For Endometriosis Awareness Month, NewsMedical interviewed Audrey Tsang, CEO of Clue, a world-leading menstrual tracking app hosting over 10 million users from more than 190 countries.
With a background spanning stints with tech giants and a transition into femtech, Audrey shares her insights into how technology can bridge the gap in women's healthcare, with a particular emphasis on addressing conditions like endometriosis. Our conversation focuses on the challenges and breakthroughs in developing a health app that empowers women globally, reflecting on Audrey's journey and the future of femtech.
Please could you share a bit about your personal journey that led you from roles at Pinterest and HotelTonight to leading Clue? How do your past experiences shape your approach to product development and leadership within a female health-focused app?
Before joining Clue, I spent over a decade leading products and teams across consumer tech in Silicon Valley. With a background in Computer Science, Human Computer Interaction, and Design Thinking, I loved taking a user-centric approach to building technology that people would use and love using.
About six years ago, I realized that consumer tech companies had tapped into an incredible ability to engage people – getting them to spend more time scrolling and, subsequently, more money on their products. I wanted to use that same ability to engage people with their own health – making a positive impact.
I was especially interested in women’s health, as it was, and still is, grossly underserved, held back by taboo and stigma, and dismissed by healthcare systems and society. For someone navigating the female health journey, this has resulted in a vast health gap and years of invisible and unnecessary suffering.
When I met Ida Tin, co-founder of Clue, I saw a company with a big vision to break this unacceptable, and unequal, status quo. I believe that diversity and new perspectives drive innovation. With a diverse team based in Berlin, Clue was already a beautiful example of innovation. It was Ida’s vision to change how the world viewed and supported female health, and seeing that vision play out at the Clue headquarters in Berlin inspired me to join the team.
My first three years at Clue were spent leading the product development operations – first as VP of Product, and then as CPO. The time I spent on the product side is vital today, in my current role as CEO. Clue is a customer-centric company; every decision we make is with our users’ best interests at heart. Because I understand the product and how it’s built, I have an understanding of how we can iterate and improve to meet user needs.
Image Credit: SeventyFour/Shutterstock.com
What have been some of the most significant challenges you've faced in the femtech space, particularly in developing and scaling health apps like Clue? How do you navigate these challenges?
Just as women and people with cycles experience taboo or have their health dismissed, the femtech industry, and the startups in it, also face continuous taboo and dismissal.
Despite addressing a market of 1.9 billion people with cycles around the world, the femtech industry is often overlooked as a “niche” market or a “lifestyle” business. Fundraising can feel like giving a primer on reproductive health rather than pitching a business.
Overcoming this bias was one of the reasons that Ida, our co-founder, coined the term “Femtech” in 2016. Similar to Fintech or Proptech, Femtech describes technology focused on female health. Giving this category a name that likened it to finance apps instead of feminine hygiene products helped to validate and increase interest in the market. On top of that, it brought together a startup ecosystem focused on solving problems in this space to exchange ideas and drive innovation.
Much of the women’s health journey today is viewed as optional or as a luxury. Chronic pain or perimenopausal symptoms can be viewed as “just a bad period”, which ultimately translates to not reimbursable in the eyes of traditional healthcare.
There is a gap between what people living with these experiences view as a need and what their healthcare system views as a need. This difference can leave people not seeking care – choosing to live with pain as an example – because treatment and support feels unavailable or unaffordable.
At Clue, we believe that people deserve better. Better support and care throughout their entire menstrual and reproductive health journey. We also believe that this care should be affordable and accessible. We lament the fact that healthcare systems don’t yet see things our way, because if they did, it would make our jobs a lot easier.
So, while we would love to make our app entirely free, to continue to sustainably do our work, we have chosen to make more specialized and advanced portions of our app part of a premium, paid subscription. We chose to do this over other business models, like selling data, based on principle. And we have continued to build a successful business, by focusing on building the best product for our users, so they have a place to get science-based support and guidance they might not otherwise have.
Clue's recent survey sheds light on the dire need for better diagnostic tools and healthcare provider education regarding endometriosis. Could you discuss any specific initiatives Clue is undertaking to address these needs? How does Clue's partnership with researchers aim to fill the gaps in medical research on female health?
Health inequity exists and persists because so much of the women’s health experience today is invisible. It’s invisible because we lack the human-centric, structured, and quantifiable data to validate the experience – an experience that has historically and systemically been ignored, overlooked, and even shamed.
