Stockholm, Sweden– Tired of the pill? Natural Cycles is a phone app that algorithmically monitors female fertility. Users get a daily notice whether it’s safe to have unprotected sex or if they need to use birth control.


It is the first app to be officially approved for use as contraception. German testing organization Tüv Süd gave its official seal of approval early this year. This means it could soon be a prescribed treatment alongside condoms and the pill.

The application uses body temperature to measure fertility. After ovulation, increased levels of progesterone make women’s bodies up to 0.45°C warmer. Users input their daily temperature into the app, which compares their readings against those in its dataset.

If the app determines it’s safe to have unprotected sex it will show a green day in its calendar. Days when it’s not safe to have unprotected sex are shown as red– on these days, users need to find an alternative source of contraception, such as condoms, the pill and intrauterine devices.

Natural Cycles conducted two clinical trials, the second of which analyzed the data of more than 4,000 women aged 20-35. Over the course of one year, there were 143 unplanned pregnancies, ten of which occurred on green days. This gives the app a 99.5 percent efficacy rating– the same as the pill.

Natural Cycles co-founder Elina Berglund is a Swedish particle physicist who is working to free women from the side effects of birth control pills.

“I wanted to give my body a break from the pill… but I couldn’t find any good forms of natural birth control, so I wrote an algorithm for myself.” -Elina Berglund, CTO & Co-founder, Natural Cycles

Why This Matters

Applications like Natural Cycles are a great reminder that digital technologies aren’t really about the technology. They are about the human experience– like living a life based on your own ‘natural cycles’ and avoiding the side effects of birth control.

Lita Sands who leads digital transformation at inVentiv Health reflects on the use of digital in healthcare:

“We need to ensure that the wonders of technology don’t distract us from starting with human beings first. If you want to be successful with digital medicine, you need to use empathy, ethnography, and design-based thinking to fully understand the truth of a patient’s experience, and then design around that.” –Lita Sands, Managing Director, Digital Transformation, inVentiv Health

Patient centricity is key and technology for the sake of technology is an innovation killer. To be human-centered in healthcare, we also should not only look to people, but the systems which they and our solutions operate in.

Human-Centered Design Across Systems

The predominate culture of those creating digital technologies has been shaped by the consumer market. These iterative approaches, lean launches and freemium business models have enabled huge innovations and sparked the transformation to a digital-first world.

Digital has long promised to revolutionize healthcare for patients. However, these approaches are counterculture to a heavily regulated healthcare landscape that has long development timelines and need for evidence to prove efficacy.

Healthcare is a complex system. There are countless stakeholders with different incentive structures, rules and specific criteria that need to buy-in before getting a solution in the hands of patients who need it. To truly be human centered, we need to solve the needs of regulators, payors, physicians, patients, family caregivers and the like.

But unlike many other digital solutions trying to disrupt healthcare– Natural Cycles worked the system to get the approvals necessary. This has us asking the questions:

What are the human needs of all the affected stakeholders across the healthcare system?

How can our digital solutions solve those needs?

For digital transformation to take hold in healthcare, we’ll need to leverage human-centered design that incorporates systems-based thinking. Yes– if we stick too closely to tradition we’ll never move the ball forward. But if we don’t uniquely understand and empathize with various stakeholders across healthcare– and design solutions that meet their needs– our innovations won’t stick.

Peter Jones is a design professor who is pushing the idea of Systemic Design– the integration between systems thinking and design thinking methods to solve for ‘wicked problems’.

“By integrating systems thinking and its methods, systemic design brings human-centered design to complex, multi-stakeholder service systems as those found in industrial networks, transportation, medicine and healthcare.” -Peter Jones, Associate Professor of Design, OCAD University

Systemic design helps us think about digital solutions, their impact on patients and their context within the healthcare system. It enables us to understand the natural cycles of behavior, and innovate within those confines.

About the Author:

Zach Friedman