Watches, Rings, and Wristbands: What’s happening in consumer wearables and women’s health
Major tech companies and FemTech startups vary greatly in how they show up for women in their consumer products.
In June of 2019 Apple announced a cycle tracking feature as their first foray into women’s health. I didn’t hide my disappointment when I realized that one of the most highly resourced tech companies in the world went with the lowest hanging fruit in the world of FemTech. Digital calendaring apps to track menstrual cycles were some of the first women’s health apps to hit the market after Apple released the iPhone and App Store in 2007. More than a decade later, Apple added menstrual cycle tracking as a feature within their Health App. They later partnered with some top tier research teams to launch the Apple Women’s Health Study, “to help advance the conversation and science around menstrual cycles.” Menstrual cycles are certainly one of the most obvious biological processes that separate XX from XY humans. However, a common refrain among innovators in the world of FemTech is that a focus solely on female fertility processes is narrow-minded.
All aspects of women’s health are underfunded and understudied. When we look at cardiovascular disease, the leading cause of death in both men and women, only one-third of research participants are female, and only 4.5% of the NIH coronary artery disease budget went to women-focused research. Only 11% of the 2020 National Institutes of Health budget supported women’s health research of any kind, despite women being 51% of the world population.
In our capitalist economy, I believe that corporations can both do good and do well. They can advance our understanding of women’s health with passive data collection from common consumer wearables, and still make a hell of a lot of money along the way. Women control 80% of the household income, and companies ignoring their role in keeping the dollars moving is to their detriment as a business.
The brief case study of Apple’s minimal contribution to women’s health is not unique. (I would gladly bear the public shame if someone wants to let me in on secret plans that Apple has to focus more on women’s health and prove me wrong.) I’ve spent the last month combing through commonly available watches, rings, and wristbands to understand a few things:
What devices are out there? Where are my blind spots?
What data do they collect? (This was surprisingly difficult to find sometimes.)
What, if anything, makes them oriented towards women’s health?
How can we advance our understanding of female biological processes, health, and disease progression with passive biometric data collection? (Spoiler– that answer will be covered in my next article.)
I was able to answer the first three questions and am sharing my findings below in a very organized list as is my custom for product roundups. From a macro-level perspective, most companies that do anything in the space are still dancing around reproductive health (period dates, ovulation prediction, and fertile windows.) However, the approach varies by company, and I’ve noticed that the marketing varies significantly as well. As a consumer as well as a researcher, those differences in colors, language, and imagery surrounding the product were obvious when companies targeted women.
Gathering the specific data points and how they are currently crunched by each company’s algorithms was an essential first step in answering my bigger question: How can we advance our understanding of female biological processes, health, and disease progression with passive biometric data collection? I hope to speak with people working for tech companies as well as biomedical science researchers and physicians to explore our near future possibilities for understanding female bodies with wearables.
WATCHES+
Company: Apple
Product: Apple Watch Series 9
What they Measure:
Cardiac Health: ECG app, heart rate, irregular rhythm notifications
Fitness: Low cardio fitness notifications
Sleep: (duration and quality)
Temperature
Cycle tracking with retrospective ovulation estimates
Crash detection
Fall detection
Cost: Starts at $399
What makes them ‘for women’: Apple has largely focused on menstrual cycle tracking as their primary women’s health offering and with the addition of temperature data, included retrospective ovulation estimates. They are currently running the Apple Women’s Health Study with Harvard T.H. Chan School of Public Health and the National Institute of Environmental Health Sciences (NIEHS) that aims to advance the understanding of menstrual cycles and how they relate to various health conditions such as polycystic ovary syndrome (PCOS), infertility, and menopausal transition.