Without hard data, individuals report that they aren’t taken seriously by their healthcare providers and the healthcare system, time and time again. Without hard data, patient concerns are dismissed, and women’s health is seen as a lifestyle concern or even a luxury good. Without hard data, the scale and severity of the disproportionately high health burden experienced in women’s health remains hard to measure, creating a vicious cycle of under-investment and lack of innovation.
But, if we make it visible, by surfacing and quantifying the experiences of women, we can unlock the insight needed to take action to improve the health inequities. That’s what we aim to do for our users at Clue. We give our users an easy and efficient way to walk into appointments, with their data in hand. Because data is insight, and insight is agency.
Our users have reported that taking this data to their healthcare providers has enabled them to be taken seriously and has potentially shortened the time it has taken them to access diagnosis and care.
This is why we recently launched our My Health Record feature which enables users to input their confirmed diagnoses for 21 health conditions common amongst those with female biology – so those with a diagnosis can help shed light on those who might not yet be diagnosed.
Anonymized data holds real power, and we are continually exploring ways to use this dataset to help move science forward on these conditions that have historically been under-researched. We have partnered with leading institutions – including the University of California at Berkeley, and the University of Exeter – to put our vast datasets to good use and drive real progress in overcoming the gender research, diagnosis, and health gaps.
It is not just Clue that has the desire to create change. Our users do too. Many of the people who use Clue believe in participating in, and contributing to, research; approximately 80% consent to their anonymized, de-identified data being used for research purposes.
By doing so, they are playing a huge role in helping to improve the lives of women and people with cycles globally. We are immensely proud that Clue enables our users to have such a profound impact.
Image Credit: Nata Shilo com/Shutterstock.com
Empowering users through cycle and symptom tracking is a core feature of Clue. How do you see this empowerment evolving with advancements in technology and data science? Can you share any success stories where data tracking significantly impacted a user's health journey?
On an individual level, we know that self-tracking and being able to present that data to a healthcare provider helps make what can otherwise feel like an invisible and lonely experience, visible and actionable. Because tracking provides data, that data provides insight, and insight enables agency when it comes to our health.
We have already seen the role our app has played in supporting those with endometriosis. Recently, as part of Endometriosis Awareness Month (in March) we asked our users with endometriosis to share their experiences. 75% of respondents found tracking their symptoms with Clue to be helpful for managing their condition and 50% indicated they found Clue helpful for collecting data to share with their healthcare provider.
One survey respondent told Clue, “Tracking helps me to validate my experience to my doctors. I can tell them that I have data points showing I experience daily pain.”
On a collective level, data improves what we know about menstrual and reproductive health and can help to close severe gaps in diagnosis and care. Endometriosis, which is estimated to affect 10% of women and people with cycles globally, is one of the 21 different health conditions Clue users can enter a confirmed diagnosis for, within the My Health Record feature of the app. Together with their tracked cycle data, these confirmed diagnoses constitute one of the largest datasets in the world matching the lived experience with diagnoses.
Another example can be seen in the perimenopause experience. We surveyed 26,500 respondents, 84% aged 35-45 had not yet received any information from their healthcare provider about perimenopause despite this age group approaching, or already being in, perimenopause.
According to the Society for Women’s Health Research, over one-third of women in perimenopause are not diagnosed, while 20% wait over 12 months before their transition into menopause is formally confirmed by a healthcare provider. These delays not only individually affect women’s health and wellbeing, and have a cost-impact on healthcare providers, but the economic cost to society - from perimenopause and menopause - can be immense.
Clue’s Perimenopause mode was built to support users going through this transition period to menopause. It features 14 new perimenopause-specific tracking options including hot flashes, night sweats, brain fog, HRT, vaginal dryness, and much more – meaning users can track symptoms in real-time and clearly see how their bodies are changing.
The insights and data from user tracking can also be hugely beneficial in closing the knowledge gap. By using de-identified, anonymous data provided by users – we have access to over 15 billion data points from our 10 million+ global users – researchers can leverage our user community to conduct ground-breaking research into conditions such as perimenopause, closing the knowledge gap and supporting earlier diagnosis of health conditions.
We are incredibly excited to already have research projects scoped by researchers from top institutions leveraging this dataset to examine pressing questions around some of the most common, misunderstood, and under-diagnosed health conditions. Some of the focus areas include improving early diagnostics for conditions like endometriosis and PMDD, as well as better understanding the signs and symptoms of perimenopause.
