, Clue — which currently boasts around 13 million users — noted that the function would be considered a “premium” feature.
The app will function as a version of the Fertility Awareness Methods of birth control, which commonly utilise key metrics including period start dates, body temperature and changes to cervical mucus in order to predict when ovulation will occur. But unlike other FAM, Clue will rely on a single metric — your period start date — in order to project fertility. Using what’s known as Bayesian modelling, the app will synthesise that data in order to predict a “high risk” window across a number of days of the user’s cycle, during which there is an increased likelihood of pregnancy (there is also a “low risk” window). On high-risk days, users are recommended to either abstain from sex entirely or to use alternate contraceptive methods, such as condoms, in order to prevent pregnancy.
“It personalizes over time,” Clue’s chief medical officer, Lynae Brayboy, told TechCrunch. “So as the individual puts in their cycle day one then we’re able to personalise the window of their high risk days vs their low risk days.”
When used correctly, Clue claims to be 92% effective at preventing unwanted pregnancy under ‘typical use’ and 97% effective under ‘perfect use’. It’s the second time an app touting a statistical modelling method to receive FDA approval in U.S. markets: In 2018, the app Natural Cycles became the first, charging close to $US100 ($128) for a thermometer that users could use to take their body temperature each morning.
Sometimes interchangeably referred to as “natural family planning” or “the rhythm method,” FAMs developed a bad reputation over time for being, and I’m paraphrasing here, homeopathic woo-woo nonsense that make an educated guesswork out of fertility. In fact, however, the methods have solid efficacy rates when used properly, but also require users to remain vigilant, responsible and consistent — adjectives that potentially might not describe the average 20-year-old user.
It’s also worth noting that shortly after Natural Cycles’ release in 2018, the app was sued for allegedly causing 37 unwanted pregnancies in Sweden. And Clue, even by its own admission, isn’t for everyone: Only individuals between the ages of 18 and 45 who have regular periods will be permitted to use the app, and CEO Audrey Tsang said that ineligible users or those with cycles that become too irregular will be locked out of the app after a time.
But while FAMs are still a far cry from a perfect science, it’s also true that mainstream education on birth control has become so dominated by abstinence-only messaging that period-having individuals have become almost entirely divorced from the nature of their own fertility. While hormonal medications like the birth control pill and long-acting reversible birth control methods like intrauterine devices (IUDs) work perfectly for some, many others are forced to merely tolerate the methods — and the host of unsavoury side-effects that often accompany them — in a world where few alternatives are viewed as legitimate.
It’s a familiar dilemma for anybody that gets a period, in that you’re sort of damned if you do and damned if you don’t. The best advice, as ever, is to just trust your gut and do what feels right.