Company: Fitbit
Product: Fitbit Sense 2
What they Measure:
Cardiac Health: Heart rate, heart rate variability, cardio fitness score (This estimates your fitness level using your VO2 Max – how well your body uses oxygen during exercise), irregular heart rhythm notifications
Fitness: Steps, stairs climbed, active zone minutes
Daily readiness score: proprietary algorithm to see if you are ready for activity or need to recover
SpO2
Temperature
Breathing rate
Menstrual health tracking in app (periods, fertile window, ovulation, menstrual health symptoms)
Sleep (duration and stages)
Stress
Cost: Starts at $199
What makes them ‘for women’: I had to search pretty deeply into Fitbit forums and blog posts from independent users to understand exactly how the menstruation tracking works with the Fitbit product. For the time being, Fitbit only uses calendar entry to predict fertile periods, and does not utilize the collected temperature data in a way that the Ava Bracelet does to identify ovulation and fertile windows. The Fitbit Sense 2 device looks similar to an Apple Watch with slightly more rounded edges on the face. You can also customize the band with options from the Fitbit site and on Amazon. From a metrics point of view, Fitbit collects A LOT of data - they are one of the original wearables – but they have not made a concerted effort to play in the women’s health space with either their data collection or features.
Company: Garmin
Product: Garmin Lily
What they Measure:
Energy Monitoring (algorithm continuously analyzing combinations of heart rate, heart rate variability (HRV) and movement data while you wear your device.
Cardiac health: Heart rate
Stress tracking
Menstrual tracking / women’s health component in app
Hydration tracking
Respiration tracking
Pulse Ox
Sleep monitoring
Fitness tracking: steps, tracking of different types of exercise
Cost: $250
What makes them ‘for women’: The watch boasts a 34 mm watch case and feminine design with jewelry-like details. Garmin actually has a woman-focused wearables section on their website, which highlights all the tracking but also pays homage to the fact that stress affects men differently than women and that women are more likely to have insomnia. I tend to think of Garmin products as best for the athletes among us based upon their marketing and training optimization algorithms.
Company: Samsung
Product: Galaxy Watch 2 Active
What they Measure:
Fitness: tracking of different types of exercise, MapMyRun app already on the device
Cardiac health: Heart rate, single lead ECG, stress
Sleep tracking (duration and stages)
Blood O2
Cost: $229-279
What makes them ‘for women’: The watch has smaller size options for the watch face (40mm) and is pink-washed (literally, with the band choice and rose gold watch face option.) Users can track menstrual cycle within the app. Menstrual tracking can be done manually or via skin temperature.
RINGS
Company: Oura
Product: Oura Ring
What they Measure:
Temperature trends
Cardiac health: Heart rate monitoring, heart rate variability
Activity: Daily activity score, daily readiness score, automatic activity detection
Sleep: Daily sleep score, sleep stages, bedtime guidance (tells you when to start winding down)
Women’s Health: period prediction based upon temperature
Stress: Daytime stress and stress resilience (this are likely calculated with a proprietary algorithm)
SpO2
Early Illness Detection: Notification if temperature trends higher than usual, suggestions for rest and recovery if you may be getting sick.
Cost: $299- $499 based upon finish
What makes them ‘for women’: Oura syncs with the Natural Cycles app to predict fertility based upon temperature changes at ovulation and self-entered period data. They also speak to in-depth cycle insights on the website, but as I haven’t used the ring I can’t say what that is specifically. Oura also mentions a commitment to prioritizing women’s health on their website. So far they have focused on the menstrual tracking work but are investing in research across a women’s lifespan. I’ve been impressed by some preliminary research they have released, such as, What happens to your body during pregnancy? and their how the Oura ring may be able to predict the onset of labor. This is one to watch.
Company: Movano Health
Product: Evie Ring
What they Measure:
Sleep (Sleep duration, sleep quality)
Activity (step count, active minutes, distance traveled, calories burned, workout tracking)
Temperature
Cardiac health: Heart rate, resting heart rate, heart rate variability
SPO2
Respiration Rate
Daily summary: “With Daily Summary, get a holistic look at your day from activity to recovery. Receive insights based on health data and logged metrics, that customize to you over time, helping to connect the dots between aspects of your health. Prioritize the health goals that are most important to you, and easily view your progress and trends.”
Cost: $269.00
What makes them ‘for women’: The ring connects with a phone app where you can track your menstrual cycle, see ovulation prediction, and self-enter mood and symptom tracking. The ring also comes in silver, gold, and rose gold options. This is a new product and I’ve heard mixed reviews from early users related to difficulty in charging. I hope that they can improve the product since the company is unique in their dedication to women’s health and building a product that serves their specific needs.
Bonus Info: Movano states on their website: “Your data is yours. At Movano Health, we believe that data about your body belongs to you and only you. We do not sell data we collect from the Evie Ring, and we don’t use it for advertising purposes.” Excellent.