Your press release mentions centuries of bias and blindspots in medical research contributing to conditions like endometriosis being underserved. As a leader in femtech, how does Clue work to overcome these biases within the healthcare system and in technology development?
When you don’t have data showing that there is an issue, you believe there is nothing to solve. To close this innovation gap, we need to start with more concrete data revealing the gravity of this situation. Our results already show the lack of innovation and R&D, along with the lack of empathy and understanding of women’s health issues.
We constantly hear from Clue members that they are tired of their pain being gaslit and that they just want their health to be taken seriously. Diagnosis takes longer, treatment takes longer, and as a result, many women still live in silent, invisible suffering.
According to the recent Clue survey I previously mentioned, an overwhelming 74% of respondents reported that they feel, or have felt, like their symptoms were dismissed by healthcare providers. And this is just the tip of the iceberg.
The qualitative stories shared are heartbreaking. Years of severe pain and worry would be completely dismissed. “I had years of doctors telling me it was just bad period pains and putting me on birth control with no education about how to deal with symptoms and flare ups”.
Or infuriatingly: “I was often told to, ‘Come back when you want to get pregnant.’
We see this same dismissal at an industry level as well. Currently, only 4% of traditional biopharma research and development funding goes into female health conditions – despite women spending nearly twice as much on healthcare as men.
Tracking as an individual with Clue allows you to visualize your health as structured data. It demands that healthcare providers pay attention based on facts not feelings.
And tracking on a collective level with Clue, along with user surveys, new features including My Health Record, and partnerships with leading academic institutions are generating anonymized datasets capable of producing valuable insights into underserved conditions, including endometriosis.
Looking ahead, what are the next big steps for Clue and the femtech industry at large? Are there new technologies or methodologies on the horizon that you believe will transform how we approach female health and wellness?
While femtech during its early stages focused on tracking menstrual cycles, at Clue we aim to go ‘beyond bleeding.’ We focus on supporting our users throughout their lifetime, from their first cycle to their last, delivering science-based health tracking, insights, and content to support people in making highly personalised decisions about their health.
Beyond reproductive health, there's a growing recognition of the interconnectedness between menstrual cycles and overall wellbeing. Future iterations of Clue are likely to encompass broader aspects of health providing users with a holistic approach to health and wellbeing management.
As I touched on earlier, femtech apps like ours have already begun to facilitate better interactions with healthcare providers. We know that across the healthcare space, remote monitoring, treatments, and consultations are becoming increasingly common as an accessible way for people to access healthcare. Clue and other femtech players should be part of this wider healthcare ecosystem that empowers individuals to take proactive steps in managing their health.
Clue is used by millions across over 190 countries. How do you tailor your app's features and educational content to meet the diverse needs and cultural sensitivities of your global user base?
So much of the female health journey is still unsupported today. It’s under-diagnosed, under-treated, and more often we’re told to just “deal with it.” Our mission at Clue is to be the first place anyone with a cycle turns to, in order to take control of their health. We are an evidence-based, empathetic companion for all of the changes and choices that are part of the female health experience.
Our app starts with period tracking, as health starts with tuning into the body. We pair this with trustworthy health information and personalised insights to empower our users to understand their health, take action, make lifestyle changes, or talk to a healthcare provider if needed.
I am proud that Clue is, and will remain, an inclusive app. From our language to our content, we’re constantly taking steps to make sure that everyone with a cycle can use Clue and feel empowered and supported to understand their health and wellbeing. We meet people where they are, supporting them in meeting their health goals, whatever they may be.
Image Credit: Jacob Lund/Shutterstock.com
Leading teams across different roles and companies, you’ve emphasized the importance of coaching in leadership. Can you share how you’ve fostered a culture of learning and growth at Clue, and how do you support your team in navigating the fast-paced and often emotionally charged space of female health technology?
At Clue, our values are care, courage, and connection. They describe how we treat our users and how we treat each other. These three “big C’s” acknowledge that sometimes we have to make hard decisions, and that not everyone will be happy with what we choose. But regardless, we will treat every decision with care, face the toughest situations with courage, and connect and rely on each other to do what’s best for our users.
I’m oversimplifying, but coaching is starting from a place of believing in someone’s creativity and resourcefulness, and asking questions or reflecting back observations to help that person live the life, have the career, or navigate the change that they envision.
I believe this applies directly to leadership at Clue. We start from a place of trust; we trust each other as team members, and we earn each other's trust through transparency, fairness, and love. We have collective goals that we aspire to achieve, and we believe in the creativity and resourcefulness of the team to get there.
Just as we look at the health of our users holistically, we look at the wellbeing and growth of our team members through the same lens. Our in-house coaching services provide personalised support for both professional and personal challenges, emphasising the transformative power of open dialogue.
We allocate Professional and Personal Growth Budgets to empower employees in their professional development and self-care journeys. Whether investing in role-related skills or nurturing personal wellbeing through a variety of activities, these resources underscore our commitment to individual growth and fulfilment.
Beyond the app, Clue has the potential to influence policy and societal attitudes towards menstrual and reproductive health. In what ways is Clue working towards advocating for policy changes or greater societal awareness around female health issues like endometriosis?
Clue, along with the Clue community, has a history of being vocal and clear on our commitments. Whether it was our ‘Just Say Period’ campaign from 2017 to destigmatize talking about menstruation or supporting our users to advocate for themselves when visiting their healthcare providers or even just talking to their family, friends, or colleagues about things like perimenopause.
While society has made progress in education and awareness of female health issues, there is still a long way to go. There is undeniably a diagnosis gap, a research gap, and an empathy gap when it comes to discussions around female health issues.
Our endometriosis survey shone a light on this as some users told us that their symptoms were dismissed as a bad period or put down to being psychosomatic, and shockingly some users were told to only worry about it when they were looking to conceive. By highlighting these concerns and using our app to educate and raise awareness, we hope that we can play our role in shifting wider societal attitudes towards female health.
Finally, as someone deeply embedded in the advancement of female health technology, how has your work with Clue influenced your views on healthcare, technology's role in personal health, and the future of women's health advocacy?
Before joining Clue, I knew one experience of the female health journey – mine. I didn’t know whether it was normal. I didn’t know whether I needed to be concerned. I didn’t know what I could do about the things I was experiencing. I didn’t know where to turn, and at times, I would be willing to try anything even if I didn’t know what my options were.
What I have realised through listening to and learning from the Clue user community about their needs, their health goals, and their pain is that I was not alone in feeling… alone. And I was also not alone in feeling that my health was invisible, or at best dismissed.
I have seen in my own journey, and I have heard from our user community that empathetic technology can empower. Tracking can lead to personal insight and ultimately health agency. It can lead to making a new lifestyle choice or advocating for better care from healthcare providers.
Ultimately, data-enabled and science-driven technology can engage people in their health. And it is, in fact, necessary to do so in order to improve healthcare moving forward.
Where can readers find more information?
Clue is the menstrual and reproductive health app that enables profound, science-driven body literacy for women and people with cycles everywhere, by harnessing the power of full cycle intelligence.
Loved by over 10 million monthly active users across 190+ countries, and supporting 20+ languages, the Clue app guides members through each cycle and life stage. From general cycle health education to fertility, pregnancy, perimenopause, and all changes and choices in between – big or small.
The Clue app is free to download and features its distinctive data-driven cycle tracking. With a premium subscription to Clue Plus, members gain access to advanced insights and modes including Clue Conceive, Clue Pregnancy, and Clue Perimenopause. The Clue app is CE-marked as a Class 1 medical device.
As the pioneer of femtech, Clue regularly partners with researchers from top institutions around the world to illuminate the blindspots in female health. Incorporated in the EU, Clue user health data is protected by the world’s strictest data laws (EU GDPR) and Clue’s absolute commitment to stand up for the health data privacy of its users.
For more, visit https://helloclue.com/
About Audrey Tsang
Audrey Tsang is the CEO of Clue, the pioneering menstrual and reproductive health platform with 10 million global users, covering users’ entire reproductive health journey from puberty to menopause.
Audrey joined Clue as the company’s Chief Product Officer in 2018. She was named co-CEO with Carrie Walter in March 2021, and became CEO in August 2023. Since joining the Berlin-based company, she has focused on serving the company’s users with data-driven, science-based information, empowering them to take charge of their menstrual and reproductive health, with a particular focus on Clue’s product strategy and innovation.
Prior to joining Clue, Audrey led product teams at Pinterest, HotelTonight, and Yelp. She is a trained leadership coach and an angel investor.
Audrey holds bachelor’s and master’s degrees in computer science from Stanford University, as well as an MBA from Northwestern University’s Kellogg School of Management.
She is an experienced public speaker, frequently speaking at leading technology and health events, and is regularly quoted in leading media publications.
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