Ring Conn
Product: Ring Conn
What they Measure:
Cardiac health: Heart rate, heart rate variability
Sp02
Temperature
Activity (steps, calories burned, standing)
Sleep (duration and stages)
Proprietary stress index
Cost: $279, no annual subscription fee
What makes them ‘for women’: There is nothing about this product that makes it seem like women are a target market. There is no fertility or menstrual tracking data available in the app in relation to the temperature collection, nor do I see manual entry of data fields. Additionally the sizing starts at a size 6, which excludes some women’s hands (such as my own) that wear a smaller size.
Company: Femometer
Product: Femometer Smart Ring
What they Measure:
Temperature
Sleep
Menstrual cycle: Ovulation and fertile days
Cost: $149
What makes them ‘for women’: Similar to the Ava bracelet, the primary purpose of the Femometer Smart Ring is to assist with an understanding of fertility and increase the chance of conception. It is also only worn at night. The associated app also provides insights into menstrual cycles, pairing temperature data with user-entered data. Once pregnant, users can convert to pregnancy mode which provides educational content.
Company: Samsung
Product: The Samsung Smart Galaxy Ring was just announced in January 2024, but what it actually does and what it will cost is still unknown at the time of publication.
What they Measure: TBD
Cost: TBD
What makes them ‘for women’: TBD
OTHERS
Company: FemTech Health
Product: Ava Bracelet
What they Measure:
Temperature: Skin temperature
Resting pulse rate
Breathing rate
Sleep (movement and duration)
Cycle tracking: Manual entry
More details on each of the points of measurement here
Cost: Starting at $279
What makes them ‘for women’: Ava Fertility is the first and only FDA-cleared fertility tracking bracelet, designed specifically for biological females with menstrual cycles. Once pregnant, women can continue to use the Ava app to track vitals and read educational content during the course of the pregnancy. The Ava bracelet’s purpose is to shed light around fertility windows and conception, and therefore their insights into the rest of women’s health are slim. The company also states that 20% of every sale goes towards women’s health research and development.
Company: Whoop
Product: Whoop 4.0 band + membership
What they Measure:
Cardiac health: heart rate, heart rate variability
Blood Oxygen levels, Sp02
Temperature
Sleep
Daily log/ user-entered tracking
Whoop then aggregates these data points with proprietary algorithms to distill different scores, including Health Trends, Stress Monitor, Recovery Score, and Strain Score. To learn more about each of these, visit this site.
Cost: Whoop offers a free one month trial, and then you purchase a membership which is inclusive of the device. Memberships start at $239 per year or $399 for two years.
What makes them ‘for women’: The Whoop app includes Menstrual cycle coaching and make suggestions for workouts based upon where a woman is in her menstrual cycle. The app includes a journal feature with toggles for ovulation, trying to conceive, pregnancy, perimenopause, and postmenopause. PMS symptoms can also be logged in the journal, and pregnant users can find others within similar due dates within the community. Whoop also states on it’s website that it is dedicated to advancing the field of women’s performance science.
Company: BellaBeat
Product: Ivy Health Tracker
What they Measure:
Cardiac health: heart rate,
Fitness: Steps, active minutes, calorie burn
Women’s health:
Sleep: duration and quality
Respiratory rate
Cost: $249
What makes them ‘for women’: The Ivy Health Tracker is designed to look like a piece of jewelry without a display and can be worn as a bracelet or a necklace. The company offers cycle tracking in the My Diary app, and says that their algorithms are “optimized for women.’ Users can pay $9.99 per month for access to BellaBeat coach which includes workouts, nutrition, mindfulness techniques, and menstrual cycle support based upon individual goals.
Product: Leaf
The Leaf is less robust than the Ivy Health Tracker and has been on the market for a few years already. There isn’t as much information about what it offers for data tracking, which makes me think it may be phased out in the near future. The marketing and content for the Ivy Health Tracker is much more robust. The Leaf Tracker does sync with the Bella Beat App and users can also access BellaBeat coach.
What they Measure:
Activity
Tracks sleep
Menstrual cycle (no specific data mentioned)
Can be worn as a necklace, bracelet or clip
Cost: $99
